Open AccessOccupational causes of hypersensitivity pneumonitis: a systematic review and compendium
Author(s) -
Ngamjit Kongsupon,
Gareth Walters,
Steven Sadhra
Publication year - 2021
Publication title -
occupational medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.509
H-Index - 85
eISSN - 1471-8405
pISSN - 0962-7480
DOI - 10.1093/occmed/kqab082
Subject(s) - hypersensitivity pneumonitis , medicine , compendium , occupational asthma , occupational exposure , environmental health , medline , occupational medicine , exposure assessment , systematic review , occupational disease , occupational hygiene , occupational safety and health , pathology , biology , biochemistry , archaeology , lung , history
Background Hypersensitivity pneumonitis (HP) is caused by a variety of antigens and low-molecular-weight chemicals, often through occupational exposure. Making a diagnosis of HP and identifying a cause are challenging. Cryptogenic cases are frequently reported, and missing or incomplete exposure histories can cause misclassification. Aims To provide an evidence-based compendium of sources of exposure and causes of HP for the clinician, through systematic review of medical literature. Methods Articles related to HP causative agents and occupational exposure were searched from the databases OVID Medline (1946 to October 2020) and EMBASE (1974 to October 2020). Abstracts and full texts of articles were screened by two reviewers. Data on causative antigens, occupational source of exposure and any associated eponymous name were extracted and grouped according to source of exposure. Results A total of 1790 articles were identified, from which 305 articles met the inclusion criteria. An additional 22 articles were identified from citation lists of the selected review articles. Sources of exposure identified for HP were sorted into 14 categories of work (agricultural, plant matter processing, wood, animal-related, foodstuff, food processing, metal processing, polymers, other manufacturing, chemicals, aerosolized water, service, waste and sewage and wind instruments). Conclusions This work is a comprehensive list of occupational causative agents and exposures causing HP. Cases are grouped by source of exposure, allowing an immediately accessible compendium of causes for use during occupational exposure assessment, which could also form the basis for a clinical questionnaire.