PT  - JOURNAL ARTICLE
AU  - Henrik A. Kolstad
AU  - Zuzana Dornonville de la Cour
AU  - Simon Skov
AU  - Tine Halsen Malling
AU  - Elisabeth Bendstrup
AU  - Vivi Schlünssen
TI  - Farmer's lung - How much farming is required? A quantitative re-evaluation of eight cases of hypersensitivity pneumonitis attributed to indoor mould exposure
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P4013
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P4013.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P4013.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Background Hypersensitivity pneumonitis is by definition caused by the inhalation of antigens, but limited quantitative data are available on exposure levels required to cause the disease.Objective To analyse exposure levels for mould spores in patients with clinical findings compatible with hypersensitivity pneumonitis and a history of indoor mould exposure.Methods We report eight consecutive patients diagnosed as hypersensitivity pneumonitis based on symptoms, high resolution computerized tomography, bronchoscopy, IgG findings, and self-reported mould exposure at home or work. Indoor and outdoor air samples from their dwellings or work sites were collected with slit to agar samplers, N6 Anderson samplers, and filter samplers used for quantification of moulds by the Camnea method. The concentration of fungi was calculated and expressed as colony forming units (CFU)/m3 and total spores/m3.Results The indoor air concentration of viable fungi was comparable with the outdoor air concentration, while the total spore concentration was moderately increased indoors compared with outdoors but significantly lower than previously measured in documented cases of hypersensitivity pneumonitis among farmers.Conclusion We question if the lung diseases of these patients were caused by mould exposure in their indoor environments and document the need for quantitative exposure measurements when diagnosing hypersensitivity pneumonitis in patients living or working outside environments with well-documented high mould exposure levels.