Proportion of occupational progressive fibrosing interstitial lung disease in the tertiary hospitals of Thailand

Abstract

Idiopathic pulmonary fibrosis (IPF)-the prototypical progressive fibrosing interstitial lung diseases (PF-ILDs)-is associated with occupational exposure. Other unidentified PF-ILDs may also be work-related. This study aimed to evaluate the magnitude of occupational related causes in unknown aetiology PF-ILDs. We conducted a descriptive study with a sample of 112 patients in two tertiary hospitals in Khon Kaen, Thailand, between 2016 and 2020. Descriptive statistics were used to analyse the findings. The response rate was 26.8% (30/112). Demographic data and clinical information were reviewed from medical records. Telephone interviews were used to explore occupational histories. A multi-disciplinary team (MDT) was held to reach a consensus on the final diagnosis of 8 participants who had significant exposure per their respective interview. The result demonstrated that 16.7% (5/30) of respondents were possible occupational related PF-ILDs and the majority (3/5) were due to metal dust exposure. The result is inconsistent with the occupational burden related to the IPF but resembles the proportion of occupational ILDs in USA and Europe. Moreover, we found that only 23.7% (7/30) had occupational histories taken by their treating physician. Therefore, a multi-disciplinary approach with an occupational physician in the team was used to precisely diagnose occupational related unknown ILDs.