Bagassosis: A Study of Pulmonary Function in 20 Cases

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Abstract
Twenty patients with respiratory symptoms following an occupational exposure to dry bagasse had complete studies of pulmonary function. After varying periods of exposure, the most common symptoms were shortness of breath, productive cough, chest pain, weakness, chills and fever, anoxoria, weight loss and night sweats. Relapses were common on re-exposure to the bagasse material. The most frequent physiological findings were modest reduction of the vital capacity and total lung capacity and a mild disturbance of gas transfer, as measured by a breath-holding modification of carbon monoxide diffusion. Determinations of vital capacity and DLCO (diffusing capacity of the lungs for CO) were below the mean predicted value in 85% of the patients. Arterial O2 unsaturation was found in 5 patients, either at rest or after exercise. Unsaturation was most commonly encountered in the patients with lowest diffusion measurements. Only 2 patients have chronic respiratory symptoms; both have diffuse obstruction to air flow which has persisted. The other 18 patients are asymptomatic. Serial studies show that the reduction of gas transfer is reversible and accompanies clinical and radiological improvement. It is concluded that bagassosis is a self-limited process in the majority of cases, with complete recovery. When chronic symptoms occur they are likely to be associated with diffuse obstruction of the airways.

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