Epidemiology
The prevalence of HP is not precisely known. It most likely varies with the antigen, the exposure concentration, and as yet unidentified host factors. In the past, the prevalence among Wisconsin dairy farmers was reported as being 2% to 8%. However, with remediation of the damp conditions leading to farmer's lung, that prevalence has dropped. 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).[7] A complicating factor in occupational causes of HP is the healthy worker effect and high turnover among those employees who develop HP, which, therefore, may be underreported.[5][6][8][9][10] A report suggests that deaths from HP are rising in the US.[11] 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.[12]
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