Spring 2000
Agricultural
Health: info for health care
providers
Case History: Debbie H. is a 36 year old woman who lives in northwest Iowa. She is a nurse at the local hospital, and her husband farms and raises hogs. Debbie has had no previous history of health problems. Because she is a full time nurse, she does not work a lot on the farm. However, she does help every Monday when they sort out market weight hogs from the herd and load them out to the packing plant.
One evening after having loaded hogs, Debbie began to feel ill. She felt weak and tired, she coughed, her chest was tight, she had headaches, she had a fever of 103° F. The next morning, she felt a bit better, but she was not completely better until the following day. After that episode, Debbie has similar such attacks every time she helps to sort and load hogs.
Questions:
1) What
most likely is Debbie’s condition?
a) Farmer’s Lung
b) Allergic asthma
c) Chronic bronchitis
d) Organic dust toxic syndrome
2) How
could her condition be confirmed?
a) Pulmonary function test
b) Farmer’s Lung battery test of her blood serum
c) Lung biopsy
d) A well documented history of symptoms and exposure
e) Bronchioalveolar Levage
3) What is
the most likely cause of her condition?
a) Ammonia exposure
b) Dust exposure
c) Endotoxin exposure
d) Hydrogen Sulfide
e) Hog dander allergens
4) What
does continued exposure and occurrence of these symptoms mean for her long term health?
a) She will likely develop progressive lung scarring
(interstitial fibrosis) if she does not quit
b) She may have increasingly worse influenza-like symptoms, with
even less exposures.
c) She may develop Chronic Obstructive Pulmonary Disease (COPD).
d) There should be no concern in continuing as she has.
5) How can
these episodes be prevented?
a) Make environmental changes in the hog barn to decrease dust,
such as installing an oil sprinkling system, or more frequent power washing of the
building.
b) Don’t go in the building at all.
c) Wear a properly fitted dust mask, preferably a half face mask,
or a powered air supplying respirator such as the “air stream helmet.”
d) A combination of environmental changes and the use of properly
selected and fitted dust masks.
Comments:
All of the cases reviewed in this section are real. Specific names and locations are changed to protect the privacy of those affected. The Mid-March 2000 edition of “Successful Farming” came out with an article by Cheryl Tevis, entitled “Warning: Hog Confinements Pose Health Hazards.” The case described above is but one of many cases we have heard of as a result of this article. The problems are out there, we must be aware of what they are and how to diagnose and prevent them.