Causes and Symptoms of Mold and Dust Induced Respiartory Illness From NIH site

[Guest guest]

Now let me get this straight: If I am a farmer excessively exposed to mold

and exhibiting the following symptoms then I have a legitimate physical

illness that needs physical treatment. But if I am a housewife, office worker

or

school teacher excessively exposed to mold and exhibiting these exact same

symptoms, then the appropriate treatment for me is psychotherapy and prozac!

Huh? From the NIH Website:

Causes and Symptoms of Mold and Dust Induced Respiratory Illness

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.pdf)

Glen H. Hetzel, J.

Virginia ative Extension

Table of Contents

_Introduction_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#l1)

_What is Farmer's Lung?_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#l2)

_What Are These Mold Spores and Why Are They So Dangerous?_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#l3)

_Symptoms of Lung Disease and State of Illness_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#l4)

_How to Tell If You Have Farmer's Lung_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#l5)

_Medical Treatment_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#l6)

_Measures Farmers Can Take_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#l7)

_More Information About Farmer's Lung_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#l8)

____________________________________

Introduction

Who Needs to Know About Respiratory Illnesses?

* those working in dusty fields or buildings

* those handling moldy hay

* those working in silos

* those feeding or working with feedstuffs

* those working in corn silage

* those uncapping silos

* those cleaning grain bins

* those exposed to bird droppings or feather, hair, or fur dust

* those exposed to fish meal

Farmers account for more than 30% of adults disabled by respiratory illness,

yet a large percentage of farmers are nonsmokers. If you work in any one of

these situations, then you need to be aware of Farmer's Lung as well as other

respiratory hazards.

Farmer's Lung is only one of the respiratory hazards for farmers, but it is

a serious one. The number of farmers affected has also been increasing in

recent years. This results from a growing awareness among farmers and that they

have been seeing their physicians more frequently. The larger size of silos

accounts for much of the increase.

Return to _Table of Contents_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#toc)

____________________________________

What is Farmer's Lung?

Farmer's Lung is a noninfectious allergic disease caused by inhaling dust

from moldy hay, straw or grain. It is a disease because the body reacts to the

invading contaminants (mold spores) which the body's immune system cannot

counteract.

The lungs allow oxygen to enter the bloodstream and carbon dioxide to exit

the bloodstream. They are the location for a vital process for good health;

but they are also the quickest and most direct route for hazardous contaminants

to enter the body and the bloodstream. The results from exposure to mold

spores can be so debilitating that some farmers are even forced to leave the

occupation completely.

Return to _Table of Contents_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#toc)

____________________________________

What are These Mold Spores and Why are They so Dangerous?

Mold spores are tiny bacteria less than 4 microns in size -- so small that

as many as 250,000 spores can fit on a pin head and a farmer can inhale as

many as 750,000 of these spores per minute! They are produced by microorganisms

which grow in moist hay and stored grain silage where the moisture content

is high (30%) and the area is poorly ventilated.

When farmers move or work with hay and silage materials in which mold spores

have grown, the mold spores attach themselves to airborne dust particles.

The farmer not only inhales dust particles which may not be extremely

hazardous, but he also inhales mold spores which are a serious hazard. Heavy

concentrations of mold spores appear as dry, white or grey powder or clouds.

The body has natural defense filtering systems (such as mucous lining,

coughing and sneezing) against dusty air which helps remove some contaminants,

BUT

most contaminants overpower and pass through these defenses. Mold spores not

only bypass defenses because of their number, but also because they are so

small.

Very fine particles, like mold spores, move into, accumulate and settle into

the lower lungs. There they produce toxins. Remember that the lungs transfer

oxygen to the bloodstream, and most of the actual exchange of carbon dioxide

and oxygen takes place in the lower lungs. Now the lungs become a roadway

for toxic materials to travel through the bloodstream with the oxygen. The

body's reaction to the toxins permanently affects the lungs' ability to

transfer

oxygen into the bloodstream. The lung tissue becomes permanently scared and

each exposure to mold spores increases the damage.

The body's last defense against these tiny invaders is to develop an allergy

producing cold or pneumonia-like symptoms.

Return to _Table of Contents_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#toc)

____________________________________

Symptoms of Lung Disease and State of Illness

The farmer will develop specific symptoms based upon the intensity of dust

and spores to which he has been exposed or the intensity of his body's

reaction to the dust and spores. He is also likely to develop an increased

sensitivity to mold exposure, having more severe reactions with fewer

exposures. In

all cases, each exposure aggravates the problem.

Acute State This is the most noticeable condition which typically begins 4 -

8 hours after exposure. Most farmers ignore the symptoms because they are so

similar to a common summer cold.

Typical Symptoms:

* fatigue

* chills

* shortness of breath

* tightness in the chest

Subacute State This is a more serious condition because symptoms will be

stronger and remain longer even with no further exposure to moldy dust

particles.

Typical Symptoms:

* severe shortness of breath with any exertion

* headache

* irritating cough

Chronic State This is the most serious condition because of its gradual

onset and its long-lasting debilitation. At the chronic state, the disease

becomes irreversible.

Typical Symptoms:

* chronic coughing

* progressively increasing and severe shortness of breath with even

the slightest exertion

* physical weakness

* occasional fever and sweating at night

* appetite depression

* general aches and pains

Typically farmers develop chronic Farmer's Lung slowly over time after

repeated exposure to mold spores because they continue to ignore the symptoms

of

acute attacks. However, it is possible to develop Chronic Farmer's Lung even

after one acute attack.

A delay in seeking medical help damages the farmer most. Often, by the time

a farmer sees a physician, there is already serious, permanent damage. And in

some cases scar tissue (pulmonary fibrosis) develops, further interfering

with the normal functions of the lungs.

Return to _Table of Contents_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#toc)

____________________________________

How to Tell if You Have Farmer's Lung

Self diagnosis is not recommended. Always check with your physician to

confirm your suspicions. However, here are some ways to tentatively diagnose

yourself:

* Have you experienced a sudden illness that developed a few hours

after you handled moldy crop material?

* Do you have a chronic cough?

* Do you have a general feeling of tiredness or depression?

Return to _Table of Contents_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#toc)

____________________________________

Medical Treatment

It is not enough to look at the list of symptoms and think that you may have

Farmer's Lung. You need to see your family physician. The list only helps

you recognize symptoms that might match and it is important not to ignore

them.

When you see your doctor, there are several things you can do to help

him/her diagnose you correctly. A doctor who is unfamiliar with farmers'

illnesses

or does not know you are a farmer can mistake the symptoms of Farmer's Lung

for a cold, asthma, flu or even pneumonia, and incorrectly diagnose your

illness.

Tell your doctor:

* you are a farmer and the type of farming you do

* if you have been exposed to moldy crop material

* what chemicals and/or dusts you work with

Then your doctor can do several things to confirm or disprove a tentative

diagnosis.

* take a blood test

* take a chest x-ray

* administer a breathing capacity test

* examine lung tissue

* administer an inhalation challenge

* perform an immunological investigation

* perform lung function testing

* review clinical history

Farmer's Lung can be controlled in many ways. One way for your doctor to

help control it is to give you symptomatic relief. But Farmer's Lung cannot be

cured. Unfortunately, there is no way to determine in advance if you are

immune.

Return to _Table of Contents_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#toc)

____________________________________

Measures Farmers Can Take Farmers can control or even minimize the

possibility of getting Farmer's Lung by several preventative measures:

Preventative Measures

* identify contaminants and hazards in the work environment

* minimize the amount and type of contaminants in the work environment

* avoid exposure to contaminants and mold spores and dust from decayed

grains and forages

* limit exposure to all contaminants

* operate within a controlled environment whenever possible (e.g.,

cab, control room, etc.)

* depend upon mechanical controls to remove air contaminants (e.g.,

fans, exhaust blowers, filters, etc.)

* have as much ventilation as possible in dusty areas

* move work outside whenever possible

* avoid dusty work in confined areas

* wear respirators, masks or other protective equipment

Management to Prevent Mold Spore Growth

* use mold inhibitors

* bale hay, ensile crops, harvest and store grain at recommended

moisture contents

* dry grain properly before storage

* properly ventilate storage buildings

* crops should be adequately ventilated to cool them down.

* always use a plastic sheet to cap open silos (not plant material)

holding down the edges with heavy weight (e.g. tires)

When You Must Work With Moldy Materials

* wet down feed before transferring to minimize dust

* convert to mechanical or automated feeding or feed handling systems

* wet down the top of the silo before uncapping ensiled material

* use some wetting techniques when cleaning out grain bins or other

dusty areas

* use respiratory protection when handling moldy or dusty materials.

If you decide to use some form of respiratory protection, then make sure

you use the appropriate device for the work task. Most farmers wear dust masks

to protect themselves from Farmer's Lung. This is the best and most

cost-efficient protection unless you know you will be exposed to extremely

high

levels of moldy dusts or you already have developed Farmer's Lung.

Those who have Farmer's Lung should talk to their doctor about the type of

equipment that will offer the most protection because every exposure increases

the risk of serious permanent damage.

Also, for any device you choose, make sure it fits well and is properly

maintained.

For more information about respiratory equipment, see your local extension

office or the publication on " Respiratory Protection. "

Return to _Table of Contents_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#toc)

____________________________________

More Information About Farmer's Lung

The chances of acquiring the disease are the greatest in late winter and

early spring. This is mainly because farmers feed the hay and grain materials

which have had a longer time to develop mold. Also, during those colder

months, farmers are likely to feed baled hay inside, and mold spores stay in

the

air inside a barn much longer. The amounts of mold spores a farmer will breathe

in such a confined space are much more concentrated. Unrolling large round

hay bales also may release mold spores.

Other times to be more careful about dusts that may contain higher levels

of mold spores are:

In late summer - while cleaning out grain bins before filling with new grain

In early winter- opening new silos may release mold spores from the top

layer of silage.

Return to _Table of Contents_

(http://www.cdc.gov/nasd/docs/d001201-d001300/d001270/d001270.html#toc)

Disclaimer and Reproduction Information: Information in NASD does not

represent NIOSH policy. Information included in NASD appears by permission of

the

author and/or copyright holder. _More_

(http://www.cdc.gov/nasd/disclaimer.html)

NASD Review: 04/2002

This publication was developed with funds form the Center for Disease

Control/National Institute for Occupational Safety and Health, Project UCS/CCU

306075-03-1.

October 1996

Authors: Glen H. Hetzel and J. , Agricultural Engineering Department,

Virginia Tech

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