Organic dust toxic syndrome (ODTS) describes a self-limiting noninfectious, febrile illness accompanied by malaise, chills, myalgia, nonproductive cough, dyspnea, headache, and nausea, which occurs approximately 4 to 12 hours after heavy exposure to organic dust with a high attack rate. Prior sensitiza-tion is not required as in hypersensitivity pneumonitis. Organic dust toxic syndrome is also known as silo-filler's disease, grain fever, precipitin-negative farmer's lung, toxic alveolitis, and pulmonary mycotoxicosis. Organic dust toxic syndrome is highly prevalent in swine confinement operations, with a prevalence of approximately 30% to 35%. However, ODTS has also been observed after unloading silos, removing grain from storage bins (especially with grain sorghum), and on mushroom farms. Estimates indicate that up to one third of farmers will experience an episode of ODTS at some time in their work lives. Other surveys indicate an incidence of 6% to 36% in farmers and agricultural workers at any given time (47-60).
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