[Exogenous allergic alveolitis of farmers (farmer's lung) from the viewpoint of an alpine pulmologic practice].

Extrinsic allergic alveolitis of the rural population is a relevant disease of the alpine region. Observations in a pulmonologic practice suggest that the disease may represent itself in a acute and a chronic form. Six patients with acute alveolitis, 8 cases of chronic farmer's lung, 16 cases of late disease stages and 33 patients of sensitization (with positive immunologic data) without overt disease are described. Additional 31 patients with bronchopulmonary symptoms but without specific antibodies served as controls. The entire patient population was actively working in farming jobs. Case history, clinical, radiographic and immunologic data as well as lung function testes are presented. Follow-up studies suggest that climatic and occupational factors of the region modify the incidence and the clinical course of the disease. Actually, the quantity of antigen present may determine the course of disease. The acute extrinsic alveolitis appears to be associated with massive antigenic exposure. A lower antigenic presence is assumed to initiate occult phases of alveolitis which ultimately may lead to the chronic variety of the disease. Measures for prevention and treatment of this occupational disease involve proper hay drying which abolishes the antigenic sources, prevention of exposure during working and the attempt of long term medical prophylaxis.