The epidemiology of occupational interstitial lung diseases in Russia

Abstract

Introduction. Occupational interstitial lung diseases (ILD) include exogenous allergic alveolitis (EAA), exogenous toxic alveolitis (ETA), pneumoconiosis. The scientists have established the fact of exposure to external factors in 35% of patients with ILD. We have confirmed the association of the disease with the profession in 10% of cases. The study aims to assess the prevalence and clarify the reasons for the unsatisfactory diagnosis of occupational diseases (ILD) in Russia. Materials and methods. The researchers have conducted the analysis of officially registered occupational morbidity in the Russian Federation and the North-Western Federal District (NWFD) for 2018-2020 and the study of the effectiveness of the examination of the connection of the disease with the profession in case of suspected occupational disease in 121 patients with an established diagnosis of EAA. Results. We have established that among the occupational diseases ILD first identified in the Russian Federation in 2020, pneumoconiosis occupied the leading place - 92.7%, of which a third of cases (34.6%) were silicosis. Coniotuberculosis was in 0.8% of cases, EAA - in 6% of cases, while in 9 patients (4%) the diagnosis was as "EAA", and in 5 patients (2%) - as "Hypersensitive pneumonitis". Toxic pneumosclerosis was 0.4%. In the NWFD, experts have registered all occupational diseases of the respiratory system: ILD - 18.5% (2018), 8.6% (2019), in 20.4% of cases (2020), of which pneumoconiosis took the leading place. There were only 3 cases of exogenous alveolitis. The researchers have analyzed the reasons of insufficient registration of professional exogenous alveolites. The low detectability of professional exogenous alveolitis is due to both the insufficient commitment of patients to the establishment of an occupational disease, and the poor quality of periodic medical examinations of employees due to the concealment of complaints by patients, the use of low-informative fluorography, incorrect interpretation of the results of the examination. Conclusion. Thus, among occupational ILDs, pneumoconiosis was on the leading position. Incomplete registration of cases of occupational exogenous alveolitis is due to insufficient diagnosis, terminological inconsistency in the designation of EAA and ETA, inadequate coding of ETA from exposure of industrial chemical factors. Ethics. This study did not require the conclusion of the Ethics committee.