Image: cesc_assawin/Shutterstock

Bagpipes and other wind instruments produce beautiful music, but they can also be prime breeding grounds for molds and fungi. Players then regularly breathe in those creatures, and can develop inflamed lungs as a result—or even a fatal lung disease.

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That’s the conclusion of an unusual case study just published in the journal Thorax by researchers at the University Hospital South Manchester in England. They’ve dubbed it “bagpipe lung,” because that was this particular patient’s instrument of choice, but the same risk applies to any wind instrument, the authors caution.

We’ve all experienced that annoying nagging cough that lingers on after we catch a cold or the flu. Now imagine coughing for seven years. That’s what happened to the 61-year-old man in the case study. He was diagnosed with hypersensitivity pneumonitis (HP)—essentially chronic inflammation of the lungs usually brought on by inhaling dust, fungus, mold, or chemicals—which can lead to severe lung disease.

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It can be difficult to pinpoint whatever triggered the onset of HP. This particular patient had none of the usual risk factors: there was no mold in his home, he hadn’t been exposed to pigeons or other birds, he didn’t smoke, and he didn’t work with chemicals.

CT scan of inflamed lungs of a patient suffering form HP. (Image: M. Funke, J-M. Fellrath/European Respiratory Journal.

But he did play his beloved bagpipes every day, despite having trouble breathing because of his inflamed lungs. Coincidentally, the only time his symptoms improved during those seven years was when he spent three months in Australia and left his bagpipes behind.

When samples were taken from the bag, neck, and reed protector of the instrument and placed in a petri dish, several different varieties of fungi bloomed.

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It seems that yeast, mold, and other microbes really flourish in the moist environment provided by the bagpipes. The man had been breathing in these fungi every day when he played, triggering his HP.

Alas, the man did not respond to treatment and died from all the damage to his lungs. Granted, it’s a single isolated case, but there have also been reported (non-fatal) cases of HP in people who played the saxophone and the trumpet. There are no established guidelines on the best way to clean wind instruments, but lead author Jenny King and her colleagues advise regularly swabbing them with disinfectant after use, the better to keep the growth of microbes in check.

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The case also illustrates just how vital it is to take a detailed, thorough case history, including patient hobbies. If doctors and musicians become more aware of this particular health risk, maybe the next bagpipe player with a chronic cough won’t have to wait seven years to pinpoint the trigger.

UPDATE: 8/23/16 12:45 PM: The fine folks at the Piping Live! Glasgow International Piping Festival have recorded a helpful video at the National Piping Centre to show musicians how to properly clean their bagpipes.

[Thorax]