Clinical significance of cigarette smoking and dust exposure in pulmonary alveolar proteinosis: a Korean national survey
Abstract Background This study aimed to investigate clinical characteristics of Korean PAP patients and to examine the potential risk factors of PAP. Methods We retrospectively reviewed medical records of 78 Korean PAP patients diagnosed between 1993 and 2014. Patients were classified into two group...
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| Language: | English |
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BMC
2017-11-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12890-017-0493-4 |
| _version_ | 1811337174818226176 |
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| author | Ji An Hwang Joo Han Song Jung Hoon Kim Man Pyo Chung Dong Soon Kim Jin Woo Song Young Whan Kim Sun Mi Choi Seung Ick Cha Soo Taek Uh Choon-Sik Park Sung Hwan Jeong Yong Bum Park Hong Lyeol Lee Jong Wook Shin Eun Joo Lee Yangjin Jegal Hyun Kyung Lee Jong Sun Park Moo Suk Park |
| author_facet | Ji An Hwang Joo Han Song Jung Hoon Kim Man Pyo Chung Dong Soon Kim Jin Woo Song Young Whan Kim Sun Mi Choi Seung Ick Cha Soo Taek Uh Choon-Sik Park Sung Hwan Jeong Yong Bum Park Hong Lyeol Lee Jong Wook Shin Eun Joo Lee Yangjin Jegal Hyun Kyung Lee Jong Sun Park Moo Suk Park |
| author_sort | Ji An Hwang |
| collection | DOAJ |
| description | Abstract Background This study aimed to investigate clinical characteristics of Korean PAP patients and to examine the potential risk factors of PAP. Methods We retrospectively reviewed medical records of 78 Korean PAP patients diagnosed between 1993 and 2014. Patients were classified into two groups according to the presence/absence of treatment (lavage). Clinical and laboratory features were compared between the two groups. Results Of the total 78 PAP patients, 60% were male and median age at diagnosis was 47.5 years. Fifty three percent were ever smokers (median 22 pack-years) and 48% had a history of dust exposure (metal 26.5%, stone or sand 20.6%, chemical or paint 17.7%, farming dust 14.7%, diesel 14.7%, textile 2.9%, and wood 2.9%). A history of cigarette smoking or dust exposure was present in 70.5% of the total PAP patients, with 23% having both of them. Patients who underwent lavage (n = 38) presented symptoms more frequently (38/38 [100%] vs. 24/40 [60%], P < 0.001) and had significantly lower PaO2 and DLCO with higher D(A-a)O2 at the onset of disease than those without lavage (n = 40) (P = 0.006, P < 0.001, and P = 0.036, respectively). Correspondingly, the distribution of disease severity score (DSS) differed significantly between the two groups (P = 0.001). Based on these, when the total patients were categorized according to DSS (low DSS [DSS 1–2] vs. high DSS [DSS 3–5]), smoking status differed significantly between the two groups with the proportion of current smokers significantly higher in the high DSS group (11/22 [50%] vs. 7/39 [17.9%], P = 0.008). Furthermore, current smokers had meaningfully higher DSS and serum CEA levels than non-current smokers (P = 0.011 and P = 0.031), whereas no difference was found between smokers and non-smokers. Regarding type of exposed dust, farming dust was significantly associated with more severe form of PAP (P = 0.004). Conclusion A considerable proportion of PAP patients had a history of cigarette smoking and/or dust exposure, suggestive of their possible roles in the development of PAP. Active cigarette smoking at the onset of PAP is associated with the severity of PAP. |
| first_indexed | 2024-04-13T17:51:10Z |
| format | Article |
| id | doaj.art-048ed6816ba94cd9b17659e0391063a1 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-04-13T17:51:10Z |
| publishDate | 2017-11-01 |
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| series | BMC Pulmonary Medicine |
| spelling | doaj.art-048ed6816ba94cd9b17659e0391063a12022-12-22T02:36:41ZengBMCBMC Pulmonary Medicine1471-24662017-11-011711910.1186/s12890-017-0493-4Clinical significance of cigarette smoking and dust exposure in pulmonary alveolar proteinosis: a Korean national surveyJi An Hwang0Joo Han Song1Jung Hoon Kim2Man Pyo Chung3Dong Soon Kim4Jin Woo Song5Young Whan Kim6Sun Mi Choi7Seung Ick Cha8Soo Taek Uh9Choon-Sik Park10Sung Hwan Jeong11Yong Bum Park12Hong Lyeol Lee13Jong Wook Shin14Eun Joo Lee15Yangjin Jegal16Hyun Kyung Lee17Jong Sun Park18Moo Suk Park19Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical CenterDivision of Pulmonology, Department of Internal Medicine, Institute of Chest Diseases, Severance Hospital, Yonsei University, College of MedicineDivision of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDivision of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical CenterDivision of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical CenterDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kyungpook National University HospitalDivision of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Seoul HospitalDivision of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon HospitalDivision of Pulmonology, Department of Internal Medicine, Gachon University Gil Medical CenterDivision of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart HospitalPulmonary Division, Department of Internal Medicine, Inha University HospitalDivision of Pulmonary Medicine, Department of Internal Medicine, Chung Ang University College of MedicineDivision of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of MedicineDivision of Pulmonary Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of MedicineDivision of Critical Care and Pulmonary Medicine, Department of Internal Medicine, Inje University Busan Paik HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang HospitalDivision of Pulmonology, Department of Internal Medicine, Institute of Chest Diseases, Severance Hospital, Yonsei University, College of MedicineAbstract Background This study aimed to investigate clinical characteristics of Korean PAP patients and to examine the potential risk factors of PAP. Methods We retrospectively reviewed medical records of 78 Korean PAP patients diagnosed between 1993 and 2014. Patients were classified into two groups according to the presence/absence of treatment (lavage). Clinical and laboratory features were compared between the two groups. Results Of the total 78 PAP patients, 60% were male and median age at diagnosis was 47.5 years. Fifty three percent were ever smokers (median 22 pack-years) and 48% had a history of dust exposure (metal 26.5%, stone or sand 20.6%, chemical or paint 17.7%, farming dust 14.7%, diesel 14.7%, textile 2.9%, and wood 2.9%). A history of cigarette smoking or dust exposure was present in 70.5% of the total PAP patients, with 23% having both of them. Patients who underwent lavage (n = 38) presented symptoms more frequently (38/38 [100%] vs. 24/40 [60%], P < 0.001) and had significantly lower PaO2 and DLCO with higher D(A-a)O2 at the onset of disease than those without lavage (n = 40) (P = 0.006, P < 0.001, and P = 0.036, respectively). Correspondingly, the distribution of disease severity score (DSS) differed significantly between the two groups (P = 0.001). Based on these, when the total patients were categorized according to DSS (low DSS [DSS 1–2] vs. high DSS [DSS 3–5]), smoking status differed significantly between the two groups with the proportion of current smokers significantly higher in the high DSS group (11/22 [50%] vs. 7/39 [17.9%], P = 0.008). Furthermore, current smokers had meaningfully higher DSS and serum CEA levels than non-current smokers (P = 0.011 and P = 0.031), whereas no difference was found between smokers and non-smokers. Regarding type of exposed dust, farming dust was significantly associated with more severe form of PAP (P = 0.004). Conclusion A considerable proportion of PAP patients had a history of cigarette smoking and/or dust exposure, suggestive of their possible roles in the development of PAP. Active cigarette smoking at the onset of PAP is associated with the severity of PAP.http://link.springer.com/article/10.1186/s12890-017-0493-4Disease severityDust exposurePulmonary alveolar proteinosisSmoking |
| spellingShingle | Ji An Hwang Joo Han Song Jung Hoon Kim Man Pyo Chung Dong Soon Kim Jin Woo Song Young Whan Kim Sun Mi Choi Seung Ick Cha Soo Taek Uh Choon-Sik Park Sung Hwan Jeong Yong Bum Park Hong Lyeol Lee Jong Wook Shin Eun Joo Lee Yangjin Jegal Hyun Kyung Lee Jong Sun Park Moo Suk Park Clinical significance of cigarette smoking and dust exposure in pulmonary alveolar proteinosis: a Korean national survey BMC Pulmonary Medicine Disease severity Dust exposure Pulmonary alveolar proteinosis Smoking |
| title | Clinical significance of cigarette smoking and dust exposure in pulmonary alveolar proteinosis: a Korean national survey |
| title_full | Clinical significance of cigarette smoking and dust exposure in pulmonary alveolar proteinosis: a Korean national survey |
| title_fullStr | Clinical significance of cigarette smoking and dust exposure in pulmonary alveolar proteinosis: a Korean national survey |
| title_full_unstemmed | Clinical significance of cigarette smoking and dust exposure in pulmonary alveolar proteinosis: a Korean national survey |
| title_short | Clinical significance of cigarette smoking and dust exposure in pulmonary alveolar proteinosis: a Korean national survey |
| title_sort | clinical significance of cigarette smoking and dust exposure in pulmonary alveolar proteinosis a korean national survey |
| topic | Disease severity Dust exposure Pulmonary alveolar proteinosis Smoking |
| url | http://link.springer.com/article/10.1186/s12890-017-0493-4 |
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