Outbreak of Hypersensitivity Pneumonitis in an Industrial Setting
- Elizabeth D. Woodard, MD;
- Barry Friedlander, MD;
- Robert J. Lesher, PhD;
- Wallace Font, MD;
- Richard Kinsey;
- F. Terry Hearne, MS
Abstract
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)
Footnotes
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Reprint requests to Kodak Park Medical Department, Bldg 2, First Floor, 1669 Lake Ave, Rochester, NY 14656 (Dr Woodard).
