Role of molds in farmer's lung disease in eastern France

Farmer's lung disease (FLD) is common in the east of France. In the absence of the primary recognized FLD agent, Saccharopolyspora rectivirgula, its e tiology remains unknown. A prospective case-control study was performed to find the etiology of FLD in this area. Eleven patients were matched with 11 healthy control farmers. Twenty-two urban subjects constituted the nonexpo sed control group. Microorganisms from cowshed air and fodder were identifi ed and counted. The antigens of the microorganisms most frequently isolated at the 22 farms were used for serological tests. Farms of patients with FL D contained more Absidia corymbifera than those of healthy farmers (p < 0.0 5 in air, p < 0.01 in fodder). Electrosyneresis, performed with A. corymbif era somatic antigen, differentiated 9 of 11 patients with FLD from control subjects (p < 0.01). Other significant results were obtained with Eurotium amstelodami (p < 0.01) and Wallemia sebi (p < 0.05). In contrast, no signif icant results were obtained with the other seven antigens tested, including S. rectivirgula. Absidia corymbifera and, to a lesser degree, W. sebi or E . amstelodami are likely to be the main causes of FLD in this area. Modific ations in working conditions over time could explain the emergence of these new contributing etiologies.