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					POLICYHOLDER ADVOCATE                                                                                                         Page 34

                                    dust, chronic cough may de-      necessary so that the occur-
WHAT IS HY-                         velop with excessive sputum
                                    production containing pus, and
                                                                     rence of symptoms can be
                                                                     related to environmental ex-
                                                                                                       PENUMONITIS?


PERSENSITI                          eventually there may be
                                    chronic shortness of breath.
                                                                     posure. Laboratory tests of
                                                                     the patient’s blood and identi-
                                                                                                       Avoidance of the offending
                                                                                                       dust is the single most im-
                                                                                                       portant measure because in
VITY PNEU-                          The person may also show
                                    loss of appetite and weight
                                                                     fication of specific molds from
                                                                     material at the workplace may     the early stages the disease
                                                                                                       is   completely   reversible.
                                    loss.                            help. Chest X-ray films and
MONITIS?                            WHO GETS HYPERSENSI-
                                                                     lung function tests may show
                                                                     effects of the disease during     Most drugs are of limited
                                    TIVITY PNEUMONITIS?              acute episodes or in the          value in treatment; antihista-
by American Lung Asso-                                               chronic stage of the disease –    mines and bronchodilators
                                                                     but they may be normal be-        are ineffective. Steroids can
ciation                             Hypersensitivity pneumonitis
                                                                                                       relieve the symptoms of
                                    occurs most often in people      tween episodes when the pa-
                                                                     tient is without symptoms.        acute attacks but do not cure
                                    exposed to certain organic
                                                                     Also chest X-ray and pulmo-       the disease. Recovery from
                                    dusts in their daily work or
                                                                     nary function test results are    acute attacks may take as
                                    living, especially dusts which
                                                                     not specific for hypersensitiv-   long as three weeks. Residual
                                    contain fungus spores from
                                                                     ity pneumonitis, and positive     lung damage in the form
                                    mold.
Hypersensitivity pneumonitis                                         results may be due to other       of pulmonary fibrosis is per-
(also called allergic alveolitis)                                    causes. Inhalation of the ma-     manent and may occur even
                                    Only a small proportion of
is a disease in which the air                                        terials to which the person is    after symptoms have disap-
                                    people who are exposed, per-
sacs (alveoli) of the lungs be-                                      sensitive (challenge test) may    peared. Avoiding exposure in
                                    haps 5 to 20 percent, develop
come inflamed when certain                                           be necessary to confirm the       the first place eliminates any
                                    the disease. When there is
dusts are inhaled to which the                                       diagnosis. The challenge test     possibility of later permanent
                                    frequent exposure to high
person is sensitized or allergic.                                    should be done only under the     damage.
                                    concentrations of the offend-
                                    ing substances, the likelihood   expert medical supervision of
These dusts contain organic                                          a specialist. Sometimes, a        DOES SMOKING AFFECT
                                    of developing hypersensitivity
substances, such as fungus                                           lung biopsy is needed to dis-     HYPERSENSITIVITY
                                    pneumonitis    is    greatest.
spores from moldy hay or the                                         tinguish it from other lung       PNEUMONITIS?
droppings         of      birds.    WHAT CAUSES HYPERSEN-            diseases.
When a person inhales such                                                                             There is no evidence that
                                    SITIVITY PNEUMONITIS?
dusts the first time, no prob-                                       IS    HYPERSENSITIVITY            cigarette    smoking     helps
lem is noticed. But, after re-                                       PNEUMONITIS  PREVENT-             cause hypersensitivity pneu-
peated exposure to the dust         The disease is caused by or-     ABLE?                             monitis. It may, however,
some people may develop             ganic material that is inhaled                                     aggravate the symptoms of a
symptoms. The tiny air sacs in      as a fine dust. Sensitization    Properly dried and stored farm    person who has the disease.
the lung known as alveoli be-       (allergy) develops over a pe-    products are unlikely to cause    And smokers are likely to get
come inflamed, their walls fill     riod of several months to a      hypersensitivity  pneumonitis     complicating lung diseases,
with white blood cells, and         number         of       years.   because the particular organ-     such as emphysema, chronic
sometimes the sacs fill with                                         ism causing farmer’s lung         bronchitis, or lung cancer
fluid. If the disease recurs as     Farmer’s lung is the best-       grows only in moist condi-        http://www.lungusa.org/site/
a result of continued or re-        known example. It is caused      tions. Other approaches to        pp.asp?
peated exposure to the of-          by an organism that grows on     prevention are to reduce ex-      c=dvLUK9O0E&b=849121
fending dusts, parts of the         hay, straw, or grains, and by    posure by proper ventilation
lung may develop fibrous scar       other organic materials found    and the use of respiratory
tissue and can no longer func-      on farms. Also known to cause    protection            (masks).
tion normally in breathing.         hypersensitivity   pneumonitis
                                    are dusts from moldy sugar       If a worker begins to have
WHAT ARE         THE     SYMP-      cane and barley, maple bark,     symptoms of hypersensitivity
TOMS?                               cork, animal hair, bird feath-   pneumonitis due to occupa-
                                    ers and droppings, mushroom      tional exposure, the process
The symptoms of an acute            compost, coffee beans, and       can be stopped if it is identi-
attack are similar to those of      paprika. Often the disease is    fied early enough. Permanent
the flu and appear some 4-6         named for the occupations:       lung damage is prevented by
hours      after   the    person    for     example     mushroom-    eliminating the exposure. If
breathes the offending dust.        worker’s lung or paprika-        control measures do not work
These      symptoms      include    splitter’s lung. The organism    or are not feasible, it may be
chills, fever, dry cough, short-    of farmer’s lung also grows in   necessary to change jobs,
ness of breath, a tight feeling     the water of both commercial     even though doing so may be
in the chest, and tiredness.        and home humidification sys-     difficult for many reasons.
The symptoms may persist for        tems, particularly if they are   Therefore the medical neces-
as little as 12 hours or as long    not adequately maintained.       sity for a change should be
as 10 days. Between attacks                                          determined only after careful
the person may have no              HOW IS HYPERSENSITIV-            evaluation to establish the
symptoms and feel quite nor-        ITY PNEUMONITIS DIAG-            diagnosis and specific cause.
mal.                                NOSED?
                                                                     WHAT CAN BE DONE TO
After repeated exposure to the      A careful, detailed history is   TREAT HYPERSENSITIVITY

				
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