{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:02:29Z","timestamp":1770350549334,"version":"3.49.0"},"reference-count":39,"publisher":"BMJ","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Occup Environ Med"],"published-print":{"date-parts":[[1995,9]]},"abstract":"<jats:p>OBJECTIVES--Diagnostic criteria were prepared for hypersensitivity pneumonitis (HP) and a nationwide survey was conducted to investigate epidemiological and clinical characteristics of HP in Japan. The results are presented with special focus on occupational HP and on the key to the diagnosis of HP. METHODS--A questionnaire was completed by 185 doctors from 185 hospitals (response rate 89.5%). All cases were verified according to diagnostic criteria; 835 cases were classified as HP (653 definite and 182 probable). These 835 cases (total HP) and 99 possible cases of HP diagnosed during the 1980s were analysed and presented as a case series study. RESULTS--Occupational HP was noted in 115 cases (13.8%). 21 occupations, and 20 aetiological antigens were listed. Farmer's lung: 68 cases (59% of occupational HP) was the most prevalent diagnosis followed by 19 industrial workers who handled chemicals (for example, isocyanate) and 10 office workers. Unique cases of mushroom, greenhouse, and silkworm farmers, and a new type of bagassosis are also described. Adverse environmental conditions, immunological findings on examination, antigen challenge, and pathological findings were all significantly lower for possible than for total HP. This was not true for clinical findings. The differences in antibody analysis (6% positive of possible HP v 59% of total HP) and environmental challenge (3% v 74%) were notable. CONCLUSION--These data suggest that a careful interview about the environment and an antigen panel matched to variations in exposure are the key to the diagnosis.<\/jats:p>","DOI":"10.1136\/oem.52.9.570","type":"journal-article","created":{"date-parts":[[2008,12,17]],"date-time":"2008-12-17T00:14:48Z","timestamp":1229472888000},"page":"570-574","source":"Crossref","is-referenced-by-count":28,"title":["Occupational hypersensitivity pneumonitis in Japan: data on a nationwide epidemiological study."],"prefix":"10.1136","volume":"52","author":[{"given":"K","family":"Yoshida","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Suga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y","family":"Nishiura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K","family":"Arima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Yoneda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Tamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Ando","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1995,9,1]]},"reference":[{"key":"ref_1","first-page":"201","article-title":"Antigens and hypersensitivity pneumonitis. JAllergy Clin Immunol","volume":"61","author":"Pepys, J.","year":"1978","unstructured":"Pepys J. Antigens and hypersensitivity pneumonitis. JAllergy Clin Immunol 1978;61:201-3."},{"issue":"4","key":"ref_2","first-page":"1","article-title":"Hypersensitivity diseases of the lung","volume":"1969","author":"Pepys, J.","unstructured":"Pepys J. Hypersensitivity diseases of the lung. Monogr Allergy, 1969;4:1-147.","journal-title":"Monogr Allergy"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0091-6749(84)90077-0","article-title":"Hypersensitivity pneumonitis","volume":"74","author":"Fink, J.N.","year":"1984","unstructured":"Fink JN. Hypersensitivity pneumonitis. J Allergy Clin Immunol 1984;74: 1-10","journal-title":"J Allergy Clin Immunol"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1164\/ajrccm\/145.1.1","article-title":"Controversies in hypersensitivity pneumonits","volume":"145","author":"Rose, C.; TE, Jr, King","year":"1992","unstructured":"Rose C, King TE Jr. Controversies in hypersensitivity pneumonits. Am Rev Respir Dis 1992;145:1-2.","journal-title":"Am Rev Respir Dis"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/00000441-199010000-00010","article-title":"Southwestern internal medicine conference; hypersensitivity pneumonitis","volume":"300","author":"Pitcher, W.D.","year":"1990","unstructured":"Pitcher WD. Southwestern internal medicine conference; hypersensitivity pneumonitis. Am Y Med Sci 1990;300: 251-66.","journal-title":"Am Y Med Sci"},{"key":"ref_6","first-page":"59","article-title":"Epidemiologic aspects of hypersensitivity pneumonitis","volume":"21","author":"Fink, J.N.","year":"1987","unstructured":"Fink JN. Epidemiologic aspects of hypersensitivity pneumonitis. MonogrAlergy 1987;21:59-69","journal-title":"MonogrAlergy"},{"key":"ref_7","first-page":"70","article-title":"Epidemiology of hypersensitivity pneumonitis\/allergic alveolitis","volume":"21","author":"Lopez, M.; Salvaggio, J.E.","year":"1987","unstructured":"Lopez M, Salvaggio JE. Epidemiology of hypersensitivity pneumonitis\/allergic alveolitis. Monogr Allergy 1987;21: 70-86.","journal-title":"Monogr Allergy"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/0091-6749(89)90349-7","article-title":"Guidelines for the clinical evaluation of hypersensitivity pneumonitis: report of the subcommittee on hypersensitivity pneumonitis","volume":"84","author":"Richerson, H.B.; Bernstein, I.L.; Fink, J.N.; Hunninghake, G.W.; Novey, H.S.; Reed, C.E.","year":"1989","unstructured":"Richerson HB, Bernstein IL, Fink JN, Hunninghake GW, Novey HS, Reed CE, et al. Guidelines for the clinical evaluation of hypersensitivity pneumonitis: report of the subcommittee on hypersensitivity pneumonitis. JAfiergy Clin Immunol 1989;84:839-44.","journal-title":"JAfiergy Clin Immunol"},{"key":"ref_9","first-page":"481","article-title":"Hypersensitivity pneumonitis","volume-title":"Occupational respiratory diseases. Washington DC: US Department of Health and Human Services, Public Health Service, Centers for Disease","author":"Fink, J.N.","year":"1986","unstructured":"Fink JN. Hypersensitivity pneumonitis. In: Merchant JA, Boehlecke BA, Taylor G, eds. Occupational respiratory diseases. Washington DC: US Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute Safety and Health, 1986:481-500."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/0091-6749(78)90105-7","article-title":"Farmer's lung disease among farmers with precipitating antibodies to the thermophilic actinomycetes: a clinical and immunologic study","volume":"62","author":"JJ, Jr, Marx; DA, Emanuel; WV, Dovenbarger; ME, Reinecke; RC, Roberts; MW, Treuhaft","year":"1978","unstructured":"Marx JJ Jr, Emanuel DA, Dovenbarger WV, Reinecke ME, Roberts RC, Treuhaft MW. Farmer's lung disease among farmers with precipitating antibodies to the thermophilic actinomycetes: a clinical and immunologic study. JAergy Clin Immunol 1978;62:185-9.","journal-title":"JAergy Clin Immunol"},{"key":"ref_11","first-page":"964","article-title":"Immune reactions in the lungs of asymptomatic dairy farmers","volume":"126","author":"Solal-Celigny, P.H.; Laviolette, M.; Hebert, J.; Cormier, Y.","year":"1982","unstructured":"Solal-Celigny PH, Laviolette M, Hebert J, Cormier Y. Immune reactions in the lungs of asymptomatic dairy farmers. Am Rev Respir Dis 1982;126:964-7.","journal-title":"Am Rev Respir Dis"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1002\/ajim.4700100333","article-title":"Diagnostic criteria for farmer's lung disease","volume":"10","author":"Terho, E.O.","year":"1986","unstructured":"Terho EO. Diagnostic criteria for farmer's lung disease. Am I Ind Med 1986;10:329.","journal-title":"Am I Ind Med"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1136\/thx.43.6.429","article-title":"Epidemiological study of farmer's lung in five districts of the French Doubs province","volume":"43","author":"Depierre, A.; Dalphin, J.C.; Pernet, D.; Dubiez, A.; Faucompre, C.; Breton, J.L.","year":"1988","unstructured":"Depierre A, Dalphin JC, Pernet D, Dubiez A, Faucompre C, Breton JL. Epidemiological study of farmer's lung in five districts of the French Doubs province. Thorax 1988;43:429-35.","journal-title":"Thorax"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1159\/000234647","article-title":"Incidence of organic dust toxic syndrome and allergic alveolitis in Swedish farmers","volume":"87","author":"Malmberg, P.; Rask-Andersen, A.; Hoglund, S.; KolmodinHedman, B.; Guernsey, JR","year":"1988","unstructured":"Malmberg P, Rask-Andersen A, Hoglund S, KolmodinHedman B, Guernsey JR. Incidence of organic dust toxic syndrome and allergic alveolitis in Swedish farmers. IntArch Allergy Appl Immunol 1988;87:47-57.","journal-title":"IntArch Allergy Appl Immunol"},{"key":"ref_15","first-page":"581","article-title":"Diagnostische Aspekte der allergischen Alveolitis","volume":"45","author":"Muller, V.S.","year":"1990","unstructured":"Muller VS. Diagnostische Aspekte der allergischen Alveolitis. Z Gesamte Inn Med 1990;45:581-4. (In German)","journal-title":"Z Gesamte Inn Med"},{"key":"ref_16","first-page":"449","article-title":"Summer-type hypersensitivity pneumonitis","volume-title":"disease in the tropics. Lung biology in health and disease","author":"Ando, M.","year":"1991","unstructured":"Ando M. Summer-type hypersensitivity pneumonitis. In: Sharma OP ed. Lung disease in the tropics. Lung biology in health and disease. New York: Marcel Dekker, 1991: 449-78."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1378\/chest.85.3.311","article-title":"Summer-type hypersensitivity pneumonits: a unique disease in Japan","volume":"85","author":"Kawai, T.; Tamura, M.; Murao, M.","year":"1984","unstructured":"Kawai T, Tamura M, Murao M. Summer-type hypersensitivity pneumonits: a unique disease in Japan. Chest 1984;85:311-7.","journal-title":"Chest"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1164\/ajrccm\/144.4.765","article-title":"Japanese summer-type hypersensitivity pneumonitis: geographic distribution, home environment, and clinical characteristics of 621 cases","volume":"144","author":"Ando, M.; Arima, K.; Yoneda, R.; Tamura, M.","year":"1991","unstructured":"Ando M, Arima K, Yoneda R, Tamura M. Japanese summer-type hypersensitivity pneumonitis: geographic distribution, home environment, and clinical characteristics of 621 cases. Am Rev Respir Dis 1991;144:765-9.","journal-title":"Am Rev Respir Dis"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1016\/0091-6749(91)90423-L","article-title":"Difference in the phenotypes of bronchoalveolar lavage lymphocytes in patients with summer-type hypersensitivity pneumonitis, farmer's lung, ventilation pneumonitis, and bird fancier's lung: report of a nationwide epidemiologic study in Japan","volume":"87","author":"Ando, M.; Konishi, K.; Yoneda, R.; Tamura, M.","year":"1991","unstructured":"Ando M, Konishi K, Yoneda R, Tamura M. Difference in the phenotypes of bronchoalveolar lavage lymphocytes in patients with summer-type hypersensitivity pneumonitis, farmer's lung, ventilation pneumonitis, and bird fancier's lung: report of a nationwide epidemiologic study in Japan. JAllegy Cln Immunol 1991;87:1002-9.","journal-title":"JAllegy Cln Immunol"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/0091-6749(88)90920-7","article-title":"Environmental mycological studies on the causative agent of summertype hypersensitivity pneumonitis","volume":"81","author":"Yoshida, K.; Ando, M.; Araki, Sakata T.; S.","year":"1988","unstructured":"Yoshida K, Ando M, Sakata T. Araki S. Environmental mycological studies on the causative agent of summertype hypersensitivity pneumonitis. JAllergy Clin Immunol 1988;81:475-83.","journal-title":"JAllergy Clin Immunol"},{"key":"ref_21","first-page":"407","article-title":"Hypersensitivity pneumonitis induced by Trichosporon cutaneum","volume":"130","author":"Shimazu, K.; Ando, M.; Sakata, T.; Yoshida, K.; Araki, S.","year":"1984","unstructured":"Shimazu K, Ando M, Sakata T, Yoshida K, Araki S. Hypersensitivity pneumonitis induced by Trichosporon cutaneum. Am Rev Respir Dis 1984;130:407-11.","journal-title":"Am Rev Respir Dis"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1080\/00039896.1989.9935900","article-title":"Prevention of summer-type hypersensitivity pneumonitis: effect of elimination of Trichosporon cutaneum from patient's homes","volume":"44","author":"Yoshida, K.; Ando, M.; Sakata, T.; Araki, S.","year":"1989","unstructured":"Yoshida K, Ando M, Sakata T, Araki S. Prevention of summer-type hypersensitivity pneumonitis: effect of elimination of Trichosporon cutaneum from patient's homes. Arch Environ Health 1989;44:317-22.","journal-title":"Arch Environ Health"},{"key":"ref_23","first-page":"50","article-title":"The Tsuneta Yano Memorial Society","volume-title":"Nippon: a charted survey ofJapan 199311994","author":"H, Labor In Arima","year":"1993","unstructured":"The Tsuneta Yano Memorial Society. Labor. In Arima H, ed. Nippon: a charted survey ofJapan 199311994. Tokyo: The Kokusei-sha Corp; 1993:50-63."},{"key":"ref_24","first-page":"934","article-title":"Mushroom worker's lung due to inhalation of spores of the Cortinus schiitake","volume":"11","author":"Nakazawa, T.; Kanatani, K.; Umegae, Y.; Fueki, R.; Kobayashi, S.","year":"1981","unstructured":"Nakazawa T, Kanatani K, Umegae Y, Fueki R, Kobayashi S. Mushroom worker's lung due to inhalation of spores of the Cortinus schiitake. Japanese Journal ofChest Diseases 1981;11:934-8. (In Japanese.)","journal-title":"Japanese Journal ofChest Diseases"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1378\/chest.95.5.1149","article-title":"Hypersensitivity pneumonitis due to Mushroom (Pholiota nameko) spores","volume":"95","author":"Nakazawa, T.; Tochigi, T.","year":"1989","unstructured":"Nakazawa T, Tochigi T. Hypersensitivity pneumonitis due to Mushroom (Pholiota nameko) spores. Chest 1989;95: 1149-51.","journal-title":"Chest"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1080\/00039896.1990.9940809","article-title":"Hypersensitivity pneumonitis of a mushroom worker due to Aspergillus glaucus","volume":"45","author":"Yoshida, K.; Ando, M.; Ito, K.; Sakata, T.; Arima, K.; Araki, S.; Uchida, K.","year":"1990","unstructured":"Yoshida K, Ando M, Ito K, Sakata T, Arima K, Araki S, Uchida K. Hypersensitivity pneumonitis of a mushroom worker due to Aspergillus glaucus. Arch Environ Health 1990;45:245-7.","journal-title":"Arch Environ Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1136\/bmj.3.5567.708","article-title":"Mushroom-worker's lung","volume":"3","author":"Sakula, A.","year":"1967","unstructured":"Sakula A. Mushroom-worker's lung. BMJ 1967;3:708-10.","journal-title":"BMJ"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1080\/00039896.1993.9940370","article-title":"Hypersensitivity pneumonitis resulting from Aspergillus fumigatus in a greenhouse","volume":"48","author":"Yoshida, K.; Ueda, A.; Yamasaki, H.; Sato, K.; Uchida, K.; Ando, M.","year":"1993","unstructured":"Yoshida K, Ueda A, Yamasaki H, Sato K, Uchida K, Ando M. Hypersensitivity pneumonitis resulting from Aspergillus fumigatus in a greenhouse. Arch Environ Health 1993;48:260-2.","journal-title":"Arch Environ Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/0091-6749(82)90197-X","article-title":"Isocyanate-induced pulmonary diseases: a current perspective","volume":"70","author":"Bernstein, I.L.","year":"1982","unstructured":"Bernstein IL. Isocyanate-induced pulmonary diseases: a current perspective. J Allergy Clin Immunol 1982;70: 24-31.","journal-title":"J Allergy Clin Immunol"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"31","DOI":"10.7326\/0003-4819-110-1-31","article-title":"Hypersensitivity pneumonitis induced by toluene diisocyanate: sequelae of continuous exposure","volume":"110","author":"Yoshizawa, Y.; Ohtsuka, M.; Noguchi, K.; Uchida, Y.; Suko, M.; Hasegawa, S.","year":"1989","unstructured":"Yoshizawa Y, Ohtsuka M, Noguchi K, Uchida Y, Suko M, Hasegawa S. Hypersensitivity pneumonitis induced by toluene diisocyanate: sequelae of continuous exposure. Ann Intern Med 1989;110:31-4.","journal-title":"Ann Intern Med"},{"key":"ref_31","first-page":"775","article-title":"Hypersensitivity pneumonitis induced by chemical substances. Igaku No Ayumi","volume":"162","author":"Hujimura, N.","year":"1992","unstructured":"Hujimura N. Hypersensitivity pneumonitis induced by chemical substances. Igaku No Ayumi 1992;162:775-80. (In Japanese.)"},{"issue":"23","key":"ref_32","first-page":"26","article-title":"Studies on bagassosis","volume":"1969","author":"Tsugu, M.","unstructured":"Tsugu M. Studies on bagassosis. Iryo (Japanese Journal of the National Medical Service 1969;23:26-38. (In Japanese.)","journal-title":"Iryo (Japanese Journal of the National Medical Service"},{"key":"ref_33","first-page":"499","article-title":"Recent trends in bagassosis in Japan","volume":"49","author":"Ueda, A.; Aoyama, K.; Ueda, T.; Obama, K.; Ueno, T.; Hokama, S.; Nomura, S.","year":"1992","unstructured":"Ueda A, Aoyama K, Ueda T, Obama K, Ueno T, Hokama S, Nomura S. Recent trends in bagassosis in Japan. BrJY Ind Med 1992;49:499-506.","journal-title":"BrJY Ind Med"},{"key":"ref_34","first-page":"373","article-title":"A clinical study of hypersensitivity pneumonitis in Japan","volume":"18","author":"Murao, M.; Tamura, M.; Kawai, T.; Honma, Y.; Takishima, T.; Konno, J.","year":"1980","unstructured":"Murao M, Tamura M, Kawai T, Honma Y, Takishima T, Konno J, et al. A clinical study of hypersensitivity pneumonitis in Japan. Japanese Journal of the Thoracic Soc 1980;18:373-80. (In Japanese.)","journal-title":"Japanese Journal of the Thoracic Soc"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1378\/chest.99.4.941","article-title":"Increased airways responsiveness in swine farms","volume":"99","author":"Zhou, C.; Hurst, T.S.; Cockcroft, D.W.; Dosman, J.A.","year":"1991","unstructured":"Zhou C, Hurst TS, Cockcroft DW, Dosman JA. Increased airways responsiveness in swine farms. Chest 1991;99: 941-4.","journal-title":"Chest"},{"key":"ref_36","first-page":"99","article-title":"Prevalence of farmer's lung disease and antibodies to thermophilic actinomycetes in an Iware farming population","volume-title":"Internal medicine. Excerpta medica","author":"Tamura, M.; Konishi, K.; Komuro, A.","year":"1986","unstructured":"Tamura M, Konishi K, Komuro A. Prevalence of farmer's lung disease and antibodies to thermophilic actinomycetes in an Iware farming population. In: Oda T, ed. Internal medicine. Excerpta medica. Amsterdam: Elsevier, 1986:99-105."},{"key":"ref_37","first-page":"512","article-title":"Farmer's lung in Kagoshima Prefecture","volume":"44","author":"Ueda, A.","year":"1990","unstructured":"Ueda A. Farmer's lung in Kagoshima Prefecture. Chikusan NoKenkyu 1990;44:512-30. (In Japanese.)","journal-title":"Chikusan NoKenkyu"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1136\/thx.45.3.233","article-title":"Sericulturist's lung disease: hypersensitivity pneumonitis related to silk production","volume":"45","author":"Nakazawa, T.; Umegae, Y.","year":"1990","unstructured":"Nakazawa T, Umegae Y. Sericulturist's lung disease: hypersensitivity pneumonitis related to silk production. Thorax 1990;45:233-4.","journal-title":"Thorax"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/0007-0971(85)90068-3","article-title":"Death certification of firmer's lung and chronic airway diseases in different countries of the EEC","volume":"79","author":"Farebrother, M.J.B.; Kelson, M.C.; Heller, R.F.","year":"1985","unstructured":"Farebrother MJB, Kelson MC, Heller RF. Death certification of firmer's lung and chronic airway diseases in different countries of the EEC. Br J Dis Chest 1985;79: 352-60.","journal-title":"Br J Dis Chest"}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oem.52.9.570","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T14:03:53Z","timestamp":1716473033000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oem.52.9.570"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,9]]},"references-count":39,"journal-issue":{"issue":"9","published-online":{"date-parts":[[1995,9,1]]},"published-print":{"date-parts":[[1995,9]]}},"alternative-id":["10.1136\/oem.52.9.570"],"URL":"https:\/\/doi.org\/10.1136\/oem.52.9.570","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"value":"1351-0711","type":"print"},{"value":"1470-7926","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,9]]}}}