Farmer’s lung or Hypersensitivity pneumonitis

Farmer’s lung is a serious respiratory condition also known as hypersensitivity pneumonitis. It affects people whose immune system is sensitive to fungal spores inhaled from:

Farmer’s lung is different from farmer’s fever also known as (ODTS – Organic Dust Toxic Syndrome) because it involves an allergic immune response that leads to inflammation and permanent tissue damage in the terminal airways of the lung. Farmers lung is associated with intense or repeated exposures to biologic dust and different organisms can cause farmers lung. It was described as early as 1713 notably in farmers exposed to organic dusts. Spread between people is non-existent, however, common exposure to the offending agent can lead to similar and numerous cases. Some agricultural industries with possible known exposures associated with hypersensitivity pneumonitis include:

Symptoms
The symptoms of farmer’s lung in acute attacks can last from 12 hours to 10 days. Symptoms include:

For those farmers who are sensitive, repeated exposure to the allergic trigger can lead to more severe symptoms such as chronic cough with phlegm containing pus, shortness of breath, loss of appetite and weight loss. Lung scarring (fibrosis) can occur in the later stages of the disease which greatly impacts respiratory health and cause difficulty breathing.

Farmer’s lung can be prevented by ensuring organic materials are kept dry and stored properly. Also keeping away from known allergens. Keep storage areas well-ventilated and wear appropriate Australian Standard respiratory masks which seal the face properly and protect the lungs. If working in greenhouse environs ensuring adequate ventilation and appropriate breaks out of the environment. These actions will minimise the risk of inhaling the allergic trigger and prevent the condition developing or progressing.

Fast facts:

References used for this topic

More information:

RACGP – Australian Family Physician 2012
The respiratory tract

The National Center for Biotechnology Information
Pulmonary Health Effects of Agriculture (2016)

StatPearls [Internet]. Treasure Island
Farmers Lung

Canadian Centre for Occupational Health and Safety
Farmers lung

JAMA Network
An Outbreak of Organic Dust Toxic Syndrome in a College Fraternity

Cedars-Sinai (US)
Hypersensitivity pneumonitis

University of California
Hypersensitivity pneumonitis – signs and symptoms

Zergham AS, Heller D. Farmers Lung. [Updated 2020 May 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557580/

Research & reviews:

National Center for Biotechnology Information
Systematic review of respiratory health among dairy workers.

European Respiratory Journal
Hypersensitivity pneumonitis – current concepts [PDF 132kb]

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) and respiratory illness is a major cause of death in Australia and is present in farming communities. COPD is an abbreviated term for lung conditions which include emphysema, chronic bronchitis and chronic asthma all of which are irreversible.

Chronic obstructive pulmonary disease (COPD), is often a debilitating disease that is both preventable and treatable. Previously identified as a disease of mostly smokers, COPD is now considered to be a risk of some occupational exposures.

COPD is a long-term condition of the lungs that causes shortness of breath. Even though COPD is irreversible and there is no cure, there are things you can do to breathe easier and improve your quality of life particularly if it is diagnosed and managed early. Importantly there are things you can do to prevent COPD, in the first place.

Most cases of COPD develop after repeatedly breathing in fumes (usually tobacco smoke) and dust that damage the lungs over a long period of time. It is also known that exposure to bushfire smoke and coal smoke increases the risk of worsening existing asthma or COPD. Farmers have high rates of COPD when compared to non-farming workers despite generally lower rates of smoking. This suggests that on-farm exposure to lung irritants such as animal dander, organic and inorganic dusts, smoke, fumes and chemical vapours may play a key role. The good news is there has been a steady decline in tobacco smoking since the 1970s, and we are now seeing a steady decline in COPD-related deaths.  An important factor in COPD among farmers is likely to be the respiratory exposures encountered during working and living on the farm. Exposures from livestock handling, poultry, organic and inorganic dusts, bacteria, endotoxin, spores and potentially toxic gases, such as those found in silos, vats, tanks, bushfire smoke and welding fumes.

COPD and COVID-19

Having a clinical diagnosis of COPD increases the risk of having poor clinical outcomes if you become infected with COVID-19.  People with COPD are a high-risk group, and should take all preventative measures to avoid COVID-19 and if infected seek further medical advice.

Preventing exposure is very important.

To find out more about COPD visit Better Health Channel

Fast facts:

References used for this topic

More information:

Australian Lung Foundation
Patient Support
COPD Risks, Diagnosis, Management

Alfred Health
The effects of bushfire smoke explained

Research & reviews:

National Centre for Biotechnology Information
Incident chronic obstructive pulmonary disease associated with occupation, industry, and workplace exposures in the Health and Retirement Study

European Respiratory
COPD in farmers: what have we learnt?

The Department of Health, Australian government
Chronic respiratory conditions – including asthma and chronic obstructive pulmonary disease (COPD)

The Lancet March 2021
OPD and the risk of poor outcomes in COVID-19: A systematic review and meta-analysis

Asthma

Asthma is a chronic inflammatory lung condition which causes the air ways (bronchi) of the lungs to become inflamed and narrow. The inflammation results in increased mucous production and bronchoconstriction, making it harder to breathe.

Asthma can be a life threatening condition if not treated and managed properly. It affects one in nine Australians. 

Another asthma term that affects the farming community is  thunderstorm asthma. People at risk for thunderstorm asthma are those that have spring-time allergic rhinitis (hayfever)/confirmed ryegrass pollen and allergy. It isn’t a specific type or diagnosis of asthma, but it is a trigger for some people and can be very serious. It can happen suddenly to people susceptible to asthma and or hay fever and if grass pollen is a problem for you then you may be at risk for a thunderstorm asthma event. 

Hazards and risks for farming men, women, children and agricultural workers are high as they are exposed to irritants such as organic and inorganic dusts from pollens, animal dander, grain and hay, which can trigger asthma attacks in susceptible people. Being overweight has also been identified as a risk of developing asthma as fat tissue produces inflammatory substances that might affect the lungs.

Exposure to organic and inorganic dusts is likely to occur when working with or around:

The most common signs of asthma are:

There are many allergens in the agricultural workplace that may irritate and cause asthma to develop in a previously healthy person or trigger asthma symptoms in someone that already has asthma.

Recommendations and strategies to reduce your risk of developing asthma and/or having an asthma attack include:

Asthma attacks can develop over a few minutes or a few days. In an emergency situation, farming men, women, children and agricultural workers need to act quickly as they may have longer travel distances to seek medical treatment – placing them at greater health risk. For this reason it is important to have an asthma management plan in place for those individuals on the farm or workplace who are known to suffer from asthma. This plan should at least contain:

In all cases, asthma becomes a medical emergency if the person finds it increasingly difficult to breathe and talk, has severe chest tightness, feels distressed and they are sucking in their throat and their ribs are retracting (pulling in).

Call triple zero (000) for an ambulance in an emergency.

To learn more about asthma emergency first aid visit Better Health Channel.

To find out more thunderstorm asthma visit Better Health Channel.

Fast facts

References used for this topic

More information:

National Asthma Council
What is asthma?

National Asthma Council
What is thunderstorm asthma?

Asthma Australia
Visit website

Clinical care:

National Asthma Council Australia
Managing acute asthma in clinical settings
Managing asthma in children
Asthma first aid
A quick reference guide for primary health care professionals (2024)

Research & reviews:

Australian Institute of Health and Welfare
Asthma in Australian children

Global Initiative for Asthma
National Asthma Strategy

Aspergillosis

Aspergillosis is an infection, a growth or an allergic reaction caused by the Aspergillus mould (fungus). This commonly grows on rotting vegetation.

The tiny Aspergillosis spores can be inhaled resulting in illnesses that usually affect the respiratory system. Some people with asthma are allergic to Aspergillus and develop allergic bronchopulmonary aspergillosis (ABPA). 

Symptoms of ABPA are: 

Ongoing irritation of the airways can cause complications including: 

If the infection spreads it can affect eyes, sinuses and other organs. 

Hazards and risks of Aspergillosis in farmers occurs when working with composting or decaying vegetation such as silage, rain damaged hay or mouldy grain. 

Silage, mouldy hay and grain can contain the Aspergillus mould spores which are tiny at 2-3 microns and can go deep into your lungs when inhaled, causing respiratory illness.

Hay baled at high moisture content levels increases the likelihood of hay becoming mouldy. Hay which is darker in colour or has a musty smell is indicative of mould being present.

Horses, dogs, cows and birds are also susceptible to Aspergillosis if exposed to mould spores as a result of being fed mouldy hay or grain, especially in poorly ventilated, confined areas. Mouldy hay can contain toxins that are harmful to stock especially pregnant milking cows which can lead to abortion.

Recommendations for the prevention of Asperigillosis include wearing a mask that complies with Australian Standards when handling mouldy hay or composting vegetation. Fitting the mask correctly is essential, because the presence of facial hair such as beards or even being unshaven can reduce the effectiveness of the mask. Facial hair can be 15 microns and Aspergillus spores are only 2-3 micron, therefore having an effective fitting mask is vital.

Find out more on Better Health Channel.

Fast facts:

References used for this topic

More information:

Better Health Channel
Aspergillus

Mayo Clinic
Aspergillosis

Clinical care:

Australasian Society of Infectious Diseases
Guidelines for the use of antifungal agents in the treatment of invasive Candida and mould infections

International Journal of COPD
Management of invasive aspergillosis in patients with COPD: rational use of voriconazole [PDF 169kb]

Research and Reviews:

Journal of Fungi
Allergic Bronchopulmonary Aspergillosis (2016)

Farmer’s fever – Organic Toxic Dust Syndrome (ODTS)

Farmer’s fever, also called organic dust toxic syndrome (ODTS), is caused by breathing in dust that contains moulds from spoiled plant materials such as baled hay, stored grain or silage. It is a common respiratory illness in farmers, particularly those working with grain, hay, silage and confined animals. The symptoms are a fever and flu-like symptoms which occur 4 to 12 hours after exposure to contaminated dust.

The symptoms of farmer’s fever will usually disappear within one to three days after you are no longer exposed to the dust. However subsequent exposures may increase the risk of a range of respiratory symptoms. (Farmer’s Lung, 2016). ODTS is often misdiagnosed, so it is important to tell your doctor about any recent dust exposures you may have had.

You can reduce your risk of developing ODTS by minimising hay spoilage, wetting down dusty areas and wearing a mask or respirator.

Fast facts:

References used for this topic page

More information:

Centers for Disease Control (US)
Preventing organic dust toxic syndrome [PDF 33kb]

PennState Extension
Farm Respiratory Hazards (2014)

Clinical care:

Canadian Centre for Occupational Health & Safety
Farmers Lung (2016)

Research & reviews:

Occupational and Environmental Medicine (2018)
Determinants for asthma in farmers with special reference to odts (organic dust toxic syndrome)

American Association of Swine Veterinarians (2005)
Organic dust toxic syndrome: a non-infectious febrile disease after exposure to the hog barn [PDF 453kb]

Agrifutures Australia (2006)
Respiratory illness in farmers (free PDF download)

International Journal of Environmental Research & Public Health
Agricultural Dust Exposures and Health and Safety Practices among Western Australian Wheatbelt Farmers during Harvest

Diabetes

Diabetes is one of the most common chronic conditions in Australia. It is estimated that around 1.7 million Australians have diabetes and includes all types of diagnosed diabetes (1.2 million known and registered) as well as silent, undiagnosed Type 2 diabetes where it is estimated there are another additional 500,000.

Diabetes is associated with earlier death and other chronic illnesses such as cardiovascular disease (heart disease, kidney disease and eye disease such as visual loss and blindness..

There are two main types of diabetes. Type 1 diabetes develops when your pancreas is no longer producing insulin so you are unable to process sugar/glucose in your body. Type 1 diabetics must be supplemented with insulin through injections or a pump. Type 2 diabetes develops when your body is no longer able to efficiently produce and release insulin from the pancreas to maintain healthy blood glucose levels.

Surprisingly farming men, women and agricultural workers who live rurally are at increased risk of developing diabetes, due to rural and remote communities experiencing higher rates of diabetes compared to major cities. Hospitalisation and death rates in remote and very remote areas due to diabetes are two times as high as in major cities. A possible contributing factor to this increased risk is the use of modernised farm equipment, vehicles and farm technology. These sedentary changes result in reduced physical activity from sitting in machinery and excess energy from food not being utilised. When excess energy is not used by the body, it is converted to body fat which can potentially sit around the waist as abdominal fat or toxic waste. Large waist measurements or excess abdominal fat is one of the greatest risk factors in the development of Type 2 diabetes. Other factors which increase the risk of developing Type 2 diabetes include: family history of diabetes, being overweight or obese, inactivity and an unhealthy diet.

To see if you might be at risk of diabetes, take the Diabetes Ausdrisk test. It only takes a few minutes and is free. The good news is that in most cases Type 2 diabetes can be prevented through diet and exercise. A few lifestyle choices or changes can help protect you against developing Type 2 diabetes.

  1. Maintain a healthy weight – this can be done through exercise and healthy eating (outlined below)
  2. Exercise regularly – try to build some activity into your daily routine. For example, walk instead of taking the ute or quad bike.
  3. Make healthy food choices – concentrate on getting the recommended servings of fruit, vegetables, lean meats and grains each day. See the Australian Guide to Healthy Eating for more information. Also, visit our Fact Sheet on Healthy Lunchbox ideas.
  4. Manage your blood pressure – talk to your GP about how they can help you with this.
  5. Manage cholesterol – while cholesterol can be influenced by your genetics, diet is really important in keeping cholesterol levels within a healthy range. For more information, see the Heart Foundation for healthy eating and cholesterol. Also, talk to your GP about how they can help you with this.

Often farmers are very busy and put off taking care of their health.  Living in rural and remote communities may involve long distance travel to access health services such as a doctor, diabetes educator or dietitian. There are online and phone services that are confidential and will help support you to manage your health and reduce your risk of diabetes. Read more about preventing diabetes at Diabetes Australia.

Fast facts:

References used for this topic

More information:

Australian Institute of Health and Welfare
Diabetes (2020)

Australian Institute of Health and Welfare
Rural and remote health (Australia’s health 2016)

Diabetes Australia
Life! Helping you prevent diabetes, heart disease and stroke

Department of Health, Australian Government
Australian Guide to Healthy Eating

Diabetes Australia
Are you at risk? (Type 2)

Diabetes Australia
Prevention

Diabetes Australia
Data snapshot

Clinical care:

Diabetes Australia
Best practice guidelines for health professionals

Research & reviews:

Australia Journal of Rural Health
Diabetes risk factors, diabetes and diabetes care in a rural Australian community

BMC Public Health
The association of levels of physical activity with metabolic syndrome in rural Australian adults

Wound care

Skin wounds need to be cleaned and dressed.  Contrary to many myths, wounds that are kept moist heal better and faster than those exposed to the air. Protecting the wound with a dressing provides a moist environment that encourages the surface skin cells to migrate across the gap and join up. Put simply a ‘dry wound’ is a ‘dead wound’ and you don’t want a dead wound!

Letting a wound ‘breathe’ is a common cause of wounds failing to heal. This issue has been investigated scientifically, and it is conclusively demonstrated that a covered wound heals faster than an uncovered wound! This is because the dry scab actually slows the growth of new skin cells.

Because farmers often keep knocking their wounds on their hands and limbs they can take a long time to heal. Using a dressing will help the wound heal.  Other causes of wounds failing to heal are ongoing trauma, infection, deep burns, skin cancers or underlying medical conditions such as diabetes.

If you have a blister don’t pop the blister. Wounds covered by blisters heal better and more quickly when the blister remains intact, rather than broken. This is because the skin cover provides protection and a warm moist environment to allow for healing.

For more information on wound care visit Better Health Channel

Fast facts:

References used for this topic page

More information:

Better Health Channel
Skin cuts and abrasions

Australian Broadcasting Corporation (ABC)
Wound care: What you need to know for your cuts, scrapes, grazes and burns
Wound healing and air

North East Valley Division of General Practice
Wound assessment and dressing selection

Research & reviews:

Department of Veterans’ Affairs
Wound identification and dressing selection chart

Snake bite

Australia has some of the world’s deadliest snakes, and snake bites in Australia most commonly happen in the warmer months when snakes are more active. They mainly live in rural and remote areas and are found out and about on farms looking for water or food.

Snake bites often occur if a snake needs to be defensive. Common sites to be bitten are hands, arms, feet and ankles. Medical assistance is required urgently after a snake bite.

Do not attempt to catch the snake. The snake may bite again if an attempt is made to catch it. Identification of the snake species can be obtained in the hospital through patient samples of blood and urine.

Symptoms of snake bite may include:

First aid for snake bite aims to stop the venom moving around the body. Depending on the volume of venom injected, research indicates very little venom reaches the circulation if pressure is applied over the site and the limb is immobilised. If the snake is angry and stirred up, it may release more venom when it strikes.

What you should do:

Fast facts:

References used for this topic

More information:

Department of Environment and Heritage Protection (Qld)
Snake bites

Flying Doctors Service
Outback Survival: Snakes and snake bites

St John Ambulance Australia (Vic)
Snake bite first aid tips

Clinical care:

Safer Care Victoria
Management of snake bite

Research & reviews:

The Medical Journal of Australia
The Australian Snakebite Project, 2005–2015

World Health Organization (WHO)
Snake antivenoms

Shock – physical

Medical shock is caused by not having enough blood circulating around your body. Reduced blood pressure decreases the flow of oxygen to vital organs and, unless attended to, is a life-threatening medical emergency.

Some of the many causes of medical shock include uncontrolled bleeding, severe burns, dehydration, being crushed under heavy objects, and spinal injury. A range of factors influences the impact of shock, such as your health, age, personality, where on the body the injury occurs and the environment. Signs of medical shock may include clammy skin, shallow or difficult breathing, rapid or irregular heartbeat, anxiety, thirst, dizziness, nausea and confusion.

Shock can be particularly life threatening on farms where you may be a long way from help or emergency medical facilities. It is very important that everyone on the farm knows where you are going to be and when you will return. If you are working on your own on a farm, arrange a system of notifying a family member, colleague or neighbour about where you will be and commit to checking in by a certain time each day. It is also important for everyone on the farm to have some first aid training. If someone suffers a major injury, you must send for help and then try to stop any bleeding or treat wounds and burns.

Emotional distress or sudden fright in response to a traumatic event is also often called ‘shock’ but this is different from physical shock. More information about emotional shock can be found here: Better Health Channel – Trauma reaction and recovery.

Fast facts:

References used for this topic

More information:

Better Health Channel
Shock

Cinahl Information Systems
Sepsis and Septic Shock

St John Ambulance NSW
Shock – managing shock

Clinical care:

Emergency Medicine and Trauma
Resuscitation in Hypovolaemic Shock

Emergency Medicine Practice
Diagnosis and management of shock in the emergency department

Queensland Ambulance
Clinical Practice Guidelines: Trauma/Hypovolaemic shock

Poisoning

Poisoning can occur when a person ingests, inhales or has skin contact with household, agricultural and industrial chemicals or gas. Not only are farmers and agricultural workers at risk but also children or children visiting farms. Poisoning to stock, (sheep, cattle) and domestic pets, can also occur when exposed to waste such as broken vehicle batteries, chemical containers, snail and other vermin baits and general rubbish.

Reduce the risk of accidental poisoning by:

If you think someone has been poisoned, or has an unexplained illness, do not wait for further symptoms to develop.

Ring the National Poisons Information Centre on 13 11 26 immediately.

This is a 24 hour, 7 days a week service.

Do not try to make the person vomit, unless instructed to do so it may cause more injuries. Always call triple zero (000) in an emergency and have your address and location ready.

Fast facts:

References used for this topic

More information:

Department of Agriculture and Food (WA)
Preventing lead poisoning in farm animals

Department of Agriculture (Vic)
Working with chemicals

Department of Primary Industries (NSW)
Lead poisoning to livestock

National Poisons Information Centre
Call 13 11 26 – 24 hours a day, 7 days a week

Research & reviews:

Australian Institute of Health and Welfare
Accidental Poisoning

First aid kits

First aid kits are essential on farms. Life on a farm comes with its own set of hazards and a first aid kit should be properly stocked and available at all times. It’s a good idea to keep a first aid kit in the home, car, ute, truck, shearing shed and workshop.

Well-stocked first aid kits should contain components to address: 

Thes items will enable emergency care to be given to an injured family member or employee until medical assistance arrives. The isolation of many Australian farms means medical assistance may take time to arrive. Consequently, preserving life, preventing a condition from worsening and the promotion of recovery is more likely to occur with a well-stocked first aid kit.

Everyone living and working on a farm should know the location of all first aid kits and be trained in first aid; once a course is completed, refreshers are required every three years. To remain effective, first aid kits need to be maintained through regular component checks and used or expired stock replaced as soon as possible. 

For more information on first aid kits visit Better Health Channel.

Fast facts:

References used for this topic

More information:

Australian Red Cross
First Aid and Mental Health training

Better Health Channel
First aid basics and DRSABCD

Safework Australia
First aid

St John Ambulance Australia
Visit website

Eye injury – something in your eye? Don’t ignore it!

Eye injuries on the farm: What you need to know

Working on the land means you’re often exposed to dust, dirt, chemicals, metal, grain and machinery. All of these can lead to serious eye injuries, especially when you’re welding, grinding, fencing, spraying or working with animals. 

Between 2010 and 2015, agriculture, forestry and fishing were the second highest industry for work-related eye injuries in Australia. That’s a lot of farmers, fishers and forestry workers getting hurt on the job (AIHW, 2017). 

What is a foreign body in the eye? 

A foreign body is anything that gets into your eye and doesn’t belong there – like: 

Even a tiny speck can cause big damage. Eyes are also highly vascular and will absorb chemicals into the bloodstream more rapidly than when splashed on the skin. 

Symptoms include pain, burning, irritation, a scratchy feeling, blurred vision, loss of vision, sensitivity to bright lights, bleeding into the white of the eye and a feeling that something’s still in it.  

What to do if you get something in your eye 

Do not try to remove the object yourself. You might make it worse. 

Complications with eye injuries

What causes eye injuries on farms? 

Farm kids and eye safety 

Children on farms are often around workshops, machinery, animals and even chemicals. They may be helping or copying adults, or be nearby when you’re using tools and equipment. 

Eye injuries in kids can happen when: 

When it comes to farm kids and eye safety, remember:

Prevention is better than a trip to emergency 

Find out more about this topic on Better Health Channel.

Fast facts:

References used for this topic page

More information:

Better Health Channel
Eye safety at work

Clinical care:

Australian Doctor
How to treat: minor farm issues [PDF]

Royal Children’s Hospital Melbourne
Acute eye injury

Lunz, R., Brumby, S., Clifforth, S., & Yoshimitsu, Y. (2019). Minor farm injuries: How to treat [How to treat]. Australian Doctor, (September 2019), 15-22.
Retrieved from https://ausdoc.com.au/how-treat/minor-farm-injuries

Research & reviews:

Australian Institute of Health and Welfare
Eye injuries in Australia 2010–11 to 2014–15

Bentham Open Access
Hospitalised eye injuries in New South Wales, Australia [PDF]

Safe Work Australia
Work related eye injuries in Australia [PDF]