Beware Farmer’s Lung
September 5, 2006
INTRODUCTION
We as surveyors and engineers are naturally attracted to the outdoors. There are many surveying hazards that are known to us and we accordingly avoid the associated risks; yellow jackets, poison oak, pine straw on rocky slopes, sharpening bush axes, etc. I was recently subjected to a severe experience that can be fatal or only discomforting, depending upon the individual and the precise circumstances. Hopefully my experience can prove a benefit to others.
My experience was very close to the former and proved life changing. “Farmer’s Lung” is a respiratory disease normally associated with long erm exposure to hay storage, logistics and feeding livestock. Small amounts of spores enter the lungs over a long term and systematic basis resulting in cumulative damage to the blood vessels and the attached air sacs in the lungs. As time progresses the individual has reduced immunity to pneumonia and upper respiratory infections. This can continue many years with only reduced physical complications. Predominantly, the damage results from the particulate matter inhaled from dry hay and the mold spores resulting from hay mold, or hay that has been subjected to water or rainfall.
A DIRECT EXPERIENCE
I do not own livestock. The horses I feed are 350 CI Chevrolet race engines. The Friday beforeMemorial Day I began staking a roadway alignment for a two lot subdivision on the Cullman~Winston County line
1. I cut 150' of line and set control on Friday.
2 Tuesday after Memorial Day
I returned with my alignment computed in my Allegro, a 20' branch pruning tool and ready to
complete the centerline. I finished the curve to Smith Lake about 3:30 PM and loaded my gear
and returned to Cullman, about a 30 minute drive. Once I got unloaded, I felt my first symptom,
a feeling of dehydration (although it was hot that day I had consumed the liquids that are
normally required for me to function). My wife, Sue, had left work and came directly home ‘though often she stops and buys groceries on the way home.
The second symptom was a gurgling in my throat and the third intense pain in the center of my chest, all within 30 minutes. Paramedics transported me to Cullman Regional Hospital within 50 minutes of the third attack. The contact with the hay mold spores had occurred three weeks prior. Emergency and lung specialists treated me with antibiotics for two days with no affect and on the third day Intervention identified mold spores in my lungs.
1)
four(4) miles southwest of Crane Hill Post Office and on the west side of Smith Lake, a
remote site. 34-01-21"n, 87-06-42"w
2)
My practice, a single practitioner, is nearly identical to the one described by Milton
Denny in his recent article in POB.
THE DIAGNOSIS
The next three days I was unconscious. Tuesday night the ER physician told Sue I would not survive the night; however, ER nurses managed to keep me breathing. On Wednesday night the prognosis was the same and, unknown to me, the entire family was there in the waiting room to comfort Sue. All of this time, the treatment consisted of many antibiotics, for lime disease, legionnaire’s disease, et. al. My brother-in-law, Jim Holiday(3), was idly noting that a neighbor of his had suddenly taken ill just like I had; and before his family had gotten him to the ER he died. An autopsy was performed and revealed molded hay was the source of his unfortunate circumstance. Just by chance around 5:30 PM, Sue heard the word hay and remembered seeing 3 large round bales go by our house at Remlap and toward my brother’s new house. She called my brother who had just left the hospital via cell phone and found that I had participated in the distribution of those bales for erosion control purposes with my nephew. John and his grandson used our Kabota D-19 to carry the bales to the site and were above the work area. Sue got this word to Dr. Werner, a lung specialist, and Thursday a scope was inserted by Dr. Werner directly into my lungs and confirmed presence of ruptured blood vessels. Treatment then shifted to antibiotics and steroids. Dr. Werner had only seen two other cases like mine and neither had been close enough to the ER to receive treatment. So needless to say only by the grace of God am I sitting here writing this article.The next 75 days (of which five weeks I was on a ventilator, two weeks in Cullman and three
weeks at St Vincent’s in Birmingham) are tedious to describe and I will not attempt to do so
except to say as of this writing I have been home for 16 days. Rehabilitation will continue until
January 2007. This situation is the extreme.
PRECAUTIONS
Individuals can react differently to hay mold spores ; with 30% developing an allergic reaction. The severity is that only 1 in 3 transported to a hospital after an attack arrive alive. Many times physicians diagnose the individual with pneumonia since xrays of the lungs are identical and subsequently treat the individual with antibiotics. Farmer’s Lung or hay mold allergic reactions are not affected by antibiotics and the patient will not respond. The proper treatment consists of steroids and if untreated death will result. Regional hospitals, here and Birmingham, are now more aware of “Farmer’s Lung” and since I left Birmingham, at least one young man has benefitted from my experience. Do not allowyourself to breath dust originating from hay which has been subjected to rainfall. Also, the spores are very small. The average Lowe’s respiratory mask is insufficient. Avoid being downwind of landscaping activities of all kinds and any type of hydroseeding. You have a 30% chance of having an allergic reaction.
3 Jim is a descendent of the infamous gunfighter, “Doc” Holiday.
