SMOKING PROMOTES INSIDIOUS AND CHRONIC FARMERS LUNG-DISEASE, AND DETERIORATES THE CLINICAL OUTCOME

Although the prevalence of serum precipitating antibodies for farmer's lung disease (FLD) is lower in smokers than in nonsmokers and FLD pre dominates in nonsmokers, the affects of smoking on the clinical course of the disease is not known. We compared the clinical findings and th e prognosis between 12 smokers (SM-FLD) and 31 non-smokers with FLD (N S-FLD). There was no difference in age, sex, working years on farm, cl inical symptoms, laboratory findings, radiographic findings, between t he two groups, However, for the type of onset on the first visit for F LD, ''acute single episode'' type was less common, and ''recurrent'' a nd ''insidious onset'' types were more common in SM-FLD than in NS-FLD (8.3 vs 58.1, 91.7 vs 41.9%, respectively, p<0.05). Although working status and mask wearing status were not significantly different betwee n the two groups after the diagnosis of FLD, patients with symptoms an d/or radiographic abnormalities of FLD of more than 6 months were foun d more frequently in SM-FLD than in NS-FLD (66.7 vs 19.4%, p<0.005), A nd also SM-FLD had more recurrences of FLD than NS-FLD after the initi al diagnosis of FLD (1.58+/-1.56 vs 0.47+/-1.07, p<0.05), SM-FLD tende d to have lower %VC than NS-FLD (73.6+/-7.4 vs 88.5+/-3.9%, respective ly, p=0.06. Regarding the prognosis, the 10-year survival rates were 7 0.7% in SM-FLD, and 91.5% in NS-FLD (p<0.05). These results suggest th at smoking may make FLD insidious and chronic, and deteriorates the cl inical outcome.