Organic Dust Toxicity Syndrome (ODTS, Grain Fever)

Grain fever is an illness of malaise, fever, chills, and muscle aches and pains. It occurs in grain elevator workers and anyone with a heavy exposure to grain dust. It is not an allergic reaction similar to what happens in farmer's lung. It is also called Organic Dust Toxicity Syndrome (ODTS) and is a fairly common illness affecting farmers. ODTS is also called Toxic Organic Dust Syndrome (TODS), grain fever, or pulmonary mycotoxicosis. This means it is caused by breathing in fungi, toxins produced by bacteria, or contaminants in the dust such as mites. In some workers there is long standing asthma. It may come on rapidly within 4 to 8 hours after exposure with flu-like symptoms listed below. It usually gets better in two or three days without treatment.

Other disease caused by this exposure may include:

  • Occupational asthma.

  • Allergic contact dermatitis.

  • Chronic bronchitis.

  • Inhalation fever.


  • Chest tightness.

  • Chills.

  • Cough.

  • Muscle aches.

  • Fever.

  • Runny nose.

  • Headache.

  • Loss of appetite.


  • Your caregiver can usually tell what is wrong by the history of exposure to grain dust.

  • Laboratory work and lung function tests may be helpful.


The illness usually improves in a few days. Watching to see what happens is usually all that is required.

  • If you are a smoker, it is time to quit. You will receive instructions on how to stop smoking. Your caregivers can provide medicine and counseling to help you quit.


  • Cough suppressants may be used if you are losing too much rest. Coughing is a protective mechanism for clearing our lungs. This is one reason for avoiding cough suppressants.

  • Your caregiver may also prescribe an expectorant to loosen the mucus to be coughed up.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • A cold steam vaporizer or humidifier in your home may help loosen mucous secretions.

  • Cough is most often worse at night. Sleeping in a semi-upright position in a recliner, or using a couple of pillows will help with this.

  • Obtain rest as you feel it is needed.


  • You develop more pus like (purulent) sputum, have uncontrolled temperature, or become continually more ill. This is especially true if you are elderly or debilitated from any other disease.

  • You can not control your cough with cough syrup and are losing sleep.

  • You begin coughing up blood.

  • You develop pain which is getting worse or is uncontrolled with medications.

  • You develop an oral temperature above 102° F (38.9° C), after being afebrile (not having a temperature for one or more days).

  • Any of the symptoms which initially brought you in for treatment are getting worse rather than better, or you develop shortness of breath or chest pain.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.