Workplace Medical Mystery: Influenza-like Illness Sickens Golf Course Worker

Posted on by Stephanie Stevens, MA


Chris was thrilled to have landed a summer job working at the local golf course. He was going to be a junior in college and he knew forthcoming summers would entail internships in a dark, windowless office. Chris loves playing golf and  this job would give him the opportunity to play for free whenever he had the chance.

Chris’s job at the golf course was “course maintenance.” On a typical day he arrived at 4 a.m. to mow the greens and place the pins before the first golfers teed off. He was also responsible for making repairs to the tee boxes, greens, and fairways as well as other odd landscaping jobs around the course.

After working at the course for about a month, Chris and some of his colleagues were assigned some new tasks by their manager, the golf course superintendent. Half the team would be spraying parts of the course with a pesticide to help reduce the number of mosquitos the golfers had been complaining about. Chris and eight of his co-workers would be unloading a trailer of wood chips and spreading them around some of the decorative trees and shrubs on the course.

At 8 a.m. Chris met the wood chip vendor who arrived with a 40-foot enclosed trailer filled with wood chips. As Chris signed the invoice the vendor noted that he had given the course a 10% discount since some of the wood chips were leftover from last year. Chris and four other workers went to work unloading the trailer, while the other four employees spread the chips around the course.

Chris hurriedly shoveled the mulch; after all, the sooner he finished, the sooner he could start a round of golf. It was especially hot that day so both Chris and his co-workers opted not to the wear the respiratory masks that their employer made available to them. As Chris began shoveling the wood chips from the front of the trailer, Chris yelled out to his colleagues, who were still working at the back of the trailer, “it’s a good thing they gave us a deal, these chips are all moldy and gross!”

By Noon the trailer was just about empty so they decided to call it a day and finish what was left tomorrow. Chris quickly changed his shirt—it was covered in dust from shoveling the chips—and hopped in a golf cart; he figured he could at least get nine holes in before he would be too tired.

Chris breezed through the first few holes, shooting just over par. On the third hole he had to wait for some of his co-workers to finish spraying for mosquitos over in the rough. By the eighth hole Chris wasn’t just feeling tired; he was feeling weak, chilled, and achy. By the time he was done with his round, he was short of breath and coughing uncontrollably. Feeling feverish and like he might have the flu, he went to the local emergency room.

An emergency room doctor listened to Chris’s lungs and both his breathing sounds and a chest x-ray were normal. However, lab tests showed his white blood cell count was higher than normal. The doctor sent Chris home to drink a lot of fluids and rest.

After Chris got home, he updated his status on Facebook to sick and saw that some of his work buddies had also posted that they were sick.

What is making Chris and the other golf course workers ill? Find out Friday in the next installment of Workplace Medical Mysteries.

Stephanie Stevens, MA, is a Health Communication Specialist in the NIOSH Office of the Director.

This blog is part of the NIOSH Workplace Medical Mystery Series. The names and certain personal details of the characters are fictitious and do not represent an actual person or persons.

Posted on by Stephanie Stevens, MA

14 comments on “Workplace Medical Mystery: Influenza-like Illness Sickens Golf Course Worker”

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    Organic dust toxic syndrome a/k/a pulmonary mycotoxicosis a/k/a silo unloader’s syndrome from the moldy wood chips– that’s my guess. He probably should have kept his respirator on.

    The mold spores from the wood chips have migrated to his lungs. He could be in serious trouble, since mold loves moist, dark environments. His lungs are perfect breeding grounds for the mold to thrive and grow. That can become a serious illness if not soon detected.

    Organic dust toxic syndrome, previously called “acute Farmer’s lung disease”, also previously referred to as “mycotoxicosis”.

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    Heat stroke or heat exhaustion. He started working at 4, shoveled mulch in an enclosed trailer then played 18 holes of golf during the hottest part of the day. That’s at least 11 hours of physical exertion on a “especially hot” day.

    Seems West Nile Virus or Mosquito-borne pathogen could be considered but would not result in reduced WBC counts…Heat stress…but coughing in heat stress? Unusual.

    Hey, What was the Doctor’s Diagnosis? — appears (s)he treated for heat exhaustion.

    Rule out fungal / bacterial inhalation as primary symptoms are not respiratory tract-related although the mycotoxins could be a factor, but inhalation vs. ingestion effects are less common.

    A toxic reaction associated with inhalation of large amounts of dust heavily contaminated with microbial toxins from decomposing vegetable matter

    If other workers were wearing proper equipment and it infers that they were. Why did they also get sick? How can it be prevented then?

    Thank you for your comment. The medical mystery states that “It was especially hot that day so both Chris and his co-workers opted not to the wear the respiratory masks that their employer made available to them.” In this scenario, none of the workers who became sick wore air-purifying respirators, which could have prevented or minimized exposure to the dust.

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Page last reviewed: March 17, 2017
Page last updated: March 17, 2017