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Tobacco Worker’s Lung: A Neglected Subtype of Hypersensitivity Pneumonitis

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Abstract

Tobacco worker’s lung (TWL) is a type of hypersensitivity pneumonitis (HP) affecting workers exposed to tobacco leaves and molds in the humidified environment of the tobacco production industry. Limited epidemiological data point to a prevalence of TWL that is not negligible and probably underestimated. As in other types of HP, an acute vs. chronic presentation depends on the pattern of the exposure. Therefore, the clinical presentation can vary from an acute influenza-like syndrome, mostly self-limiting with the removal of the exposure, to an insidious onset of cough, exertional dyspnea, fatigue and weight loss in chronic presentations, where fibrotic changes may be observed. The main treatment strategy is the removal of the exposure to tobacco dust and molds, while the main aim of corticosteroid therapy is to reduce morbidity and prevent complications, namely the development of pulmonary fibrosis and permanent lung dysfunction. Despite the fact that TWL is quite well described, preventive measures are not usually adopted in the tobacco production industry. We present here a state of the art review of this neglected, preventable, but still prevalent and occupational-related subtype of HP.

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Authors and Affiliations

  1. Italian Society of Tobaccology (SITAB), Bologna, Italy

    Vincenzo Zagà

  2. Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, Perugia, Italy

    Marco Dell’Omo & Nicola Murgia

  3. Division of Respirology, Western University, London, ON, Canada

    Marco Mura

  4. Victoria Hospital, London Health Science Centre, 800 Commissioners Road East, Room E6-203, London, ON, N6A 5W9, Canada

    Marco Mura

Authors
  1. Vincenzo Zagà
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  2. Marco Dell’Omo
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  3. Nicola Murgia
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  4. Marco Mura
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Contributions

VZ: review of the literature, manuscript drafting. NM: case report, manuscript drafting. MD: review of the literature, manuscript drafting. MM: review of the literature, manuscript drafting.

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Correspondence to Marco Mura.

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Zagà, V., Dell’Omo, M., Murgia, N. et al. Tobacco Worker’s Lung: A Neglected Subtype of Hypersensitivity Pneumonitis. Lung 199, 13–19 (2021). https://doi.org/10.1007/s00408-020-00416-4

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  • DOI: https://doi.org/10.1007/s00408-020-00416-4

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