Association between Occupational and Radiological Factors and Nontuberculous Mycobacteria Lung Infection in Workers with Prior Dust Exposure

• Published in: International journal of environmental research and public health Vol. 16; no. 11; p. 1966
• Main Authors: Lee, Ji-Won, Myong, Jun-Pyo
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 03.06.2019; MDPI
• Subjects: Age; Aged; Bronchiectasis; Bronchitis; Bronchopulmonary infection; Chronic obstructive pulmonary disease; Coal; Comorbidity; Cross-Sectional Studies; Diagnosis; Differential diagnosis; Dust; Emphysema; Exposure; Family medical history; Female; Health risks; Hospitals; Humans; Infections; Leprosy; Lung diseases; Lung Diseases - epidemiology; Lung Diseases - microbiology; Male; Medical treatment; Middle Aged; Mycobacterium Infections, Nontuberculous - epidemiology; Mycobacterium Infections, Nontuberculous - microbiology; Nontuberculous Mycobacteria - isolation & purification; Occupational exposure; Occupational Exposure - statistics & numerical data; Opacity; Patients; Pneumoconiosis; Radiography; Regression analysis; Republic of Korea - epidemiology; Retrospective Studies; Risk analysis; Risk Factors; Signs and symptoms; Silica; Smoking; Statistical analysis; Tuberculosis; Republic of Korea; nontuberculous mycobacteria; occupational exposure; pneumoconiosis
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph16111966

This retrospective cross-sectional study was conducted to identify the factors that promote the risk of nontuberculous mycobacteria (NTM) lung infection in subjects with prior occupational dust exposure. All consecutive patients with a history of occupational dust exposure whose expectorated sputum, bronchial wash, or bronchial lavage was subjected to acid-fast Bacilli culture in a tertiary hospital between 2011 and 2016 were identified. The patients who were infected with NTM were identified according to the bacteriological criteria of the American Thoracic Society (ATS) and The Infectious Diseases Society of America (IDSA) statement. Pneumoconiosis-associated radiological findings were graded according to the International Labor Organization guidelines. Of the 1392 patients with prior dust exposure, NTM was isolated from 82. Logistic regression analysis showed that risk factors for NTM lung infection were a history of pulmonary tuberculosis (adjusted odds ratio [aOR] = 1.82, 95% confidence intervals [CI] = 1.03-3.16). Moreover, the unadjusted odds ratios (ORs) were higher when both small-opacity profusion and the large-opacity grades increased. Even after adjustment, the ORs for the A, B, and C large-opacity grades were 2.32 (95% CI = 1.01-4.99), 2.68 (95% CI = 1.35-5.24), and 7.58 (95% CI = 3.02-17.95). Previous tuberculosis, bronchiectasis, and especially extensive small-opacity profusion, and high large-opacity grade associated significantly with NTM lung infection in dust-exposed workers.