Clinical analysis of patients with occupational hypersensitivity pneumonitis – machine operator’s lung
Authors:
S. Perečinský; L. Murínová; N. Dzurovčínová; Ľ. Legáth
Authors‘ workplace:
Klinika pracovného lekárstva a klinickej toxikológie LF Univerzity P. J. Šafárika a Univerzitnej Nemocnice L. Pasteura, Košice, Slovenská republika
Published in:
Pracov. Lék., 78, 2026, No. 1-2, s. 12-17.
Category:
Original Papers
Overview
Introduction: Hypersensitivity pneumonitis is an immune-mediated interstitial lung disease caused by inhalation of various antigens, many of which are present in occupational environments. In recent decades, increasing attention has been paid to hypersensitivity pneumonitis induced by exposure to metalworking fluids, known as machine operator´s lung, which is associated in the literature with a more favorable prognosis.
Objective: The aim of this study was to evaluate the long-term clinical status of patients with occupational hypersensitivity pneumonitis – machine operator´s lung.
Methods: The study group consisted of 28 patients (21 men and 7 women; mean age 44.5 ± 12 years) examined between 2018 and 2022 and subsequently re-evaluated in 2025. Clinical findings, pulmonary function parameters, and radiological findings were assessed at three time points: at diagnosis, after clinical stabilization following elimination of exposure and treatment, and at follow-up examination after a minimum interval of three years. Evaluated parameters included respiratory and systemic symptoms, pulmonary function tests including diffusing capacity of the lungs for carbon monoxide (DLCO), arterial blood gas values, and high-resolution computed tomography findings with a focus on fibrotic changes.
Results: At diagnosis, all patients reported dyspnea and cough; among systemic symptoms, subfebrile or febrile episodes were most common (71%). After clinical stabilization, a marked reduction in systemic symptoms was observed. However, at the final follow-up examination, exertional dyspnea (86%) and cough (57%) persisted in most patients. The fibrotic form of hypersensitivity pneumonitis was confirmed in two patients at diagnosis and in four patients at the final follow-up. Lung volumes and airflow parameters did not change significantly. In contrast, a statistically significant increase was observed in DLCO, partial pressure of oxygen, and arterial oxygen saturation.
Conclusion: Hypersensitivity pneumonitis of the machine operator´s lung type has a more favorable course compared with other forms of the disease; however, the development of pulmonary fibrosis cannot be excluded even after elimination of exposure. These findings highlight the need for long-term follow-up of patients, even in the presence of minimal clinical symptoms.
Keywords:
Pulmonary fibrosis – hypersensitivity pneumonitis – metalworking fluids – machine operator’s lung
Sources
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Hygiene and epidemiology Hyperbaric medicine Occupational medicineArticle was published in
Occupational Medicine
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