Abstract Introduction Occupational lung diseases remain a preventable cause of morbidity and mortality in the United States. Despite regulatory advances and better workplace safety measures, occupational lung diseases continue to cause substantial mortality. Tracking long-term trends helps reveal the success of preventive measures and highlights emerging conditions like hypersensitivity pneumonitis, reflecting changing exposures and improved disease recognition in older U.S. adults. Methodology We analyzed death certificate data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database from 1999 to 2023. Underlying causes of death were identified using ICD-10 codes J60, J61, J62, and J67. Age-adjusted mortality rates (AAMR) per 100,000 persons and annual percent change (APC) were calculated for adults aged 55 years and older. Results A total of 20,242 deaths among adults aged ≥55 years were attributed to occupational lung diseases in the United States from 1999 to 2023. The overall age-adjusted mortality rate (AAMR) showed a consistent decline across all subtypes, except hypersensitivity pneumonitis, which showed an increase during this period. Among disease subtypes, coal workers’ pneumoconiosis demonstrated the highest initial mortality burden, with AAMR decreasing from 0.73 per 100,000 in 1999 to 0.16 in 2023 (APC −7.50, 95% CI -8.9 to -6.4). Asbestosis followed a similar downward trend, with AAMR falling from 0.75 to 0.27 (APC −4.10, 95% CI -4.9 to -3.4), while silicosis declined from 0.15 to 0.03 (APC −4.64, 95% CI -6.7 to -3.3). All of them show statistically significant reductions (p 0.05). In contrast, hypersensitivity pneumonitis exhibited a significant upward trend, with AAMR rising from 0.06 in 1999 to 0.22, in 2023 (APC 7.74, 95%CI 6.5 to 10.1). This was the only subtype with an increasing mortality trend over the study period, with the highest mortality observed in the West, followed by the Midwest. Conclusions The significant decline in traditional occupational lung diseases in the US demonstrate the effectiveness of past prevention efforts. However, the rising mortality due to hypersensitivity pneumonitis highlights the need for renewed public health focus and modernized prevention strategies addressing evolving occupational risks. There is need for more research exploring the natural history of this disease, along with more clear and standardized criteria for diagnosis. This abstract is funded by: None
Alvi et al. (Fri,) studied this question.