Occupational non-invasive aspergillosis: a national multicenter retrospective study from the French National Network...

Aspergillosis-related diseases arise from exposure to Aspergillus fungi in diverse work environments but occupational data remain limited. We conducted a multicenter study including all adult cases of occupational non-invasive aspergillosis reported to the French National Network for the Monitoring and Prevention of Occupational and Environmental Diseases (RNV3PE) between 2001 and 2023. Cases were identified on the basis of ICD-10 codes for aspergillosis (group B44 and related) and/or documented occupational exposure to Aspergillus. We aimed to describe clinical features, estimate prevalence, and identify factors associated with occupational disease claims. Mandatory reports provided data on demographics, underlying factors, disease type, and occupational characteristics; multivariate logistic regression and cluster analysis were performed. Immuno-allergic forms predominated (74%) in the 84 adults included (67% men; median age: 49 years). The prevalence of occupational non-invasive aspergillosis was 0.15 per 100 000 inhabitants. Documented exposure involved A. fumigatus (15%) or Aspergillus spp. (66%). Causality was considered high in 45% of cases; workplace eviction was recommended in 64% of cases, and 36% were advised to file a claim. Strong causality alone was predictive of claim submission. Occupational non-invasive aspergillosis appears to be underdiagnosed, highlighting the need to improve the identification and prevention of workplace exposures.