Brass Instruments Can Cause Lung Disease

[Guest guest]

Brass Instruments Can Cause Lung Disease

Musicians Say Spit and Foul Breath Can Linger in Instrument's Plumbing, Causing

Mold, Bacteria

http://abcnews.go.com/Health/study-brass-wind-instruments-allergic-lung-disease/\

story?id=11569520

7 comments By SUSAN DONALDSON JAMES

Sept. 7, 2010

That saxophone player can sure play the blues, but his instrument may be getting

green.

Brass musicians may unknowingly inhale mold and bacteria from their instruments,

which may lead to the development of hypersensitivity pneumonitis (HP),

according to a study published today in Chest magazine.

The allergic lung condition, which can develop into a more dangerous fibrosis,

is characterized by shortness of breath and coughing.

In two separate reports, researchers from the United States and Europe

identified cases of HP in a 35-year-old patient who played the trombone and in a

48-year-old saxophone player.

In both cases, patients had no other medical or environmental exposures that

seemingly could have led to the condition.

In the French and Belgian study, a 48-year-old office clerk who played saxophone

as a hobby was diagnosed with HP. A white collar worker, he had played the

instrument as a hobby and had experienced symptoms for five months. Later, two

molds were found in his saxophone.

American scientists at University of Connecticut Health Center and University of

Texas Health Science Center at Tyler documented the case of a 35-year-old with

" trombone player's lung. " He had a nonproductive cough for 15 years with no

other medical explanation.

When he stopped playing for two weeks, the symptoms lifted. Later, his

instrument was found to be contaminated with fungal and elements and bacteria.

Neither man had allergies or exposure to allergens like pets or drugs. When each

musician cleaned his instrument, the symptoms of HP disappeared.

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Kids With Food Allergies Researchers speculate that since most brass and wind

instruments may harbor large numbers of mold and bacteria, many other musicians

could be at risk for HP.

" This isn't shocking, nor do I think it's very common, " said Dr. Blaser,

chairman of medicine at New York University and a specialist in infectious

diseases. " My guess is these are isolated events and somebody got unlucky. "

" But maybe some instruments are brewing something and perhaps it's a harbinger

of a bigger problem, " he said.

Hypersensitivity pneumonitis is a general term that refers to inflammation of

lung tissue, according to the Mayo Clinic

Although pneumonia is technically a type of pneumonitis because the infection

causes inflammation, most doctors are referring to other causes of lung

inflammation when they use the term " pneumonitis. "

Factors that can cause pneumonitis include exposure to airborne particles in the

workplace, such as asbestos or silica; some drugs, particularly chemotherapy

ones; radiation therapy to the chest, exposure to poultry, pigeons or pet birds;

and many types of mold.

Because of the association with birds and with chemicals, the condition is

sometimes referred to as " farmer's lung " or " hot tub lung. " Sometimes ingested

food or liquid can also cause pneumonitis.

Symptoms include difficulty breathing, often with a cough, and sometimes fever,

but specialized tests are necessary to make a diagnosis. For many people, the

offending substance causing the inflammation is never identified.

" HP is just what it sounds like, " said Blaser. " It's a hypersensitivity or

allergic phenomena that causes an inflammation of the lungs and has been

described for a long time with many different causes. "

" Generally, there are environmental causes, such as the classic one with people

who are exposed to moldy grain in silos or cotton fibers or certain other

molds, " he said. " Sometimes it's certain metals like beryllium. "

Doctors, Band Directors Advise Cleaning Instrument

These allergies can be dangerous and progressive, causing fibrosis of the lung,

but usually it's only an acute disease, according to Blaser.

Arthur Goodridge, 61, is a composer and professional flutist and saxophone

player from Medford, Mass. He said he is not surprised that scientists have

found a link between brass wind instruments and lung disease.

(Courtesy Sally )Doctors have long known about hypersensitivities to the

brass dust in metal factories, he said.

" People always thought it was the metal itself, but maybe it's the mold, " said

Blaser. " It's either due to the metal, the mold or the action of the metal. All

three are possibilities. "

When American researchers examined the study subject's trombone, they found

large number of microbacteria. After immersing his instrument in 91 percent

isopropyl alcohol, the man saw his cough disappear and he has been symptom free

for 20 months.

The association between disease and wind instruments, such as the trombone,

trumpet, French horn, tuba and saxophone, seems counterintuitive. Anecdotally,

wind instrument musicians have reported a greater lung capacity and even

improved asthma because of their musical hobbies.

A 2009 study of orchestras in Croatia suggested that these musicians may be

susceptible to chronic upper airway symptoms. Interestingly wind instrument

playing may be associated with higher than expected lung function parameters.

Popular saxophone player Kenny Gcan reportedly hold a note for up to 20 minutes.

Other wind artists practice so-called " circular breathing " that allows them to

inhale and exhale simultaneously.

But professionals know the brass instrument, which can't be swabbed out like a

woodwind, can harbor more than just breath.

Greg McCutcheon, a clarinet player and director of bands at Birdville

Independent School District outside Fort Worth, Texas, tell his middle school

musicians to rinse out their mouths before picking up their instruments.

" Whatever they eat before they play, even chewing gum, all the sugar gets blown

into the instrument, " said McCutcheon. " All that stuff gets stuck and is sitting

there over time. "

" In high school, the kids who are serious about playing brush their teeth before

they play, " he said.

A hot, humid climate like that in Texas can also wreak havoc with brass

instruments, according to McCutcheon, 29. " When I taught in Houston, our schools

would turn the air-conditioning off and a lot of the instruments got mold on

them. It was gross. There was mold inside and out and we had to send them in for

a 'chemical' repair. "

Arthur Goodridge, a saxophone and flute player from Medford, Mass., said he,

too, is not surprised some brass players develop HP.

The 61-year-old has been playing since he was in the fourth grade and said he

would " definitely pay attention " to any symptoms of lung disease.

" My brother and sister and cousin played trombone, " said Goodridge. " My cousin

was never hospitalized, but he had some breathing problems that were never

diagnosed when he was in his late 30s. "

Goodridge, who composed a tribute to Miles that was performed by renowned

jazz trumpeter Tiger Okoshi, cleans his mouthpiece every day and his instrument

after each use.

That, says one doctor, is prudent.

" This is a rare problem if a problem at all, " said Dr. Myron Cohen, director of

the University of North Carolina Center for Infectious Diseases. " Just clean the

instruments. "

[Guest guest]

I used to play the flute (silver, not brass) and always thought it smelled a

little " funny " to me. I would think this article would also apply to all mouth

instruments, even the harmonica. Very interesing. D

>

> Brass Instruments Can Cause Lung Disease

> Musicians Say Spit and Foul Breath Can Linger in Instrument's Plumbing,

Causing Mold, Bacteria

>

>

http://abcnews.go.com/Health/study-brass-wind-instruments-allergic-lung-disease/\

story?id=11569520

>

> 7 comments By SUSAN DONALDSON JAMES

> Sept. 7, 2010

>>

> That saxophone player can sure play the blues, but his instrument may be

getting green.

>

> Brass musicians may unknowingly inhale mold and bacteria from their

instruments, which may lead to the development of hypersensitivity pneumonitis

(HP), according to a study published today in Chest magazine.

>