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Home environment exposure assessment in hypersensitivity pneumonitis

Jos M. Rooijackers, Vanessa Zaat, Marcel Veltkamp, Martin Meijer, Jos Houbraken, Emeline Scherer, Gabriel Reboux, Jan Grutters
European Respiratory Journal 2020 56: 795; DOI: 10.1183/13993003.congress-2020.795
Jos M. Rooijackers
1Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, Netherlands
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  • For correspondence: j.rooijackers@nkal.nl
Vanessa Zaat
2Netherlands Expertise Centre for Occupational Respiratory Disorders (NECORD), Utrecht, Netherlands
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Marcel Veltkamp
3Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St. Antonius Hospital, Nieuwegein, Netherlands
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Martin Meijer
4Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands
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Jos Houbraken
4Westerdijk Fungal Biodiversity Institute, Utrecht, Netherlands
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Emeline Scherer
5Besançon University Hospital, department of Mycology, Besançon, France
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Gabriel Reboux
5Besançon University Hospital, department of Mycology, Besançon, France
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Jan Grutters
3Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St. Antonius Hospital, Nieuwegein, Netherlands
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Abstract

Objective: To identify the causal agent in hypersensitivity pneumonitis.

Method: Between 2015 and 2020 an occupational hygienist performed an exposure assessment in the home environment of patients with hypersensitivity pneumonitis (HP), in whom common causes of HP were excluded. If indicated, work place exposure was assessed. Indoor and outdoor air samples were analysed for fungi. In the case of qualitative or quantitative abnormal patterns in the analysed samples indicating the presence of an etiologic agent, serology (double diffusion/Ouchterlony and electrosyneresis on cellulose acetate) was performed for general panels and specific fungi.

Results: Assessment was performed in 41 patients (23-73 yrs). In 8 (20%) a source and causal agent was identified in the home environment, in two cases results were controversial. Main sources were carpets, mouldy bathrooms, poorly maintained dwellings and a car air conditioning. Among causal agents were Aspergillus spp., Penicillium sp., Wallemia sebi, Botrytis cinerea, Trichoderma pseudokoningii, Cephalotrichum sp., Thermoactinomyces vulgaris and goose feathers. Additional exposure assessment in the work place was performed in 8 patients, which revealed a causal agent in another 3 cases and one controversial finding. Sampling repeated in 2 cases after removal of the source showed that the causal agent was no longer present.

Conclusion: A causal agent was identified in at least 25% of patients with HP. Standard protocols for indoor air sampling and individual tailored serology may contribute to the diagnosis of HP and intervention (Reboux G, et al. Indoor Air 2019; 29:5-16).

This study is part of ZonMw project Topzorg, PRJ140088

  • Diagnosis
  • Allergy
  • Environment

Footnotes

Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 795.

This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2020
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Home environment exposure assessment in hypersensitivity pneumonitis
Jos M. Rooijackers, Vanessa Zaat, Marcel Veltkamp, Martin Meijer, Jos Houbraken, Emeline Scherer, Gabriel Reboux, Jan Grutters
European Respiratory Journal Sep 2020, 56 (suppl 64) 795; DOI: 10.1183/13993003.congress-2020.795

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Home environment exposure assessment in hypersensitivity pneumonitis
Jos M. Rooijackers, Vanessa Zaat, Marcel Veltkamp, Martin Meijer, Jos Houbraken, Emeline Scherer, Gabriel Reboux, Jan Grutters
European Respiratory Journal Sep 2020, 56 (suppl 64) 795; DOI: 10.1183/13993003.congress-2020.795
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