Table 1:

Select list of important agents known to cause occupational hypersensitivity pneumonitis*

TypeAgentExposure examples
BacteriaThermophilic actinomycetesFarmers, bagasse workers, mushroom workers, potato riddlers, compost workers, ventilation systems
Lichtheimia corymbiferaFarmers
Acinetobacter, OchrobactrumMetal working fluids
Streptomyces albusCompost workers
Klebsiella oxytocaHumidifiers
Bacillus subtilis enzymesDetergent industry
Mycobacterium avium complex and other nontuberculous mycobacteriaSpa workers
Mycobacterium immunogenumMetal working fluids, machine operators
FungiAlternaria alternataHumidifiers, wood workers
Aspergillus spp.Stucco workers, tobacco growers, malt workers
Trichosporon cutaneumSeasonal mold contamination in homes
Penicillium speciesCork workers, cheese workers, food processors, peat moss processors
Cryptostroma corticaleMaple bark strippers, florists
Botrytis cinereaWine makers
Mucor stoloniferPaprika slicers
Various mushrooms (Shiitaki, Bunashimeji, Pleurotus, Pholiota, Shimeji, Agaricus)Mushroom workers
EnzymesPhytase, subtilisinAnimal feeding, cleaners
Animal & insect proteinsAvian serum and feather proteinsBird breeders
Rat serum proteinsLaboratory workers
PearlPearl industry
Mollusk shellNacre industry
SilkTextile workers
CarmineFood and cosmetic industry
Sitophilus granariusFarmers
Plant proteinsTiger nuts, legumes (e.g., soy), maltFood processors
AlginateSeaweed workers
Woods (ramin, pine)Wood workers
Esparto dustStucco workers
Low-molecular-weight chemicalsDi-isocyanatesChemical and polyurethane industry, painters
Acid anhydridesPlastic workers, aircraft industry
Acrylate compoundsDental technicians
Triglycidyl isocyanuratePainters (powder paint)
Pharmaceutical agents (penicillins, cephalosporins)Pharmaceutical industry
Dimethyl phthalate and styreneYacht manufacturing
MetalsCobaltHard-metal workers
ZirconiumCeramic workers
  • * Adapted from Quirce and colleagues6 and published with permission from John Wiley and Sons.