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Hypersensitivity pneumonitis in peat moss processing plant workers

Y Cormier¹, E Israël-Assayag, G Bédard

¹Unité de Recherche, Centre de Pneumologie, Hôpital and Université Laval, Ste-Foy, Québec, Canada.

American Journal of Respiratory and Critical Care Medicine

|August 12, 1998

Summary

This study identified a new cause of hypersensitivity pneumonitis (HP) in peat moss packaging workers. Smoking appeared to protect against developing HP and antibodies to mold antigens.

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Area of Science:

Environmental and Occupational Medicine
Pulmonary Medicine
Immunology

Background:

Hypersensitivity pneumonitis (HP) is an immune-mediated lung disease caused by inhaled antigens.
Occupational exposures in agricultural settings are known causes of HP.
The role of specific environmental exposures and host factors in HP development requires further investigation.

Observation:

A nonsmoking worker in a peat moss packaging plant developed HP.
Analysis of peat moss revealed high concentrations of Monocillium sp. and Penicillium citreonigrum.
Workers exposed to peat moss showed varying immune responses, with smokers exhibiting fewer antibodies to detected fungi.

Findings:

HP was diagnosed in two workers, both nonsmokers or minimal smokers.

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Serological testing revealed antibodies to Monocillium and Penicillium in nonsmokers and minimal smokers, but not in heavy smokers.

Asymptomatic seropositive workers showed lymphocytic alveolitis on bronchoalveolar lavage (BAL), while smokers had normal BAL findings.

Implications:

Peat moss packaging environments represent a previously unrecognized source of occupational HP.
Smoking may have a protective effect against the development of hypersensitivity pneumonitis and specific immune responses to mold antigens.
Further research is needed to elucidate the mechanisms behind smoking's protective effect in occupational lung diseases.