TY - JOUR T1 - Farmer's lung - How much farming is required? A quantitative re-evaluation of eight cases of hypersensitivity pneumonitis attributed to indoor mould exposure JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P4013 AU - Henrik A. Kolstad AU - Zuzana Dornonville de la Cour AU - Simon Skov AU - Tine Halsen Malling AU - Elisabeth Bendstrup AU - Vivi Schlünssen Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P4013.abstract N2 - 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. ER -