The prevalence of hypersensitivity pneumonitis (HP) is not precisely known. It most probably varies with the antigen, the exposure concentration, and as yet unidentified host factors. One US claims study found the yearly prevalence to be 1.67 to 2.71 per 100,000 people, and the 1-year cumulative incidence to be 1.28 to 1.94 per 100,000 people.[8]Fernández Pérez ER, Kong AM, Raimundo K, et al. Epidemiology of hypersensitivity pneumonitis among an insured population in the United States: a claims-based cohort analysis. Ann Am Thorac Soc. 2018 Apr;15(4):460-9.
https://www.atsjournals.org/doi/10.1513/AnnalsATS.201704-288OC
http://www.ncbi.nlm.nih.gov/pubmed/29236517?tool=bestpractice.com
The annual incidence is estimated to be 0.89 to 1.53 per 100,000 people in Denmark, and 1.14 to 2.16 per 100,000 people in South Korea.[9]Rittig AH, Hilberg O, Ibsen R, et al. Incidence, comorbidity and survival rate of hypersensitivity pneumonitis: a national population-based study. ERJ Open Res. 2019 Oct;5(4):00259-2018.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6801213
http://www.ncbi.nlm.nih.gov/pubmed/31649947?tool=bestpractice.com
[10]Jung HI, Nam DR, You SH, et al. Nationwide study of the epidemiology, diagnosis, and treatment of hypersensitivity pneumonitis in Korea. J Korean Med Sci. 2024 Mar 18;39(10):e96.
https://jkms.org/DOIx.php?id=10.3346/jkms.2024.39.e96
http://www.ncbi.nlm.nih.gov/pubmed/38501183?tool=bestpractice.com
The epidemiology of HP also varies with occupation. One study using data from the UK’s occupational health reporting scheme found that the most common cause of occupational HP was metalworking fluids, followed by farming and birds.[11]Barber CM, Wiggans RE, Carder M, et al. Epidemiology of occupational hypersensitivity pneumonitis; reports from the SWORD scheme in the UK from 1996 to 2015. Occup Environ Med. 2017 Jul;74(7):528-30.
https://oem.bmj.com/content/74/7/528.long
http://www.ncbi.nlm.nih.gov/pubmed/27919062?tool=bestpractice.com
It has been estimated that HP occurs in 6% to 21% of pigeon breeders. One Danish study reported that the hazard ratio for pigeon breeders developing HP is 14.36 (95% CI: 8.10 to 25.44).[12]Cramer C, Schlünssen V, Bendstrup E, et al. Risk of hypersensitivity pneumonitis and interstitial lung diseases among pigeon breeders. Eur Respir J. 2016 Sep;48(3):818-25.
http://www.ncbi.nlm.nih.gov/pubmed/27230447?tool=bestpractice.com
A complicating factor in occupational causes of HP is the healthy worker effect and high turnover among those employees who develop HP; therefore, HP may be under-reported.[13]Mohr LC. Hypersensitivity pneumonitis. Curr Opin Pulm Med. 2004 Sep;10(5):401-11.
http://www.ncbi.nlm.nih.gov/pubmed/15316440?tool=bestpractice.com
[14]Jacobs RL, Andrews CP, Coalson JJ. Hypersensitivity pneumonitis: beyond classic occupational disease-changing concepts of diagnosis and management. Ann Allergy Asthma Immunol. 2005 Aug;95(2):115-28.
http://www.ncbi.nlm.nih.gov/pubmed/16136760?tool=bestpractice.com
[15]Cormier Y, Gagnon L, Bérubé-Genest F, et al. Sequential bronchoalveolar lavage in experimental extrinsic allergic alveolitis. The influence of cigarette smoking. Am Rev Respir Dis. 1988 May;137(5):1104-9.
http://www.ncbi.nlm.nih.gov/pubmed/3195809?tool=bestpractice.com
[16]Girard M, Cormier Y. Hypersensitivity pneumonitis. Curr Opin Allergy Clin Immunol. 2010 Apr;10(2):99-103.
http://www.ncbi.nlm.nih.gov/pubmed/20093932?tool=bestpractice.com
A report using national data from 1988 to 2016 suggested that deaths from HP increased in the US over that period.[17]Fernández Pérez ER, Sprunger DB, Ratanawatkul P, et al. Increasing hypersensitivity pneumonitis-related mortality in the United States from 1988 to 2016. Am J Respir Crit Care Med. 2019 May 15;199(10):1284-87.
https://www.atsjournals.org/doi/abs/10.1164/rccm.201807-1258LE
http://www.ncbi.nlm.nih.gov/pubmed/30768910?tool=bestpractice.com
A cohort study carried out at a single hospital in Denmark between 2003 and 2009 found that 7% of patients diagnosed with interstitial lung diseases had HP.[18]Hyldgaard C, Hilberg O, Muller A, et al. A cohort study of interstitial lung diseases in central Denmark. Respir Med. 2014 May;108(5):793-9.
http://www.ncbi.nlm.nih.gov/pubmed/24636811?tool=bestpractice.com