HISTOPLASMOSIS: Protecting Workers at Risk

DHHS (NIOSH) PUBLICATION
NO. 97-146 SEPTEMBER 1997

Foreword

  Most reported outbreaks of the disease histoplasmosis share the same scenario: Individuals who caused or were near disturbances of dusty material contaminated with Histoplasma capsulatum, inhaled spores of this fungus, and became ill did not know the health risks associated with their activities. Consequently, because of a lack of knowledge about histoplasmosis, employers and their employees were inadequately or not at all prepared to take effective preventive action. This booklet will help readers understand what histoplasmosis is, recognize activities with risks for exposure to H. capsulatum, and learn ways to protect themselves and others from exposure.

This booklet should be read by safety and health professionals, environmental consultants, supervisors, and anyone else with direct or indirect responsibility for the health and safety of workers who might be involved in activities where contaminated material might be disturbed. Examples include disturbance of soil at an active or inactive bird roost or poultry house, excavation in regions where H. capsulatum is endemic, or removal of an accumulation of bat or bird manure from a building.

Local, state, and national public health professionals may also find this booklet useful for understanding the health risks of H. capsulatum exposure so that they can provide guidance about work practices and personal protective equipment. The appendix consists of two 2-page fact sheets about histoplasmosis, one in English and one in Spanish. The fact sheets are intended for distribution by employers, health agencies, unions, or cooperatives to workers and the public to help educate them about histoplasmosis.

Linda Rosenstock, M.D., M.P.H.
Director, National Institute for Occupational Safety and Health
Centers for Disease Control and Prevention

 

Authors and Acknowledgements

This booklet was written by Mr. Steven W. Lenhart, Dr. Millie P. Schafer, and Dr. Mitchell Singal, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), and Dr. Rana A. Hajjeh, National Center for Infectious Diseases (NCID), also of CDC. Secretarial support was provided by Ms. Ellen Blythe. Ms. Priscilla Wopat, Spokane Research Laboratory, NIOSH, was the document's editor. The cover design and respirator drawings were created by Mr. Richard A. Carlson. The histoplasmosis fact sheet was translated to Spanish by Dr. Veronica Herrera-Moreno. The authors also extend gratitude to Dr. Donald L. Campbell, Ms. Teresa A. Seitz, Mr. Kenneth F. Martinez, and Ms. Dawn G. Tharr of NIOSH; Dr. Ted Pass II of Morehead State University; and Dr. Myat Htoo Razak for their encouragement and invaluable contributions to this work.

 

Table of Contents

  What is histoplasmosis?

  How is histoplasmosis diagnosed?

  Where are H. capsulatum spores found?

  Who can get histoplasmosis and what jobs and activities put people at risk for exposure to H. capsulatum spores?

  Should workers who might be exposed to H. capsulatum have pre-exposure skin or blood tests?

 What can be done to reduce exposures to H. capsulatum?

  What are the advantages and disadvantages of various kinds of respirators for protecting workers against exposure to H. capsulatum?

  What personal protective equipment other than respirators should workers wear?

  What other infectious agents are health risks for workers who disturb accumulations of bat droppings or bird manure?