Tobacco Worker's Lung Clinical Presentation

Updated: Apr 17, 2018
  • Author: Roger B Olade, MD, MPH; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
  • Print
Presentation

History

A comprehensive history of exposure to tobacco mold and leaves should be obtained. Workers who do not use masks during their working period are 5 times more likely to develop this disease, [12] and longer duration of work is associated with an increased risk of disease. In one study, those working with tobacco for more than 10 years were twice as likely to develop the disease than those who worked in the field for less than 5 years. [12]

Tobacco worker’s lung, as with most hypersensitivity pneumonitis syndromes, has acute, subacute, and chronic presentations. In acute presentations, patients develop abrupt onset of fever, cough, chills, myalgias, headache, and malaise about 4-6 hours after exposure to tobacco plants and molds. These symptoms are self-limited, resolving in 12 hours to several days once the patient avoids the inciting agent. The symptoms may recur with reexposure.

Patients who have had long-term exposure to tobacco plantations usually have insidious onset of cough, exertional dyspnea, fatigue, and weight loss. Disabling and irreversible respiratory findings due to pulmonary fibrosis may occur late in the course of the disease. Removing patients from tobacco exposure results in only partial improvement.

Next:

Physical

Physical examination reveals the following:

  • Tachypnea

  • Diffuse fine rales

  • Wheezing

  • Weight loss

  • Digital clubbing

  • Fever

  • Evidence of cor pulmonale

Previous