@article {Blackley790, author = {David J Blackley and Cara N Halldin and J W Awori Hayanga and A Scott Laney}, title = {Transplantation for work-related lung disease in the USA}, volume = {77}, number = {11}, pages = {790--794}, year = {2020}, doi = {10.1136/oemed-2020-106578}, publisher = {BMJ Publishing Group Ltd}, abstract = {Objectives Work-related lung diseases (WRLDs) are entirely preventable. To assess the impact of WRLDs on the US transplant system, we identified adult lung transplant recipients with a WRLD diagnosis specified at the time of transplant to describe demographic, payer and clinical characteristics of these patients and to assess post-transplant survival.Methods Using US registry data from 1991 to 2018, we identified lung transplant recipients with WRLDs including coal workers{\textquoteright} pneumoconiosis, silicosis, asbestosis, metal pneumoconiosis and berylliosis.Results The frequency of WRLD-associated transplants has increased over time. Among 230 lung transplants for WRLD, a majority were performed since 2009; 79 were for coal workers{\textquoteright} pneumoconiosis and 78 were for silicosis. Patients with coal workers{\textquoteright} pneumoconiosis were predominantly from West Virginia (n=31), Kentucky (n=23) or Virginia (n=10). States with the highest number of patients with silicosis transplant were Pennsylvania (n=12) and West Virginia (n=8). Patients with metal pneumoconiosis and asbestosis had the lowest and highest mean age at transplant (48.8 and 62.1 years). Median post-transplant survival was 8.2 years for patients with asbestosis, 6.6 years for coal workers{\textquoteright} pneumoconiosis and 7.8 years for silicosis. Risk of death among patients with silicosis, coal workers{\textquoteright} pneumoconiosis and asbestosis did not differ when compared with patients with idiopathic pulmonary fibrosis.Conclusions Lung transplants for WRLDs are increasingly common, indicating a need for primary prevention and surveillance in high-risk occupations. Collection of patient occupational history by the registry could enhance case identification and inform prevention strategies.}, issn = {1351-0711}, URL = {https://oem.bmj.com/content/77/11/790}, eprint = {https://oem.bmj.com/content/77/11/790.full.pdf}, journal = {Occupational and Environmental Medicine} }