NIOSH 2022-103: Histoplasmosis: Protecting Workers at Risk

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Publisher: Centers for Disease Control and Prevention (CDC) / National Institute for Occupational Safety and Health (NIOSH)

URL: https://www.cdc.gov/fungal/diseases/histoplasmosis/

Overview

Histoplasmosis is an infection caused by the fungus Histoplasma capsulatum. It lives in the environment, particularly in soil that contains large amounts of bird or bat droppings. Histoplasmosis is the most common fungal lung infection in the United States.

Where Histoplasma Is Found

• Soil enriched with bird or bat droppings
• Central and eastern United States — especially the Ohio and Mississippi River Valleys
• Also found in other parts of the world

Symptoms

Many workers who breathe in Histoplasma spores do not develop symptoms. When symptoms do occur, they typically appear 3–17 days after exposure and may include:

• Fever
• Cough
• Fatigue (extreme tiredness)

In some people, the infection can spread from the lungs to other parts of the body — this is more likely in people with weakened immune systems.

Work Activities With Higher Risk of Exposure

• Disturbing material contaminated with bird or bat droppings
• Disrupting soil — especially in areas where birds roost or bats live
• Digging, excavating, or grading soil
• Doing plant care or landscaping work
• Demolishing or renovating old buildings
• Doing construction work

High-Risk Industries

• Construction and demolition
• Mining, quarrying, oil and gas extraction
• Agriculture, forestry, fishing, and hunting

How Employers Can Protect Workers

Site Safety Plan

Develop and implement a site safety plan before work begins. The plan should address:

• Potential exposure to Histoplasma
• Control measures to reduce exposure

Engineering Controls

• Wet down or suppress dust in contaminated areas before and during work
• Use vacuum equipment with HEPA filtration

Administrative Controls

• Properly dispose of contaminated material per applicable state and local requirements
• Post health risk warnings about the potential for Histoplasma exposure at the worksite
• Train workers to recognize tasks that may disturb Histoplasma and how to protect themselves

Personal Protective Equipment (PPE)

When working in areas that may contain Histoplasma, provide workers with:

• NIOSH-approved respirator (minimum: N95)
• Eye protection
• Gloves
• Coveralls with a hood
• Disposable shoe coverings

Resources

• CDC Histoplasmosis information: https://www.cdc.gov/fungal/diseases/histoplasmosis/
• NIOSH: https://www.cdc.gov/niosh/