PT  - JOURNAL ARTICLE
AU  - Michael J Abramson
AU  - Tsitsi Murambadoro
AU  - Sheikh M Alif
AU  - Geza P Benke
AU  - Shyamali C Dharmage
AU  - Ian Glaspole
AU  - Peter Hopkins
AU  - Ryan F Hoy
AU  - Sonja Klebe
AU  - Yuben Moodley
AU  - Shuli Rawson
AU  - Paul N Reynolds
AU  - Rory Wolfe
AU  - Tamera J Corte
AU  - E Haydn Walters
ED  - ,
TI  - Occupational and environmental risk factors for idiopathic pulmonary fibrosis in Australia: case–control study
AID  - 10.1136/thoraxjnl-2019-214478
DP  - 2020 Oct 01
TA  - Thorax
PG  - 864--869
VI  - 75
IP  - 10
4099  - http://thorax.bmj.com/content/75/10/864.short
4100  - http://thorax.bmj.com/content/75/10/864.full
SO  - Thorax2020 Oct 01; 75
AB  - Introduction Idiopathic pulmonary fibrosis (IPF) is a lung disease of unknown cause characterised by progressive scarring, with limited effective treatment and a median survival of only 2–3 years. Our aim was to identify potential occupational and environmental exposures associated with IPF in Australia.Methods Cases were recruited by the Australian IPF registry. Population-based controls were recruited by random digit dialling, frequency matched on age, sex and state. Participants completed a questionnaire on demographics, smoking, family history, environmental and occupational exposures. Occupational exposure assessment was undertaken with the Finnish Job Exposure Matrix and Australian asbestos JEM. Multivariable logistic regression was used to describe associations with IPF as ORs and 95% CIs, adjusted for age, sex, state and smoking.Results We recruited 503 cases (mean±SD age 71±9 years, 69% male) and 902 controls (71±8 years, 69% male). Ever smoking tobacco was associated with increased risk of IPF: OR 2.20 (95% CI 1.74 to 2.79), but ever using marijuana with reduced risk after adjusting for tobacco: 0.51 (0.33 to 0.78). A family history of pulmonary fibrosis was associated with 12.6-fold (6.52 to 24.2) increased risk of IPF. Occupational exposures to secondhand smoke (OR 2.1; 1.2 to 3.7), respirable dust (OR 1.38; 1.04 to 1.82) and asbestos (OR 1.57; 1.15 to 2.15) were independently associated with increased risk of IPF. However occupational exposures to other specific organic, mineral or metal dusts were not associated with IPF.Conclusion The burden of IPF could be reduced by intensified tobacco control, occupational dust control measures and elimination of asbestos at work.