Exposures and Idiopathic Lung Disease

Varsha Taskar; David Coultas

doi:10.1055/s-0028-1101277

Seminars in Respiratory and Critical Care Medicine, Table of Contents

Semin Respir Crit Care Med 2008; 29(6): 670-679
DOI: 10.1055/s-0028-1101277

Exposures and Idiopathic Lung Disease

Varsha Taskar¹ , David Coultas¹

¹Department of Medicine, The University of Texas Health Science Center at Tyler, Tyler, Texas

Abstract

ABSTRACT

Of the idiopathic lung diseases, idiopathic pulmonary fibrosis (IPF) and sarcoidosis have been the focus of a growing number of epidemiological investigations on the risk of environmental and occupational exposures. To date, the consistency of epidemiological evidence is suggestive of a causal relationship between several environmental exposures and IPF, with the strongest evidence for cigarette smoking and metal dust. Current knowledge about pathogenesis provides further support for a causal link. However, scant epidemiological evidence for dose–response and temporality weaken the case for making causal inferences. In contrast to IPF, the quantity of epidemiological evidence for environmental exposures and sarcoidosis is smaller. Two studies provide consistent evidence for exposures to agricultural dust and musty odor/mold/mildew, and studies among military personnel and firefighters suggest mixed dust and fume exposures as risk factors for sarcoidosis. Although studies of the pathogenesis of sarcoidosis also provide evidence supporting environmental causation, more epidemiological studies are needed to establish consistency of associations, dose–response, and temporality. Future investigations, of gene–environment interaction offer the potential for strengthening the evidence of causation between several environmental and occupational exposures and idiopathic lung diseases.

KEYWORDS

Idiopathic pulmonary fibrosis - sarcoidosis - exposures - epidemiology - causation

Full Text

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David CoultasM.D.

Department of Medicine, The University of Texas Health Science Center at Tyler

11937 US Hwy. 271, Tyler, TX 75708

Email: david.coultas@uthct.edu