{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:02:59Z","timestamp":1791925379852,"version":"4.3.4"},"reference-count":37,"publisher":"European Respiratory Society (ERS)","issue":"6","content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2015,8,27]]},"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:p>\n                    Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary hypertension characterised by predominant remodelling of pulmonary venules. Bi-allelic mutations in the eukaryotic translation initiation factor 2\u03b1 kinase 4 (\n                    <jats:italic>EIF2AK4<\/jats:italic>\n                    ) gene were recently described as the major cause of heritable PVOD, but risk factors associated with PVOD remain poorly understood. Occupational exposures have been proposed as a potential risk factor for PVOD, but epidemiological studies are lacking.\n                  <\/jats:p>\n                  <jats:p>\n                    A case\u2013control study was conducted in consecutive PVOD (cases, n=33) and pulmonary arterial hypertension patients (controls, n=65). Occupational exposure was evaluated\n                    <jats:italic>via<\/jats:italic>\n                    questionnaire interview with blinded assessments using an expert consensus approach and a job exposure matrix (JEM).\n                  <\/jats:p>\n                  <jats:p>\n                    Using the expert consensus approach, PVOD was significantly associated with occupational exposure to organic solvents (adjusted OR 12.8, 95% CI 2.7\u201360.8), with trichloroethylene being the main agent implicated (adjusted OR 8.2, 95% CI 1.4\u201349.4). JEM analysis independently confirmed the association between PVOD and trichloroethylene exposure. Absence of significant trichloroethylene exposure was associated with a younger age of disease (54.8\u00b121.4\u2005years, p=0.037) and a high prevalence of harbouring bi-allelic\n                    <jats:italic>EIF2AK4<\/jats:italic>\n                    mutations (41.7%\n                    <jats:italic>versus<\/jats:italic>\n                    0%, p=0.015).\n                  <\/jats:p>\n                  <jats:p>Occupational exposure to organic solvents may represent a novel risk factor for PVOD. Genetic background and environmental exposure appear to influence the phenotypic expression of the disease.<\/jats:p>","DOI":"10.1183\/13993003.00814-2015","type":"journal-article","created":{"date-parts":[[2015,11,6]],"date-time":"2015-11-06T13:58:32Z","timestamp":1446818312000},"page":"1721-1731","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":121,"title":["Occupational exposure to organic solvents: a risk factor for pulmonary veno-occlusive disease"],"prefix":"10.1183","volume":"46","author":[{"given":"David","family":"Montani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmund 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