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?