title: Association between occupational dust exposure and prognosis of idiopathic pulmonary fibrosis: a Korean national survey.
abstract: BACKGROUND
  Previous studies have investigated the relationship between occupational and environmental agents and idiopathic pulmonary fibrosis (IPF). However, there have been few studies regarding the prognosis of patients with IPF according to patient occupation.
  
  
  METHODS
  We investigated whether occupational dust exposure was associated with clinically decreased lung function and poor prognosis. The Korean Interstitial Lung Disease Research Group conducted a national survey to evaluate the clinical, physiologic, radiologic, and survival characteristics of patients with IPF. A total of 1,311 patients with IPF were stratified into five groups according to their occupation: (1) unemployed or homemakers (n = 628); (2) farmers, fishers, or ranchers (n = 230); (3) sales or service personnel (n = 131); (4) clerical or professional personnel (n = 151); and (5) specific dust-exposed workers (n = 171).
  
  
  RESULTS
  The mean age of subjects at diagnosis, was 67.5 ± 9.7 years. Current smokers were 336 patients, 435 were exsmokers, and 456 were never smokers. Dust-exposed workers showed early onset of IPF (61.3 ± 8.6 years; P < .001) and a longer duration of symptoms at diagnosis (17.0 ± 28.2 months; P = .004). Aging (P = .001; hazard ratio [HR], 1.034; 95% CI, 1.014-1.054), FVC % predicted at diagnosis (P = .004; HR, 0.984; 95% CI, 0.974-0.995), and dust-exposure occupation (P = .033; HR, 1.813; 95% CI, 1.049-3.133) were associated with mortality.
  
  
  CONCLUSIONS
  These findings indicate that occupational dust may be an aggravating factor associated with a poor prognosis in IPF.
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Yonsei University, College of Medicine, Yonsei University Health Service, Seoul.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul.
authors.forename: Dong Soon
authors.initials: DS
authors.lastname: Kim
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul.
authors.forename: Young Whan
authors.initials: YW
authors.lastname: Kim
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul.
authors.forename: Man Pyo
authors.initials: MP
authors.lastname: Chung
authors.affiliation: Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul.
authors.forename: Soo Taek
authors.initials: ST
authors.lastname: Uh
authors.affiliation: Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon.
authors.forename: Choon Sik
authors.initials: CS
authors.lastname: Park
authors.affiliation: Division of Pulmonology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon.
authors.forename: Sung Hwan
authors.initials: SH
authors.lastname: Jeong
authors.affiliation: Division of Pulmonary, Allergy & Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul.
authors.forename: Yong Bum
authors.initials: YB
authors.lastname: Park
authors.affiliation: Pulmonary Division, Department of Internal Medicine, Inha University Hospital, Incheon.
authors.forename: Hong Lyeol
authors.initials: HL
authors.lastname: Lee
authors.affiliation: Pulmonary Division, Department of Internal Medicine, St. Mary's Hospital, Catholic University College of Medicine, Seoul.
authors.forename: Jeong Sup
authors.initials: JS
authors.lastname: Song
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Chung Ang University College of Medicine, Seoul.
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Shin
authors.affiliation: Division of Pulmonary Medicine, National Medical Center, Seoul.
authors.forename: Nam Soo
authors.initials: NS
authors.lastname: Yoo
authors.affiliation: Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul.
authors.forename: Eun Joo
authors.initials: EJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, Seoul.
authors.forename: Jin Hwa
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Division of Pulmonary Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan.
authors.forename: Yangin
authors.initials: Y
authors.lastname: Jegal
authors.affiliation: Division of Critical Care and Pulmonary Medicine, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan.
authors.forename: Hyun Kyung
authors.initials: HK
authors.lastname: Lee
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea. Electronic address: pms70@yuhs.ac.
authors.forename: Moo Suk
authors.initials: MS
authors.lastname: Park
mesh_terms: D000368:Aged; D032268:Ailanthus; D004391:Dust; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D008175:Lung Neoplasms / Q000150:complications / Q000401:mortality; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure; D011379:Prognosis; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000150:complications / Q000401:mortality; D016019:Survival Analysis
chemical_list: D004391:Dust