Farmer’s Lungs Disease: It’s Take A Breath Away!

Abstract

Farmers were evaluated for the presence of farmer’s lung disease by serologic methods and by clinical histories. Farmer’s  lung  disease  (FLD)  is  a  form  of  hypersensitivity  pneumonitis  (HP)  caused  by  inhaling  microorganisms  from  hay  or  grain  stored  in  conditions  of  high  humidity  in  the  agricultural  workplace. The  epidemiology  of  the  disease  is  not  well  known,  and  is  based  on  studies  conducted  by  Central European  and  Asian  groups. The  clinical  presentation  may  vary,  differentiating  the  chronic  (exposure  to  lower  concentrations  of the  antigen  over  a  longer  period  time)  and  the  acute  forms  (after  exposure  to  high  concentrations  of the  antigen). It  is  more common  in  middle-aged  men,  although  this  probably  reflects  differences  in  exposure  levels.  It  is  also  more  common  in  non-smokers, probably  because  tobacco  reduces  the  IgG  response  to  inhaled antigens,  affects  cytokine  production,  and  alters  macrophage function. The etiology of the disease is clear - the inhalation of mouldy hay dust - and much can be done to prevent it ifthis is borne in mind. Mouldy hay dust is a very complex material consisting of innumerable fungal spores, hyphae and bacteria and fragments of vegetable matter. The treatment of FLD is based mainly on avoiding exposure to the antigen. This is the only measure that has been shown to delay disease progression. Corticosteroids are traditionally recommended in patients with impaired lung function and beta agonist and alpha blockers are also helpful in the treatment of disease.