Antigen identification and avoidance is the foundation of treatment in hypersensitivity pneumonitis and is linked to better outcomes. Take a detailed exposure history at home and work: birds and feathers (including pigeons and feather bedding), mould and damp, humidifiers and air coolers, hot tubs, and occupational dusts. In India, pigeon exposure and water-based air coolers are common and easily missed.
- Ask specifically about pigeons, other birds and feather pillows or quilts.
- Ask about damp, visible mould and evaporative air coolers.
- Check occupational exposures, including farming and wood dust.
- Advise complete avoidance where an antigen is found, and document it.
Why it matters
No drug works as well as removing the exposure that drives the disease.
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