Occupational and Environmental Exposures Analysis in Interstitial Lung Diseases.

Interstitial lung diseases (ILDs) represent a diverse group of parenchymal lung disorders associated with significant morbidity and mortality, with few FDA-approved treatment options available. While certain subtypes-such as hypersensitivity pneumonitis and pneumoconiosis-are clearly linked to environmental exposures, the role of such exposures in other ILD forms remains less well defined. Recent evidence has showed that most patients across all types of ILD had potentially relevant inhalational exposures. Exposures were associated with worse transplant-free survival. Thus, identification and avoidance of exposures represent actionable targets in ILD management.

Different questionnaires have been proposed to evaluate occupational and environmental exposure in such patients. However, to date, there aren't standardized and validated questionnaires addressing exposures in patients with ILD. Interstitial lung diseases (ILDs) represent a diverse group of parenchymal lung disorders associated with significant morbidity and mortality, with few FDA-approved treatment options available. While certain subtypes-such as hypersensitivity pneumonitis and pneumoconiosis-are clearly linked to environmental exposures, the role of such exposures in other ILD forms remains less well defined. Recent evidence has showed that most patients across all types of ILD had potentially relevant inhalational exposures. Exposures were associated with worse transplant-free survival. Thus, identification and avoidance of exposures represent actionable targets in ILD management.

Different questionnaires have been proposed to evaluate occupational and environmental exposure in such patients. However, to date, there aren't standardized and validated questionnaires addressing exposures in patients with ILD. Moreover, frequency of exposure across different types of ILDs are not well defined in Italy.

• standard interview (Other): standard interview to detect relevant exposures

Primary outcomes

• Frequency of any exposure (environmental and/or occupational) in ILD patients. [5 years]: to assess the frequency of environmental and/or occupational exposures among patients with newly diagnosed ILD
• Use of a standardized questionnaire in all the centers [5 years]: To standardise exposure assessment through a structured questionnaire across participating centres

Secondary outcomes

• The prevalence of environmental and/or occupational exposures in patients diagnosed with IPF, HP or other forms of ILD [5 years]: To compare the frequency of any exposure among patients with idiopathic pulmonary fibrosis (IPF), hypersensitivity pneumonitis (HP), and other forms of ILD
• All-cause mortality [5 years]: All-cause mortality
• Development of a progressive pulmonary fibrosis (PPF) phenotype. [5 years]: To evaluate the percentage of patients developing a progressive pulmonary fibrosis (PPF) phenotype in the "exposure" and "no exposure" group.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Age ≥ 18 years old
* Any gender
* Any race
* Ability to give informed consent according to ICH/EU GCP, and national/local regulations.
* New diagnosis of ILD according to classified according to American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias

Exclusion Criteria:

* Sarcoidosis
* Primary diagnosis of COPD and/or Asthma

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• Francesco Amati, MD, Principal investigator, Humanitas Research Hospital IRCCS, Rozzano-Milan