Although males and females with farmer’s lung disease have comparable odds of developing acute respiratory failure, a new study reports that females may have higher odds of needing non-invasive and invasive ventilatory support.
Farmer’s lung disease is a form of hypersensitivity pneumonitis triggered by inhaling antigens from moldy hay or straw that cause an inflammatory response in the small airways, potentially leading to hypoxia and respiratory compromise. According to a 2007 study, farmer’s lung disease accounted for 11% of all hypersensitivity pneumonitis cases in the United States, but no recent studies have examined the healthcare burden and the differences in complications and hospitalization outcomes based on sex.
National Inpatient Sample Data
The researchers used data from the National Inpatient Sample, the largest all-payer inpatient care database in the United States. The study authors investigated adults hospitalized in rural and urban hospitals with farmer’s lung disease, excluding COVID-19-positive cases, and they analyzed differences in demographics and outcomes between males and females.
The mean age of the 2,935 (85.4%) males and 500 (14.6%) females treated for farmer’s lung disease between 2016 and 2022 was 75.18 years, and 30.0% of admissions were in rural centers.
Females tended to be younger (mean age 72.55 vs 75.63, P<0.01) and have a lower Charlson Comorbidity Index score (2.67 vs 3.31, P<0.01). Around 94.3% of males and 88.7% of females were non-Hispanic White (P<0.01), and Medicare covered 78.2% of males and 78.0% of females.
Although acute respiratory failure occurrences were similar in males and females (aOR 1.271; 95% CI, 0.968-1.668; P=0.084), females were more likely to use non-invasive ventilation (aOR 1.646; 95% CI, 1.126-2.408; P=0.010), mechanical ventilation (aOR 1.497; 95% CI, 1.005-2.228; P=0.047), and be intubated (aOR 2.146; 95% CI, 1.371-3.357; P<0.01).
Lengths of hospital stay were similar for males (mean 5.30 days) and females (mean 5.25 days), and patient sex did not impact their all-cause in-hospital mortality (aOR 0.686; 95% CI, 0.396-1.188; P=0.178).
Mean hospital costs for males and females were also similar ($20,883 and $18,108, respectively), and admissions for farmer’s lung disease cost hospitals roughly $10 million per year.
The researchers recommend further research to generate better understanding of the sex-based differences and long-term symptom progression of farmer’s lung disease. They also advocate for sensitization campaigns for people at risk of exposure to the antigens that cause the disease.
Reference
Ramphul K, Kaur K, Mahajan K, et al. Evaluating the Disparities in Demographics and Complications Based on the Sex of Patients With Farmer’s Lung Disease in the United States. Presented at: CHEST 2025, October 19-22, 2025; Chicago.
