Occupational hypersensitivity pneumonitis: an EAACI position paper
Open Access
- 23 February 2016
- Vol. 71 (6), 765-779
- https://doi.org/10.1111/all.12866
Abstract
The aim of this document was to provide a critical review of the current knowledge on hypersensitivity pneumonitis caused by the occupational environment and to propose practical guidance for the diagnosis and management of this condition. Occupational hypersensitivity pneumonitis (OHP) is an immunologic lung disease resulting from lymphocytic and frequently granulomatous inflammation of the peripheral airways, alveoli, and surrounding interstitial tissue which develops as the result of a non‐IgE‐mediated allergic reaction to a variety of organic materials or low molecular weight agents that are present in the workplace. The offending agents can be classified into six broad categories that include bacteria, fungi, animal proteins, plant proteins, low molecular weight chemicals, and metals. The diagnosis of OHP requires a multidisciplinary approach and relies on a combination of diagnostic tests to ascertain the work relatedness of the disease. Both the clinical and the occupational history are keys to the diagnosis and often will lead to the initial suspicion. Diagnostic criteria adapted to OHP are proposed. The cornerstone of treatment is early removal from exposure to the eliciting antigen, although the disease may show an adverse outcome even after avoidance of exposure to the causal agent.This publication has 100 references indexed in Scilit:
- Systematic Review of Respiratory Outbreaks Associated with Exposure to Water-Based Metalworking FluidsAnnals of Work Exposures and Health, 2012
- An Official ATS/ERS/JRS/ALAT Statement: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and ManagementAmerican Journal of Respiratory and Critical Care Medicine, 2011
- Bird Fancier's LungMedicine, 2008
- Respiratory Symptoms, Sensitization, and Exposure–Response Relationships in Spray Painters Exposed to IsocyanatesAmerican Journal of Respiratory and Critical Care Medicine, 2007
- Pesticides and other agricultural factors associated with self-reported farmer's lung among farm residents in the Agricultural Health StudyOccupational and Environmental Medicine, 2007
- Extrinsic allergic alveolitis: incidence and mortality in the general populationQJM: An International Journal of Medicine, 2007
- Clinical features of recurrent and insidious chronic bird fancier's lungAnnals of Allergy, Asthma & Immunology, 2003
- High-resolution computed tomographic characteristics in acute farmer's lung and in its follow-upEuropean Respiratory Journal, 2000
- Hypersensitivity pneumonitis (extrinsic allergic alveolitis) induced by isocyanatesJournal of Allergy and Clinical Immunology, 1995
- Incidence of Organic Dust Toxic Syndrome and Allergic Alveolitis in Swedish FarmersInternational Archives of Allergy and Immunology, 1988