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Inhaled Exposures and PF


University of Calgary to build a clinical tool for identifying environmental and occupational risks in pulmonary fibrosis

CHICAGO, December 14, 2021 — Three Lakes Foundation announces support for the University of Calgary in Alberta, Canada to identify inhaled exposures that increase the risk of developing pulmonary fibrosis (PF). Once identified, the data will be used to build a clinically implementable, exposure questionnaire to help identify individuals at risk for PF.

PF is a progressive lung disease that occurs when the organ tissue becomes damaged and scarred. It is part of a group of chronic lung disorders called interstitial lung disease (ILD). Approximately 40-50,000 people are diagnosed each year and another 40,000 individuals die annually from PF. Currently, there are no available therapies that can stop or reverse the disease’s progression, and screening and early diagnosis tools are limited. Additionally, despite the importance of inhaled exposures on the risk of ILD/PF, there is no standardized approach to characterizing these exposures, and no questionnaire is in widespread use.

“We know that certain inhaled exposures, such as smoking or asbestos, can lead to some forms of ILDs,” said Bridget Burke, associate director of Three Lakes Foundation. “There are other environmental and occupational exposures that could trigger the development of disease, but we don’t have a clear understanding of what those are yet or a standardized tool to help clinicians screen at-risk patients. This project will help us to learn more about PF and turn those learnings into action within the clinic setting.”

The project will be led by Kerri Johannson, MD, associate professor of medicine and community health sciences at the Cumming School of Medicine, University of Calgary. She is also the director of clinical research for the university’s interstitial lung disease program.

“Understanding the exposures associated with PF will help us to discover how the disease evolves and progresses,” noted Dr. Johannson. “It may also lead us to develop effective interventions and treatments.”

The project will be executed in four stages over 18 months. Stage one begins with a systematic review of the medical literature to identify all known occupational and environmental exposures associated with fibrotic lung disease.

In the second stage, the research team will synthesize all published ILD questionnaires that physicians and research centers are utilizing because there is still no single, standardized approach to assessing environmental exposures in patients.

In stage three, the team will collaborate with ILD experts from various geographic regions in the world, including U.K., Australia and the U.S. to establish a consensus and develop one comprehensive questionnaire designed to pinpoint those specific exposures — environmental or occupational — that could lead to the risk factors for PF.

The fourth stage is to pilot-test the questionnaire within small prospective registries to evaluate its ease of use and performance in comparison to other currently used exposure-assessment tools. The final questionnaire will be available for public use across the PF community. Beyond these initial four stages, the long-term intentions are to validate the questionnaire’s utility in large cohorts of patients with ILD, employ it broadly to identify new potential exposures of interest, and modify it iteratively as new information becomes available.

About Three Lakes Foundation

Three Lakes Foundation (TLF) is a nonprofit dedicated to serving as a catalyst for uniting research, industries, and philanthropy in pulmonary fibrosis. We connect entrepreneurs, advocates and institutions to an innovation ecosystem that will transform our approach to improve time to diagnosis and accelerate new therapies. To learn more, visit



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