Employment, treatment and lung function outcomes at 1-year following diagnosis of occupational hypersensitivity pneumonitis

Introduction: We have described a series of 50 consecutive patients diagnosed with occupational hypersensitivity pneumonitis (OHP) at our occupational lung disease unit, through a variety of exposures [Respir Med 2019;155:19-25]. These are predominantly males with acute/sub-acute symptoms, normal lung function, and less fibrosis than those diagnosed with cryptogenic- or non-OHP. Long term employment outcomes from occupational HP are unknown. Methods: We aimed to describe changes in lung function, treatment and employment status at 1-year following diagnosis, in these patients. The following additional data at diagnosis and 1 year could be found for 38 patients, by searching electronic medical records: steroids/immunosuppression, spirometry, gas transfer, and employment status. Categorical data was displayed with percentages, and hypothesis testing undertaken by Chi-squared testing. Results: Median age=48 (IQR=42-54), no. males=33 (87%), current smokers=9 (25%), airway disease=9 (24%), median time symptoms to diagnosis=18 months (IQR=9-27). Causes were: MWF=30 (79%), moulds=3 (8%), avian protein=2 (5%), others=3 (8%). Conclusion: Lung function and treatment are unchanged at 1-year from diagnosis. Fewer patients remain employed at 1-year; of those who are, the majority are relocated within their employer or move to a different employer; 22% become unemployed 1-year after diagnosis.