Chest
Clinical InvestigationsExposure to Microorganisms Associated With Allergic Alveolitis and Febrile Reactions to Mold Dust in Farmers
Section snippets
Allergic Alveolitis and Febrile Reactions
The investigation was designed as a prospective study which lasted for 28 months. Physicians in all departments of internal medicine, lung medicine, occupational medicine, and infectious diseases; district medical centers; and health care centers in Sweden were requested to participate in this study. The physicians were asked to report to the project all new cases of probable AA and cases involving farmers with febrile reactions to mold dust who did not meet the criteria of AA (febrile reaction
Allergic Alveolitis
Eighteen patients were reported with a preliminary diagnosis of AA caused by mold dust. In two farms, the workplaces had been completely cleaned before notification to the project, and these farmers were not further evaluated. Based on evaluation of the clinical data, the diagnosis was confirmed in 11 of the remaining 16 farmers (Table 1). Two farmers with AA who became ill at approximately the same time were from the same farm. In five cases, the diagnosis of AA was not confirmed. In two of
DISCUSSION
The concentrations of mold spores or actinomycetes, or both, were very high in representative samples from farms of the two disease groups compared with levels observed in normal farming. The most conspicuous difference between the disease groups was that exposure associated with AA had occurred on most days for weeks, while the febrile reactions (ODTS) were observed following a single occurrence of exceptional exposure. One out of 11 farmers with a confirmed diagnosis of AA had, however, an
ACKNOWLEDGMENTS:
The authors thank Dr. Urban Palmgren; Göran Blomquist, Ph.D; and laboratory technicians Maria Eriksson and Sven Olof Westermark for collecting and enumerating spore samples. We also thank Katrin Karlsson who evaluated spore samples with electron microscopy and Lars Belin, M.D., who performed the analysis of precipitating antibodies. Finally, we thank all physicians who reported cases to the project, notably the physicians of the Farmers Safety and Health Association.
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Pulmonary illness as a consequence of occupational exposure to shrimp shell powder
2016, Environmental ResearchCitation Excerpt :For HP, patients may upon continued exposure, develop a chronic form of the disease with lung fibrosis. ODTS is described as a self-limiting syndrome, but where some cases may progress to severe acute lung injury (Seifert et al., 2003), and extremely high exposure during ODTS episodes have been attributed to development of asthma (Malmberg et al., 1993; May et al., 1990). Microbial contaminants, such as endotoxins or bacterial contaminants, or high exposure to respirable particles were considered plausible causes of the condition.
Farmer's Lung Disease. A Review
2016, Archivos de BronconeumologiaCitation Excerpt :A negative result for plasma precipitins does not rule out the diagnosis, particularly in the chronic forms of the disease, since antibody titers and levels of exposure are correlated, and may become negative if there has been no contact with the causative antigen for some time. The determination of precipitins may also be limited, firstly by the lack of standardized analytical methods, and secondly because the panel of precipitins will vary among the different regions, so it will be necessary to determine which are the most common antigens in each site.23,24 In this respect, it is also very useful to perform a culture for fungi and actinomycetes from the hay or other material to which the patient has been exposed.
Evaluation of exposure-response relationships for health effects of microbial bioaerosols - A systematic review
2015, International Journal of Hygiene and Environmental HealthCitation Excerpt :Six studies from farming workplaces were analyzed by the bioaerosol expert network. None of the six evaluated studies are appropriate for derivation of exposure limits because of insufficient exposure data (V1) (Cormier et al., 2000; Eduard et al., 2009; Heederik et al., 1991; Malmberg et al., 1993; Rimac et al., 2010), missing evaluation of dust measurements (V2) (Heederik et al., 1991; Malmberg et al., 1993; Sabino et al., 2012), inappropriate or insufficient health endpoints (V5) (Rimac et al., 2010; Sabino et al., 2012) and missing indicator parameters (V6) (Cormier et al., 2000; Heederik et al., 1991; Malmberg et al., 1993). However, three studies demonstrated exposure data on possible indicator parameters for the workplace farming (Eduard et al., 2009; Rimac et al., 2010; Sabino et al., 2012).
Attempts to reduce exposure to fungi, β-glucan, bacteria, endotoxin and dust in vegetable greenhouses and a packaging unit
2014, Science of the Total EnvironmentCitation Excerpt :For handling of straw, we have previously seen that increasing water content caused a decrease in dustiness in terms of endotoxin (Madsen and Nielsen, 2010). Avoiding exposure to the extremely high concentrations of endotoxin (3700 EU m− 3) and dust (15 mg m− 3) is important because exposure to very high concentrations of bioaerosols can cause diseases like ODTS and allergic alveolitis (Malmberg et al., 1993; Weber et al., 1993; Madsen et al., 2012). Clearing of cucumber plants is a task performed few times a year, and it is more important during clearing to protect the workers from acute health effects caused by very high short-term exposure than from health effects caused by repeated long-term exposure.
Supported by grants 83–0153, 84–0952, 85–1236, 85–0508 and 86–1229 from the Swedish Work Environment Fund.
Manuscript received May 22; revision accepted August 25.