@poodledoc There are probably multiple reasons for the increase of NTM. “The number of people at risk is increasing because the population is aging and more people are living with chronic lung diseases. Increasing environmental exposure is also likely a factor, as is greater awareness of NTM disease among physicians.” With the many women who get NTM, I read that it is because we live longer and are more likely to seek medical care. There may be unidentified biological and genetic factors that contribute to the greater incidence and prevalence among women. Personally, I believe there is a genetic and/or biological connection. With that said, I am wondering about the increase in environmental exposure. As I typed this I started thinking about autism. When I was a child in the 1950’s, nobody ever mentioned autism. Before I retired in 2014, there was an entire program at my school, at the middle school, and at the high school for these children. One of my fourteen grandbabies has autism, and I worked with a sweet woman who had three children with autism. Three of my grown children teach children with autism. All this, in my opinion, also begs the question “why”? None of what I read about NTM @poodledoc answers “why” sufficiently for me. When I was first diagnosed doctors asked me if I lived on a farm or worked with animals ( especially birds). That might be food for thought for some of us but certainly only a small percentage. I too would like answers to the question. irene5