J Pharm Pharmacol 32:517518, Sorenson WG, Simpson J, Castranova V (1985) Toxicity of the mycotoxin patulin for rat alevolar macrophages. It is important for clinical and investigational purposes that organic dust toxic syndrome be distinguished from acute farmer's lung. Organic toxic dust syndrome (OTDS): a flu-like illness that arises after heavy exposure to organic dust. Many agricultural workers are at risk for developing various respiratory illnesses due to regular exposure to inhaled dusts. Although a producer who has been exposed to silo gases may not experience symptoms, damage to the lungs may still have occurred. HEALTH EFFECTS OF ORGANIC DUST Agricultural workers may develop ODTS after inhaling dust from contaminated organic materials. Mold spores, which are not always visible, are so tiny that 250,000 spores can fit on the head of a pin. This process is experimental and the keywords may be updated as the learning algorithm improves. Etiology of ODTS usually from . (2004)Agri-Facts:Silo gas (NO2) safety. Unable to load your collection due to an error, Unable to load your delegates due to an error. Hypersensitivity pneumonitis (HP) has many features in common with ODTS, including similar exposure settings and clinical symptoms (Emanuel et al. Agents Actions 35:5056, Frisvad JC, Filtenborg O (1989) Terverticillate penicillia: chemotaxonomy and mycotoxins production. Avoid exposure to contaminants and mold spores. o rganic dust toxic syndrome (odts), also called "toxic alveolitis" and "pulmonary mycotoxosis" in the current medical literature, is a very common noninfectious febrile illness that is seen after inhalation exposure to organic dust. The .gov means its official. The presence of high levels of fungi and bacteria in the dust has since been found to be a hallmark of the syndrome (Dutkiewicz et al. Before [3], Research and data collection in the agricultural industry is difficult, as many workers are casual. PMC Respiratory illnesses associated with agriculture. Cited By ~ 34. Br J Ind Med. Organic Dust Toxic Syndrome The National Institute for Occupational Safety and Health (NIOSH) warns agricultural workers that they may be at risk for developing organic dust toxic syndrome (ODTS), a common respiratory illness that may follow exposures to heavy concentrations of organic dust contaminated with microorganisms. Six volunteers were exposed to wood chip mulch dust. In: Samson RA, Flannigan B (eds) International workshop: health implications of fungi in indoor environments. Bethesda, MD 20894, Web Policies J Gen Microbiol 134:12651274, Scuderi P (1990) Differential effects of copper and zinc on human peripheral blood monocyte cytokine secretion. The three main respiratory illnesses associated with production agriculture are: Farmers lung, or farmers hypersensitivity pneumonitis (FHP), is a noninfectious allergic disease that affects normal lung function. It is a common respiratory illness in farmers, particularly those working with grain, hay, silage and confined animals. Cyr, D. and Johnson, S. (2002) Upright silo safety. Organic dust toxic syndrome in a child Clin Pediatr (Phila). Organic Dust Toxic Syndrome (ODTS) is a flu-like illness following respiratory exposure to organic dusts. People who have experienced ODTS and who experience additional exposures to organic dust have an increased risk for respiratory problemsand the potential for developing chronic bronchitis. Due to their size, the mold spores easily move into and settle in the lower part of the lungs. Epub 2012 Jan 24. [1], Laboratory investigations may show a raised white cell (and specifically neutrophil) count, while a chest X-ray is often normal or shows minimal interstitial infiltration. Appl Environ Microbiol 53:13701375, Sorenson WG, Shahan TA, Lewis DM (1994) Activation of alveolar macrophages by conidia of common fungi associated with organic dust toxic syndrome. 2020-41595-30123 from the USDA National Institute of Food and Agriculture. Organic Dust Toxicity Syndrome (ODTS), also called grain fever, toxic alveolitis, or pulmonary mycotoxicosis, is caused by exposure to very large amounts of organic dust. It was first reported in the mid-1970s [1] and has been accepted as a distinct clinical ent. Adv Immunol 28:293450, Morrison DC, Ryan JL (1987) Endotoxins and disease mechanisms. License. Organic dust toxic syndrome (ODTS) was manifestation of some acute symptoms, (same with acute hypersensitivity pneumonitis or extrinsic allergic alveolitis) with initially by flu like syndrome that were fever, malaise, myalgia, dry cough, dyspnea, and headache after exposure of organic dust in several hours. CAS Click. The most frequent respiratory symptoms are dyspnea and a dry cough, while a wheeze may be present less commonly. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1637683/. pp. 1986; May et al. Plenum Press, New York, pp 383396, Pitt JI, Hocking AD (1985) Fungi and food spoilage. Common generalised symptoms include fever over 38C, chills, myalgia and malaise. A farmers or ranchers life is not always associated with the great outdoors and fresh air. Organic dust toxic syndrome (ODTS) was manifestation of some acute symptoms, (same with acute hypersensitivity pneumonitis or extrinsic allergic alveolitis) with initially by flu like syndrome that were fever, malaise, myalgia, dry cough, dyspnea, and headache after exposure of organic dust in several hours. 1992). Neutrophil chemotaxis is Environ Res 38:407416, Sorenson WG, Gerberick GF, Lewis DM, Castranova V (1986) Toxicity of mycotoxins for the rat pulmonary macrophage in vitro. Crit Rev Microbiol 17:189208, Christensen CM (1957) Deterioration of stored grains by fungi. Int J Cancer 18:93104, Hggblom P (1987) De novo synthesis of alternariol in conidia of Alternara alternata. 1995 Apr;12(2):275-8. See also farmer's lung , hypersensitivity pneumonitis . Harvest, bale, store, and ensile grains at the recommended moisture level to reduce mold growth. [citation needed], The illness is generally self-limiting. Cancer Res 45:34823486, Morrison DC (1983) Bacterial endotoxins and pathogenesis. Science 142: 10781080, Yanaki T, Ito W, Tabata K, Kojima T, Norisuye T, Takano N, Fujita H (1983) Correlation between the antitumor activity of a polysaccharide schizophyllan and its triple-helical conformation in dilute aqueous solution. Although both illnesses appear to involve inflammation of lung parenchyma, they may not be mediated by the same mechanisms. Symptoms arise 4 to 12 hours after exposure to an organic dust, and generally last from one to five days. J Gen Microbiol 133:35273529, Hoffman OA, Olson EJ, Limper AH (1993) Fungal -glucans modulate macrophage release of tumor necrosis factor- in response to bacterial lipopolysaccharide. In: Samson RA, Pitt JI (eds) Advances in Penicillium and Aspergillus systematics. Toxicol Lett 30:137150, Vidal D, Mavet S (1989) In vitro and in vivo toxicity of T-2 toxin, a Fusarium mycotoxin, to mouse peritoneal macrophages. Organic dust toxic syndrome appears to be a common and substantial respiratory hazard to young farm workers. Farmers lung. Bookshelf Retrieved from http://www.aasv.org/shap/issues/v13n5/v13n5p273.pdf. Organic dust toxic syndrome is a term recently coined to describe a noninfectious, febrile illness associated with chills, malaise, myalgia, a dry cough, dyspnea, headache and nausea which occurs after heavy organic dust exposure. Scand J Work Environ Health 17:276280, Siegel PD, Shahan TA, Sorenson WG (1992) Analysis of environmental histamine from agricultural dust. Authors D L Patterson 1 , J W Yunginger. Can J Microbiol 30:15071521, Latg JP, DeBeaupuis JP, Moutaouakil M, Diaquin M, Sarfati J, Prevost MC, Wieruszeski JM, Leroy Y, Fournet B (1991) Galactomannan and the circulating antigens of Aspergillus fumigatus In: Latg JP, Boudas D (eds) Fungal cell wall and immune response. J Med Vet Mycol 27:4550, Becklake MR (1980) Grain dust and health: state of the art. 2012 Mar;33(1):151-63. doi: 10.1016/j.ccm.2011.12.004. Toxicol Appl Pharmacol 125:198205, Johannsen L (1993) Biological properties of bacterial peptidoglycans. Journal of Swine Herd Health and Production. Organic dust toxic syndrome results from the response of the innate immune system to organic dust inhalation.25 This reaction does not require prior sensitization and is not a specic response of the adaptive im-mune system. CRC Press, Boca Raton, pp 113115, Malmberg P, Rask-Andersen A (1993) Organic dust toxic syndrome. The inhalation of organic dust contaminated with microbes has been recognized as an occupational hazard for persons who work with decomposing vegetable matter (1-6). Short term changes in lung function, leukocytosis in blood, and lachrymal fluid among bacterial single cell protein workers after an episode with high exposure to endotoxins. 2005; 13(5): 273-276. Mycotoxin Res. To the Editor. sharing sensitive information, make sure youre on a federal [1], Diagnosis is first done through the inspection of the swollen mucosa in the mouth and visible airways. 2008 Dec;102(12):1839-43. doi: 10.1016/j.rmed.2008.07.006. In: Dosman JA, Cockcroft DW (eds) Principles of health and safety in agriculture. (2012) Farm and Ranch eXtension in Safety and Health (FReSH) Community of Practice. Sigurdarson ST, Gudmundsson G, Sigurvinsdottir L, Kline JN, Tomasson K. Respir Med. There are various sources of hazardous exposure to organic dust in the occupational setting (Table 1). To provide the best experiences, we use technologies like cookies to store and/or access device information. 1975). Agents Actions 38:C221C223 (Spec Conf Issue), Olenchock SA, Burrell R (1976) The role of precipitins and complement activation in the etiology of allergic lung disease. In: Dosman JA, McDuffie HH, Olenchock SA, Semchuk KM, Senthilselvan A (eds) Practical applications in health and agriculture. New mycotoxins continue to be described and the fumonisins, for example, now considered an especially important group because of the frequency of their occurrence and the severity of their toxicity, were not known until 1988. Careers. Alberta Agriculture, Food, and Rural Development. I. Move work outside and avoid dusty work in confined areas whenever possible. It has been most commonly described in agricultural workers who inhale dust contaminated with microorganisms. Any inspection of the lung stays nonetheless unapparent. Organic dust toxic syndrome: a review. See Answer Lancet 336:12101213, Ruiz-Herrera J (1992) Fungal cell wall: structure, synthesis and assembly. Affiliation 1 Division of Allergic Diseases . Disclaimer, National Library of Medicine (eds) Human and Animal Relationships. Organic dust toxic syndrome in a child. Environmental Health Perspectives. To reduce the risk of contracting farmers lung, take the following steps: Silo fillers disease results from inhaling nitrogen dioxide, a silo gas produced during the silage fermentation process. "Organic Dust Toxic Syndrome" or ODTS, as the name suggests, is a toxic reaction as compared to the allergic reaction that causes FHP. Elsevier, Amsterdam, pp 325343, Sorenson WG, Shahan TA, Milanowski J, Lewis DM (1995) Role of fungal spores in ODTS. 1-3 this problem occurs in a variety of work settings, but has been reported most often in individuals working in I. Headache, rhinitis, conjunctivitis and keratitis can also be present, and skin irritation may occur in those handling grain. Because of differences in presentation, clinical course, diagnostic testing, treatments, prognosis, followup requirements and prevention strategies between ODTS, hypersensitivity pneumonitis, oxides of nitrogen and other pulmonary exposure-related illnesses, it is important for poison centers and clinicians to obtain appropriate elements of history, physical examination, and laboratory data . Nephron 64:621625, Dutkiewicz J (1978) Exposure to dust-borne bacteria in agriculture. ORGANIC DUST TOXIC SYNDROME: Occurs when organic dusts/aerosols containing large quantities of micro-organisms are inhaled. Mycologia 81:837861, Furch B, Gooday GW (1978) Sporopollenin in Phycorny ces blakleeanus. Photo provided by the Central States Center for Agricultural Safety and Health (CS-CASH). The syndrome is characterized by fever occurring 4 to 12 Organic dust toxic syndrome Fever or facial warmth, chills, shivering, malaise, fatigue, muscle and joint aches, and headache Respiratory symptoms, such as dry cough, nasal irritation, throat burning, mild dyspnea, chest tightness, and wheezing, may also occur Results from a study on Icelandic animal farmers. Scand J Work Environ Health 18 Suppl 2:6062, Smith MJH, Ford-Hutchinson AW, Bray MA (1980) Leukotriene B4: a potential mediator of inflammation. The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network. Appl Microbiol 16:12511252, Parker JE, Petsonk EL, Weber SL (1992) Hypersensitivity pneumonitis and organic dust toxic syndrome. Experi-mentia 40:12401244, Patchen ML, DAlesandro MM, Brook I, Blakely WF, MacVittie TJ (1987) Glucan: mechanisms involved in its radioprotective effect. Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in and transmitted securely. The respiratory system can get inflamed from the dust, molds, bacteria, and endotoxins in grain dust. Surgery 93:448454, Williams DL, Sherwood ER, McNamee RB, Jones EL, Di Luzio N R (1985) Therapeutic efficacy of glucan in a murine model of hepatic metastatic disease. [1] In 1994, the National Institute for Occupational Safety and Health published case reports and highlighted the urgency for study of the syndrome. The mold spores that cause farmers lung are microorganisms that grow in baled hay, stored grain, or silage with high moisture content (30%). HP, also known as extrinsic allergic alveolitis, has been recognized for a very long time and occurs in a variety of occupational settings (Parker et al. Hepatology 7:12961304, Williams DL, McNamee RB, Jones EL, Pretus HA, Ensley HE, Browder IW, Di Luzio NR (1991a) A method for the solubilization of a (13)--D-glucan isolated from Saccharomyces cerevisiae. Results of serological studies did not demonstrate an allergic or viral cause for these illnesses. Can Med Assoc J 125:4146, Warren RE, Warnock DW (1982) Clinical manifestations and management of aspergillosis in the compromised patient. Mucosal Immunol. PMC 1986). November 3, 2022 Farmer's fever, also called organic dust toxic syndrome (ODTS), is caused by breathing in dust that contains moulds from spoiled plant materials such as baled hay, stored grain or silage. MeSH John Wiley, Chichester, pp 119153, Weber S, Kullman G, Petsonk EL, Jones WG, Olenchock S, Sorenson W, Parker J, Marcelo-Baciu R, Frazer D, Castranova V (1993) Organic dust exposure from compost handling: case presentation and respiratory exposure assessment. If entry is necessary after the three-week period, run the silo blower for a minimum of 30 minutes prior to and during entry, and use a portable gas monitor to continually monitor the gas and oxygen levels in the silo. Please enable it to take advantage of the complete set of features! Would you like email updates of new search results? Article. Organic dust toxic syndrome is a potentially severe flu-like syndrome originally described in farmers, mushroom workers, bird breeders and other persons occupationally exposed to dusty conditions. Cough, hemoptysis (coughing up blood from the respiratory tract), dyspnea (shortness of breath), and chest pain can occur after an exposure to 20 ppm, a moderate level of nitrogen dioxide. It results fromthe inhalation of mold spores from moldy hay, straw, or grain. Workers [Granulomatous diseases and pathogenic microorganism]. 1986; May et al. 1990). Atmos Environ 26A:21632172, Mislivec PB, Tuite J (1970) Species of Penicillium occurring in freshly harvested and in stored dent corn kernels. Because the spores are so small, it is easy for a farmer or rancher to breathe in millions of spores in a few minutes. Organic Dust Toxicity Syndrome (ODTS), also called grain fever, toxic alveolitis, or pulmonary mycotoxicosis, is caused by exposure to very large amounts of organic dust. [Dust exposure, dust-induced lung diseases and respiratory protective measures in agriculture]. 2001 Jun;17 Suppl 2:224-8. doi: 10.1007/BF03036441. Environ Health Perspect 66:105108, Parker GF, Jenner PC (1968) Distribution of trypacidin in cultures of Aspergillus fumigatus. Previously, cases had been reported and given various names such as pulmonary mycotoxicosis, silo unloaders syndrome, grain fever, malt fever, toxin fever, humidifier fever, mill fever, toxic alveolitis or allergic alveolitis. It is nonallergic and noninfectious. Consenting to these technologies will allow us to process data such as browsing behavior or unique IDs on this site. Atopy and reaction to nail dust inhalation. This work is supported in part by New Technologies for Agriculture Extension grant no. Organic dust toxic syndrome (ODTS) is a condition that exists when workers are exposed to moldy or dusty areas. In: Warnock DW, Richardson MD (eds) Fungal infection in the compromised host. II. Structure and dependence of conformation on the molecular weight. Rev Infect Dis 7:404418, Winchurch RA, Togo J, Adler J (1987) Supplemental zinc (Zn2+) restores antibody formation in cultures of aged spleen cells. Semin Resp Med 14:212225, Blaser P (1976) Taxonomische und physiologische Untersuchungen ber die Gattung Eurotium Link ex Fries. Mycologia 62:6774, Morikawa K, Kamegay a S, Yamazaki M, Mizuno D (1985) Hydrogen peroxide as a tumoricidal mediator of murine polymorphonuclear leukocytes induced by a linear beta-l,3-D-glucan and some other immuno-modulators. January 2008; Seminars in Respiratory and Critical Care Medicine 14(01):38-48 The investigation that followed is described below. Environ Res 32:269285, Gerberick GF, Sorenson WG, Lewis DM (1984) The effects of T-2 toxin on alveolar macrophage function in vitro. Virginia Cooperative Extension. Can J Microbiol 29:15, Williams DL, Browder IW, Di Luzio NR (1983) Im-munotherapeutic modification of Escherichia coli-induced experimental peritonitis and bacteremia by glucan. 1979 Mar;99(3):121-48. Symptoms can include fever, chills, dry cough, fatigue, muscle aches, shortness of breath, headaches, and nausea. [The importance of allergen exposure for development of allergic respiratory tract diseases--especially "house dust asthma"]. 8600 Rockville Pike [Extrinsic allergic alveolitis: farmer's lung. Am Ind Hyg Assoc J 39:177194, Fogelmark B, Goto H, Yuasa K, Marchat B, Rylander R (1992) Acute pulmonary toxicity of inhaled -l,3-glucan and endotoxin. CRC Press, Boca Raton, Saito H, Ohki T, Takasuka N, Sasaki T (1977) A 13C-N.M.R.-spectral study of a gel-forming, branched (13)-beta-D-glucan, (lentinan) from Lentinus edodes, and its acid-degraded fractions. Infect Immun 60:22372245, Tanaka Y, Shiozaka S, Morimoto I, Fujita T (1990) Role of zinc in interleukin 2 (IL-2)-mediated T-cell activation. In: Howard, D.H., Miller, J.D. Certain agricultural areas may have large amounts of organic dust: grain storage, hog barns, poultry barns, and cotton-processing areas. Plenum Press, New York, pp 479488, Palmgren MS, Lee LS (1986) Separation of myco toxin-containing sources in grain dust and determination of their mycotoxin potential. Clin Rev Allergy 3:197216, Wilson ME (1985) Effects of bacterial endotoxins on neutrophil function. 10.1136/oem.2005.021527 . Please enable it to take advantage of the complete set of features! [Treatment by HDM (house dust mite) of respiratory tract allergies to house dust acarians. Appl Environ Microbiol 55:10931099, Eduard W, Sandven P, Johannsen BV, Bruun R (1988) Identification and quantification of mould spores by scanning election microscopy (SEM): analysis of filter samples collected in Norwegian saw mills. Scand J Work Environ Health 10:115119, Kozakiewicz Z (1985) Solutions to some problems in Aspergillus taxonomy using the scanning electron microscope. Skogstad M, Eduard W, Holme J, Qvenild T, Einarsdottir E. Occup Environ Med. Recursos en Espaol sobre Seguridad y Salud Agrcola, A Guide to Teaching Safe Tractor Operation, Respiratory Illnesses Associated with Agriculture, http://www.extension.org/pages/63439/respiratory-illnesses-associated-with-agriculture, http://www1.agric.gov.ab.ca/$department/deptdocs.nsf/all/agdex9036/$file/726-1.pdf?OpenElement, http://www.ccohs.ca/oshanswers/diseases/farmers_lung.html, http://www.pubs.ext.vt.edu/442/442-602/442-602.html, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1637683/, https://extension.psu.edu/farm-respiratory-hazards, http://www.aasv.org/shap/issues/v13n5/v13n5p273.pdf, national agenda for agricultural safety and health, national ag safety health reference documents and visuals, national ag safety health resource organizations. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture. Symptoms include shaking chills or sweats, cough or shortness of breath, headache, anorexia, and myalgia. Sydowia 28:149, Borkowska-Opacka B, Truszczynski M (1979) The occurrence of toxigenic fungi in industrial feed mixtures. FEBS Lett 309:119122, De Lucca AJ, Brogden KA, French AD (1992) Aggluina-tion of lung surfactant with glucan. Williams & Wilkins, Baltimore, Robertson MA, Seaton A, Milne LJR, Raeburn JA (1987a) Suppression of host defences by Aspergillus fumigatus. Epub 2009 Jan 7. 2022 Springer Nature Switzerland AG. Am J Ind Med 17:7980, Ito H, Iiizuka H, Sato T (1973) Identification of osmophilic Aspergillus isolated from rice and their radiosensitivity. Although initial work was associated with farming, one should recognize that workers involved in wood processing, large-scale production of animal feed, treatment and disposal of sewage and garbage by composting, and various bioindugtrial processes may be exposed to high concentrations of microorganisms and their products. Atia, A. HHS Vulnerability Disclosure, Help Convert from a manual to a mechanical or automated feeding or feed-handling system to reduce the release of airborne mold spores. Carbohydr Res 58:293305, Samson RA (1985) Occurrence of molds in modern living and working environments. Schweiz Med Wochenschr. One of the most common illnesses is organic dust toxic syndrome (ODTS), a respiratory and systemic illness that can follow exposures to heavy concentrations of organic dusts contaminated with microorganisms. This Alert describes four case reports in which a total of 29 agricultural . Organic dust toxic syndrome among farmers. We investigated whether inflammatory pulmonary responses occur, even after relatively brief, low-level wood chip mulch exposure. An inverse association with the number of years worked as pig farmer was found (up to 5 years vs. more than 5 years; POR 5.0, 95% . Organic Dust Toxic Syndrome (ODTS) is a respiratory and systemic illness that may follow exposures to heavy concentrations of organic dusts contaminated with microorganisms. Springer, Berlin, Heidelberg. This condition typically affects the entire group of workers. Although initial work was associated with farming, one should r Exposure to higher concentrations (greater than 100 ppm) can result in pulmonary edema (fluid accumulation in the lungs) and in swelling in the lungs, leading to long-term respiratory problems or death. The site is secure. https://doi.org/10.1007/978-3-662-10373-9_8, DOI: https://doi.org/10.1007/978-3-662-10373-9_8, Publisher Name: Springer, Berlin, Heidelberg. Organic dust toxic syndrome in a child. Apropos of 300 cases]. Federal government websites often end in .gov or .mil. Implement best management practices to maintain good air quality in confinement buildings for swine and poultry. The https:// ensures that you are connecting to the dust, grain dust, and wood dust [NIOSH 1992b], but these limits may not adequately protect workers exposed to organic dusts contaminated with microorganisms. 1994;62(1-2):5-10. Organic Dust Toxic Syndrome. Environ Res 33:246260, Goldman R (1988) Characteristics of the -glucan receptor of murine macrophages. document.write(new Date().getFullYear()) All rights reserved. Organic dust toxic syndrome (ODTS) and hypersensitivity pneumonitis (HP) are associated with inhalation of high concentrations of organic materials, particularly agricultural materials such as dust from grain, hay, or silage contaminated with microorganisms (Pratt and May 1984; Lecours,et al. Livestock and poultry production workers have an increased risk of developing respiratory diseases, such as asthma-like syndrome, rhinosinusitis, hypersensitivity pneumonitis, organic dust toxic syndrome, chronic obstructive pulmonary disease (COPD) and chronic bronchitis, as a result of chronic inhalation exposure to farm animal production buildings [1-4]. MeSH An official website of the United States government. FOIA [2] The airways are exposed to high concentrations of organic dust created by some form of disturbance or mechanical process. It needs to be differentiated from farmer's lung and other forms of hypersensitivity pneumonitis. OrganicDust Toxic Syndrome: Animal House Fever? Qatar Univ Sci Bull 8:5968, Emanuel DA, Wenzel FJ, Lawton BR (1975) Pulmonary mycotoxicosis. Organic dust toxic syndrome is a term recently coined to describe a noninfectious, febrile illness associated with chills, malaise, myalgia, a dry cough, dyspnea, headache and nausea which occurs after heavy organic dust exposure.
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