Abstract
Organic dust toxic syndrome (ODTS) and hypersensitivity pneumonitis (HP) are associated with inhalation of high concentrations of organic materials, particularly agricultural materials such as dust from grain, hay, or silage contaminated with microorganisms (Pratt and May 1984; Lecours,et al. 1986; May et al. 1986; Pratt et al. 1990). Although initial work was associated with farming, one should recognize that workers involved in wood processing, large-scale production of animal feed, treatment and disposal of sewage and garbage by composting, and various bioindugtrial processes may be exposed to high concentrations of microorganisms and their products. HP, also known as extrinsic allergic alveolitis, has been recognized for a very long time and occurs in a variety of occupational settings (Parker et al. 1992). Farmer’s lung disease (FLD) is the most familiar form of HP in agriculture. The term “pulmonary mycotoxicosis” was applied to ODTS to differentiate it from FLD and to underscore the apparent importance of fungi and/or their metabolic products (Emanuel et al. 1975). Attempts to implicate mycotoxins in the syndrome were limited, in both number and scope, and failed to reveal significant amounts of those few mycotoxins which were sought in dust samples collected from outbreaks of ODTS (May et al. 1986). New mycotoxins continue to be described and the fumonisins, for example, now considered an especially important group because of the frequency of their occurrence and the severity of their toxicity, were not known until 1988. The presence of high levels of fungi and bacteria in the dust has since been found to be a hallmark of the syndrome (Dutkiewicz et al. 1989; Olenchock et al. 1990). ODTS is a noninfectious flu-like illness, and is characterized by fever, malaise, myalgia, and a neutrophilic inflammation of the lower respiratory tract (Lecours et al. 1986; Parker et al. 1992). Hypersensitivity pneumonitis (HP) has many features in common with ODTS, including similar exposure settings and clinical symptoms (Emanuel et al. 1975; Pratt and May 1984; Parker et al. 1992). Although both illnesses appear to involve inflammation of lung parenchyma, they may not be mediated by the same mechanisms. Notably, HP is characterized by a lymphocytic infiltrate into the lower airways, suggesting that it may be due to a cell-mediated hypersensitivity reaction. Prevalence of HP in individuals chronically exposed to potential antigens ranges from 0.03 or 0.42% in farming populations to as much as 15% in office workers exposed to contaminated ventilation systems (Parker et al. 1992).
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Sorenson, W.G., Lewis, D.M. (1996). Organic Dust Toxic Syndrome. In: Howard, D.H., Miller, J.D. (eds) Human and Animal Relationships. The Mycota, vol 6. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-10373-9_8
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