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Two outbreaks of occupationally acquired histoplasmosis: more than workers at risk.
Environ Health Perspect. 2005 May; 113(5):585-9.EH

Abstract

OBJECTIVE

The objective of this study was to determine the etiology and risk factors for acute histoplasmosis in two outbreaks in Illinois among laborers at a landfill in 2001 and at a bridge reconstruction site in 2003.

DESIGN

We performed environmental investigations during both outbreaks and also performed an analytic cohort study among bridge workers.

PARTICIPANTS

Workers at the landfill during May 2001 and those at the bridge site during August 2003 participated in the study. At the landfill, workers moved topsoil from an area that previously housed a barn; at the bridge, workers observed bat guano on bridge beams.

EVALUATIONS/MEASUREMENTS

We defined a case by positive immunodiffusion serology, a > or = 4-fold titer rise in complement fixation between acute and convalescent sera, or positive urinary Histoplasma capsulatum (HC) antigen. Relative risks (RR) for disease among bridge workers were calculated using bivariate analysis.

RESULTS

Eight of 11 landfill workers (73%) and 6 of 12 bridge workers (50%) were laboratory-confirmed histoplasmosis cases. Three bridge workers had positive urinary HC antigen. At the bridge, seeing or having contact with bats [RR = 7.0; 95% confidence interval (CI), 1.1-43.0], jack-hammering (RR = 4.0; 95% CI, 1.2-13.3), and waste disposal (RR = 4.0; 95% CI, 1.2-13.3) were the most significant job-related risk factors for acquiring histoplasmosis.

CONCLUSIONS

Workers performing activities that aerosolized topsoil and dust were at increased risk for acquiring histoplasmosis. Relevance to professional and clinical practice: Employees should wear personal protective equipment and use dust-suppression techniques when working in areas potentially contaminated with bird or bat droppings. Urinary HC antigen testing was important in rapidly identifying disease in the 2003 outbreak.

Authors+Show Affiliations

Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Gregory_Huhn@rush.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15866767

Citation

Huhn, Gregory D., et al. "Two Outbreaks of Occupationally Acquired Histoplasmosis: More Than Workers at Risk." Environmental Health Perspectives, vol. 113, no. 5, 2005, pp. 585-9.
Huhn GD, Austin C, Carr M, et al. Two outbreaks of occupationally acquired histoplasmosis: more than workers at risk. Environ Health Perspect. 2005;113(5):585-9.
Huhn, G. D., Austin, C., Carr, M., Heyer, D., Boudreau, P., Gilbert, G., Eimen, T., Lindsley, M. D., Cali, S., Conover, C. S., & Dworkin, M. S. (2005). Two outbreaks of occupationally acquired histoplasmosis: more than workers at risk. Environmental Health Perspectives, 113(5), 585-9.
Huhn GD, et al. Two Outbreaks of Occupationally Acquired Histoplasmosis: More Than Workers at Risk. Environ Health Perspect. 2005;113(5):585-9. PubMed PMID: 15866767.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Two outbreaks of occupationally acquired histoplasmosis: more than workers at risk. AU - Huhn,Gregory D, AU - Austin,Connie, AU - Carr,Mark, AU - Heyer,Diana, AU - Boudreau,Pam, AU - Gilbert,Glynnis, AU - Eimen,Terry, AU - Lindsley,Mark D, AU - Cali,Salvatore, AU - Conover,Craig S, AU - Dworkin,Mark S, PY - 2005/5/4/pubmed PY - 2005/8/17/medline PY - 2005/5/4/entrez SP - 585 EP - 9 JF - Environmental health perspectives JO - Environ Health Perspect VL - 113 IS - 5 N2 - OBJECTIVE: The objective of this study was to determine the etiology and risk factors for acute histoplasmosis in two outbreaks in Illinois among laborers at a landfill in 2001 and at a bridge reconstruction site in 2003. DESIGN: We performed environmental investigations during both outbreaks and also performed an analytic cohort study among bridge workers. PARTICIPANTS: Workers at the landfill during May 2001 and those at the bridge site during August 2003 participated in the study. At the landfill, workers moved topsoil from an area that previously housed a barn; at the bridge, workers observed bat guano on bridge beams. EVALUATIONS/MEASUREMENTS: We defined a case by positive immunodiffusion serology, a > or = 4-fold titer rise in complement fixation between acute and convalescent sera, or positive urinary Histoplasma capsulatum (HC) antigen. Relative risks (RR) for disease among bridge workers were calculated using bivariate analysis. RESULTS: Eight of 11 landfill workers (73%) and 6 of 12 bridge workers (50%) were laboratory-confirmed histoplasmosis cases. Three bridge workers had positive urinary HC antigen. At the bridge, seeing or having contact with bats [RR = 7.0; 95% confidence interval (CI), 1.1-43.0], jack-hammering (RR = 4.0; 95% CI, 1.2-13.3), and waste disposal (RR = 4.0; 95% CI, 1.2-13.3) were the most significant job-related risk factors for acquiring histoplasmosis. CONCLUSIONS: Workers performing activities that aerosolized topsoil and dust were at increased risk for acquiring histoplasmosis. Relevance to professional and clinical practice: Employees should wear personal protective equipment and use dust-suppression techniques when working in areas potentially contaminated with bird or bat droppings. Urinary HC antigen testing was important in rapidly identifying disease in the 2003 outbreak. SN - 0091-6765 UR - https://www.unboundmedicine.com/medline/citation/15866767/Two_outbreaks_of_occupationally_acquired_histoplasmosis:_more_than_workers_at_risk_ L2 - https://ehp.niehs.nih.gov/doi/10.1289/ehp.7484?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -