Farmers lung in a cohort with chronic Hypersensitivity Pneumonitis in Southern Italy

<bold>Background:</bold> Chronic Hypersensitivity Pneumonitis is an interstitial lung disease, caused by inhalation of organic dust and low molecular weight chemicals, resulting in sensitization in predisposed individuals. <bold>Aim:</bold> To address the specific work environment is associated with the development of chronic Hypersensitivity Pneumonitis. <bold>Methods:</bold> From a cohort of 217 patients with ILDs, 57 patients (20 women, 35.1%, mean age 71.8 ± 8.7 years, range age 49-87) showed the features of progressive fibrosis Hypersensitivity Pneumonitis, referred to Rare Diseases clinic at the “V. Monaldi” Hospital of Naples. Depending on professional anamnesis, patients were divided into groups based on work exposure to dust or low molecular weight chemical agents (exposed group and non-exposed group) and work environment (farmers, 22.8%; automotive sector, 10.5%; handicraft, 17.5%; factory work, 10.5%, mason, 3.5%; other, 14%; shopkeeper, 7%; physician, 5.3%; housewife, 5.3%). The average years of exposure is 51.8 ± 8.7 years. The association between Hypersensitivity Pneumonitis and work environment was studied using chi square test. <bold>Results:</bold> HP patients have statistically significantly more frequent professional anamnesis of exposure to dust and low molecular weight chemicals (p=0.029). The frequency of work exposure is statistically significantly different in patients with HP (p=0.025): in particular, prevalence for farmer and handcraft is greater. <bold>Conclusions:</bold> Although this study is limited by the small number of patients, the work environment is an established risk factor for HP and there is a higher prevalence among farmers and handcrafts, likely associated to a particular genetic background.