AgDARE - Agricultural Disability Awareness and Risk Education

Farmer's Lung - Supplemental Activity 1

Case Report

Materials needed: Case report (Dairy Farmer Diagnosed with Farmer's Lung)

Time required: 15 minutes

Divide the students into groups of five to seven. Tell the students they are going to hear a real story about a farmer with hypersensitivity pneumonitis. Assign one or two students to read aloud the case report "Dairy Farmer Diagnosed with Farmer's Lung."

After reading the report, have the students discuss and answer the following questions as a group:

1. What actions caused the disease?	Working in moldy dusty hay without respiratory protection
2. How could the illness have been avoided?	Mr. Early could have used methods to decrease his exposure to the molds and dust by lightly spraying the hay with oil before he chopped it. He could have used ventilation, making certain the airflow was away from him (back to front of his body) to carry the dusts and molds away from his breathing zone. He could have used a 2 strap particulate dust mask.
3. How did the injury affect his life?	He had medical expenses, lost work time, and his symptoms reoccur.
4. How did the injury affect the family?	His daughter had to do his job while he recovered. Medical expenses affected the family's finances.
5. How would you have handled the situation?

Case Report: Dairy Farmer Diagnosed with Farmer's Lung

Source: New York Center for Agricultural Medicine and Health (www.nycamh.com)

Summary:
Mr. Early is a 47 year old dairy farmer. He has farmed all his life in upstate New York. He never wore respiratory protection for any of his farm work and had never experienced any breathing problems until one day last year.

What happened:
Mr. Early remembers it well. "It was really bad. I had symptoms…my bones ached, I would get hot …so hot until I would get the chills with it, and I got a fever. This went on 3 or four weeks, until finally I got so short of breath doing just about anything. One day I was in the barn feeding the cows and I couldn't push the feed cart. I had to sit down right there and try to catch my breath."

Diagnosis:
Convinced that he had to see a doctor, Mr. Early visited a local medical facility where he was diagnosed with bronchitis and asthma. He was treated with antibiotics twice but did not get better. Finally, he sought treatment from another medical facility known for treating respiratory illnesses. He underwent tests and was diagnosed with Farmer's Lung. The source of his problem was most likely chopping moldy, dusty hay that he had been working in without respiratory protection. His symptoms had started several hours after he had been chopping the hay to use as bedding for his cows. He says, "I ended up in the hospital for tests. They put this thing on my finger that measured the oxygen in my body and it was only 84%. They put me on oxygen and medicines for about a week in the hospital. I had these tests to see how well I could breath and I improved from 50% to 90%. Dr. John told me that I needed to wear a respirator whenever I was working in dust and he gave me a mask. It helps a lot. I forgot it one time when I was working on some brake pads and I just couldn't breath. I've remembered it from then on."

Farm work after diagnosis:
Mr. Early couldn't return to his farm work right away. "I had to ease back in it. When I went home I had an extra weekend I didn't have to go in the barn because my daughter was home from college and so she did my work." Gradually Mr. Early was able to return to full capacity on the farm, but family members had to cover for him until he recovered.

What does he do differently now on the farm? "I wear that mask whenever I am in dust. I always wear it when I throw the lime under the cows and when I run the chopper. Anything I do that's dusty, it brings back the symptoms." Mr. Early is quick to point out that his mask is NIOSH approved and has two straps. He fits the mask to his face to prevent leaks that would let the dust in.

Mr. Early had farmed all his life without breathing problems. He had chopped moldy, dusty hay before. But that day last year it caught up with him. And now the damage is done. He can prevent further damage to his lungs by wearing appropriate respiratory protection. He knows what to do and he does it. He knows if he doesn't he will be sick and eventually his lungs will be damaged so much he won't be able to work. He is no longer willing to take that risk.

Discuss these questions with your group:

1. What actions caused the disease?

2. How could the illness have been avoided?

3. How did the injury affect his life?

4. How did the injury affect the family?

5. How would you have handled the situation?

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