Annals of Occupational Hygiene Advance Access originally published online on January 7, 2005
Annals of Occupational Hygiene 2005 49(3):259-265; doi:10.1093/annhyg/meh090
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© 2005 British Occupational Hygiene Society Published by Oxford University Press;
Original Article |
Occupational and Environmental Factors and Idiopathic Pulmonary Fibrosis in Japan
1 Department of Public Health, Fukuoka University School of Medicine, Fukuoka, Japan; 2 National Institute of Health and Nutrition, Tokyo, Japan; 3 Department of Technology Assessment and Biostatistics, National Institute of Public Health, Wako, Japan; 4 Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan; 5 Fourth Department of Internal Medicine, Nippon Medical School, Tokyo, Japan; 6 Department of Hygiene, Hyogo College of Medicine, Nishinomiya, Japan; 7 Department of Public Health, Aichi Prefectural College of Nursing and Health, Nagoya, Japan; 8 Department of Health for Senior Citizens, Hokkaido University Graduate School of Medicine, Sapporo, Japan; 9 Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan; 10 Department of Epidemiology, Juntendo University School of Medicine, Tokyo, Japan
* Author to whom correspondence should be addressed. Tel: +81-82-801-1011 (ext. 3311); fax: +81-92-863-8892; e-mail: miyake-y{at}cis.fukuoka-u.ac.jp
ABSTRACT
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease of unknown etiology. Environmental factors, especially occupational agents, may be of great importance in the manifestation of IPF. We examined the relationship between occupational and environmental factors and IPF in Japan. A multicenter hospital-based case–control study was performed in 2001. Included were 102 cases aged 40 years or over who were within 2 years of having been diagnosed in accordance with the most recent criteria. Controls, aged 40 years or over, were 55 hospitalized patients diagnosed as having acute bacterial pneumonia and four outpatients with common colds. Data on occupational and environmental factors were obtained from a questionnaire. Multiple logistic regression analysis was used to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of IPF for single factors with adjustment for age, sex and region. Compared with controls, cases were more likely to have been managers, officials or production workers and less likely to have been protective service or materials handling workers. Clerical and related work was significantly related to a decreased risk of IPF after further adjustment for pack-years of smoking (OR = 0.42; 95% CI = 0.18–0.95). Exposure to metal dust was significantly associated with an increased risk of IPF (OR = 9.55; 95% CI = 1.68–181.12). From 20.0 to 39.9 pack-years of smoking was significantly associated with an increased risk of IPF (OR = 3.23; 95% CI = 1.01–10.84). Our results appear to confirm data from previous epidemiologic studies. Metal dust exposure may be a particularly important risk factor for IPF.
Keywords: case–control studies • metal dust • occupations • pulmonary fibrosis • smoking
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