Symptoms of both include cough, fever, chills, fatigue, muscle pain, and loss of appetite 4-8 hours after exposure to spoiled plant materials such as moldy grain, feed, silage or hay. ODTS is also caused by confinement house dust and cotton dust. Farmer's lung, on the other hand, is more broadly known as hypersensitivity pneumonitis. It can affect anyone repeatedly exposed to certain molds, especially thermoactinomycetes or Aspergillus. Mushroom workers and bird breeders are some examples of occupations at risk for hypersensitivity pneumonitis. Air conditioners, humidifiers, and ventilation shafts are examples of places where mold could develop that could affect almost anyone. Floods have also raised concern about mold related illness. The Missouri Department of Health identified 19 cases associated with flooding during 1993 and 1994.
Farmer's Lung ODTS ------------- ---- characteristics allergic nonallergic onset 4-8 hrs after exposure 4-8 hrs after exposure resolution 2-5 days acute phase, 1-10 days, may recur with can become chronic or repeated exposure but fatal doesn't worsen, never fatal exposure to dusts low to high extremely high chest X-rays finely nodular densities usually normal of lower lung fields blood gas decreased oxygen (pO2) normal serum precipitins positive to thermoac- usually negative tinomycetes* lung function mild to severe restric- usually normal tion lung sounds crepitations, rales usually normal broncho lavage lymphocytes neutrophils treatment corticosteroids, other; treat symptoms, avoid avoid offending material offending material
* Caution must be used in interpreting these tests, since many farmers have antibodies to molds implicated in Farmers Lung, even if they do not have the disease.