0
April 1, 1988, Vol 259, No. 13 >
ARTICLE | April 1, 1988

Outbreak of Hypersensitivity Pneumonitis in an Industrial Setting FREE

Elizabeth D. Woodard, MD; Barry Friedlander, MD; Robert J. Lesher, PhD; Wallace Font, MD; Richard Kinsey; F. Terry Hearne, MS
[+] Author Affiliations

Reprint requests to Kodak Park Medical Department, Bldg 2, First Floor, 1669 Lake Ave, Rochester, NY 14656 (Dr Woodard).


JAMA. 1988;259(13):1965-1969. doi:10.1001/jama.1988.03720130029025
Text Size: A A A
Published online
Article
References

Symptoms consistent with hypersensitivity pneumonitis developed in several workers in two multistory buildings in an industrial complex. A health questionnaire survey was conducted to determine the extent of the problem. Eighty-seven percent of the population of 1050 employees completed the health questionnaire. Serological testing identified 152 positive precipitin reactors to the fungus Aureobasidium pullulans; 115 reactors were symptomatic. The clinical and laboratory features at the time of the acute illness and during four years of follow-up are described. The agent, A pullulans, was identified as a contaminant of the heating-cooling ventilation units containing open water-spray chambers. Control was accomplished by replacement of the ventilation systems. A secondary source of antigen was found to be corrugated cardboard. Some sensitized employees required removal from work exposure to corrugated cardboard to prevent recurrent symptoms.

(JAMA 1988;259:1965-1969)

REFERENCES

1 +
Ramazzini B: DeMorbis Artificum Diatriba, 1713 . University of Chicago Press, 1940;.
2 +
Campbell JM:  Acute symptoms following work with hay. Br Med J 1932;;2:1143-1166.
3 +
Salvaggio JE:  Diagnosis and management of hypersensitivity pneumonitis. Hosp Pract 1980;;15:93-103.
4 +
Bernardo J, Center D:  Hypersensitivity pneumonia. DM , (May) 1981;.
5 +
Schlueter DP:  Infiltrative lung disease hypersensitivity pneumonitis. J Allergy Clin Immunol 1982;;70:50-55.
6 +
Reed CE, DeShazo R:  Immunologic aspects of granulomatous and interstitial lung diseases. JAMA 1982;;248:2683-2691.
7 +
Banaszak EF, Thiede WH, Fink JN:  Hypersensitivity pneumonitis due to contamination of an air conditioner. N Engl J Med 1970;;283:271-276.
8 +
Ganier M, Lieberman P, Fink J, et al:  Humidifier lung. Chest 1980;;77:183-187.
9 +
Cockcroft A, Edwards J, Bevan C, et al:  An investigation of operating theatre staff exposed to humidifier antigens. Br J Ind Med 1981;;38:144-151.
10 +
Reed CE, Swanson MC, Lopez M, et al:  Measurement of IgG antibody and airborne antigen to control an industrial outbreak of hypersensitivity pneumonitis. J Occup Med 1983;;25:207-210.
11 +
Edwards JH:  Microbial and immunological investigations and remedial action after an outbreak of humidifier fever. Br J Ind Med 1980;;37:55-62.
12 +
Hodgson MJ, Morey PR, Simon JS, et al:  An outbreak of recurrent acute and chronic hypersensitivity pneumonitis in office workers. Am J Epidemiol 1987;;125:631-638.
13 +
American Thoracic Society:  Snowbird workshop on standardization of spirometry. Am Rev Respir Dis 1979;;119:831-838.
14 +
Knudson RJ, Slatin RC, Lebowitz MD, et al:  The maximal expiratory flow-volume curve: Normal standards, variability and effects of age. Am Rev Respir Dis 1976;;113:587-600.
15 +
Cohen H, Merigan T, Kosek J, et al:  Sequoiosis. Am J Med 1967;;43:785-794.
16 +
Sayer WJ, MacKnight NM, Wilson HW:  Hospital airborne bacteria as estimated by the Andersen sampler versus the gravity settling culture plate. Am J Clin Pathol 1972;;58:558-562.
17 +
Friend JA, Gaddie J, Palmer KN, et al:  Extrinsic allergic alveolitis and contaminated cooling water in a factory machine. Lancet 1977;;1:297-300.
18 +
Burke GW, Carrington CB, Strauss R, et al:  Allergic alveolitis caused by home humidifiers. JAMA 1977;;238:2705-2708.
19 +
Morgan DC, Smyth J, Lister R, et al:  Chest symptoms and farmer's lung: A community survey. Br J Ind Med 1973;;30:259-265.
20 +
Lee TH, Wraith DG, Bennett CO, et al:  Budgerigar fancier's lung. Clin Allergy 1983;;13:197-202.
21 +
Richerson HB:  Hypersensitivity pneumonitis—pathology and pathogenesis. Clin Rev Allergy 1983;;1:469-486.
22 +
Storm WW:  Occupational hypersensitivity lung disease. J Occup Med 1978;;20:823-824.
23 +
Hodges GR, Fink J, Schleuter DP:  Hypersensitivity pneumonitis caused by a contaminated cool-mist vaporizer. Ann Intern Med 1974;;80:501-504.
24 +
Metzger WJ, Patterson R, Fink J, et al:  Sauna-taker's disease: Hypersensitivity pneumonitis due to contaminated water in a home sauna. JAMA 1976;;236:2209-2211.
25 +
Belin L:  Clinical and immunological data on wood trimmer's disease in Sweden. Eur J Respir Dis 1980;;107:169-176.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Ramazzini B: DeMorbis Artificum Diatriba, 1713 . University of Chicago Press, 1940;.
2 +
Campbell JM:  Acute symptoms following work with hay. Br Med J 1932;;2:1143-1166.
3 +
Salvaggio JE:  Diagnosis and management of hypersensitivity pneumonitis. Hosp Pract 1980;;15:93-103.
4 +
Bernardo J, Center D:  Hypersensitivity pneumonia. DM , (May) 1981;.
5 +
Schlueter DP:  Infiltrative lung disease hypersensitivity pneumonitis. J Allergy Clin Immunol 1982;;70:50-55.
6 +
Reed CE, DeShazo R:  Immunologic aspects of granulomatous and interstitial lung diseases. JAMA 1982;;248:2683-2691.
7 +
Banaszak EF, Thiede WH, Fink JN:  Hypersensitivity pneumonitis due to contamination of an air conditioner. N Engl J Med 1970;;283:271-276.
8 +
Ganier M, Lieberman P, Fink J, et al:  Humidifier lung. Chest 1980;;77:183-187.
9 +
Cockcroft A, Edwards J, Bevan C, et al:  An investigation of operating theatre staff exposed to humidifier antigens. Br J Ind Med 1981;;38:144-151.
10 +
Reed CE, Swanson MC, Lopez M, et al:  Measurement of IgG antibody and airborne antigen to control an industrial outbreak of hypersensitivity pneumonitis. J Occup Med 1983;;25:207-210.
11 +
Edwards JH:  Microbial and immunological investigations and remedial action after an outbreak of humidifier fever. Br J Ind Med 1980;;37:55-62.
12 +
Hodgson MJ, Morey PR, Simon JS, et al:  An outbreak of recurrent acute and chronic hypersensitivity pneumonitis in office workers. Am J Epidemiol 1987;;125:631-638.
13 +
American Thoracic Society:  Snowbird workshop on standardization of spirometry. Am Rev Respir Dis 1979;;119:831-838.
14 +
Knudson RJ, Slatin RC, Lebowitz MD, et al:  The maximal expiratory flow-volume curve: Normal standards, variability and effects of age. Am Rev Respir Dis 1976;;113:587-600.
15 +
Cohen H, Merigan T, Kosek J, et al:  Sequoiosis. Am J Med 1967;;43:785-794.
16 +
Sayer WJ, MacKnight NM, Wilson HW:  Hospital airborne bacteria as estimated by the Andersen sampler versus the gravity settling culture plate. Am J Clin Pathol 1972;;58:558-562.
17 +
Friend JA, Gaddie J, Palmer KN, et al:  Extrinsic allergic alveolitis and contaminated cooling water in a factory machine. Lancet 1977;;1:297-300.
18 +
Burke GW, Carrington CB, Strauss R, et al:  Allergic alveolitis caused by home humidifiers. JAMA 1977;;238:2705-2708.
19 +
Morgan DC, Smyth J, Lister R, et al:  Chest symptoms and farmer's lung: A community survey. Br J Ind Med 1973;;30:259-265.
20 +
Lee TH, Wraith DG, Bennett CO, et al:  Budgerigar fancier's lung. Clin Allergy 1983;;13:197-202.
21 +
Richerson HB:  Hypersensitivity pneumonitis—pathology and pathogenesis. Clin Rev Allergy 1983;;1:469-486.
22 +
Storm WW:  Occupational hypersensitivity lung disease. J Occup Med 1978;;20:823-824.
23 +
Hodges GR, Fink J, Schleuter DP:  Hypersensitivity pneumonitis caused by a contaminated cool-mist vaporizer. Ann Intern Med 1974;;80:501-504.
24 +
Metzger WJ, Patterson R, Fink J, et al:  Sauna-taker's disease: Hypersensitivity pneumonitis due to contaminated water in a home sauna. JAMA 1976;;236:2209-2211.
25 +
Belin L:  Clinical and immunological data on wood trimmer's disease in Sweden. Eur J Respir Dis 1980;;107:169-176.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems