Tobacco Worker's Lung Treatment & Management

Updated: Apr 17, 2018
  • Author: Roger B Olade, MD, MPH; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Medical Care

The major treatment strategy is elimination of exposure to tobacco molds or leaves. Preventing further exposure to the offending agents usually leads to symptom resolution.

Most available studies have been on farmer's lung. Because farmer's lung has strong similarities to tobacco worker's lung, treatment strategies are generally extrapolated from those for farmer's lung. Antigen avoidance usually results in regression of disease, but corticosteroid treatment may be required in more severe cases.

Corticosteroids are effective in the initial recovery in severely ill patients; however, the long-term outcome appears unchanged by corticosteroid treatment. [18] Treatment is recommended in patients with subacute or chronic disease presentations, patients with persistent symptoms, abnormal pulmonary function tests, hypoxemia, and radiographic evidence of extensive lung involvement.

Therapy is usually initiated with prednisone, 0.5 to 1 mg/kg of ideal body weight daily (up to a maximum daily dose of 60 mg per day), given as a single dose each morning. This dose is maintained for about 2 weeks and then tapered over the next 2-4 weeks.

Maintenance doses are not necessary, assuming patients have implemented good measures to avoid the culprit antigen. Inhaled corticosteroids might also be an option, but no strong supporting data are available at present.