Does compressed air dry out the lung / ABPA

Question

Hello,
I want to ask 2 questions in behalf of my boy-friend, who is 28 years old and suffers from CF. For a few weeks, he is for the first time in his life under oxygen therapy (24 hours) and has to adapt himself additionally 5 hours a day to a compressed air device, in order to bring the C02 value down. What is responsible for his bad clinical condition in the first row - besides the chronic germ Stenotrophomonas for 1 year - could not be revealed clearly until now, in spite of detailed tests. The test for ABPA has been borderline however and he gets voriconazloe and cortisone in addition to the actual IV-therapy.
2 questions:
-In the oxygen tube, water is collected therefore there is the question, if for hygienic reasons an abandonment of the aquapack would make sense with 1l/hour, but in case of using the compressed air device - which is anyhow inconvenient - this could be probably disadvantageous due to increased drying out?
- My friend stays at the moment in the house of his parents from the 1930ties, which is visually in good condition. The physician of my friend however had the suspicion from afar, that he could be exposed to mould fungi there (possibly not directly visible). This is hard to check. In the basement and in the poorly isolated attic, which is wainscoted with wood, possible mould could not be excluded, he avoids however entering those rooms at the moment. How should one behave concerning this problem? Perform mould tests? Could those be paid by the health insurance (probably not)?
Many thanks and best regards,

Answer

Dear questioner,
many thanks for the 2 interesting questions, which I like to answer. In swiss hospitals a "humidifying" of the oxygen has been abandonned for a long time because of the exact reason of hygiene, particularly as the benefit is questionable. The air is namely automatically humidified in the nose and therefore the humidification does not play a role for the lung, at least for the nose. Here a good nasal ointment helps. The things are a bit different for the compressed air device (I assume it deals with a cPaP or BiPAP-device). Here one can indeed use a humidifier, which is supplied with the device, as this is a lot more convenient for the patient. However, a good hygiene has here also to be taken into account, that means to clean the humidifier well always in the mornings and let it dry out. Then this should not present a hygienc problem.
Concerning the second question, it is not as easy to answer. In general, mould fungi live especially in humid rooms, an old house is therefore not per se a real refuge of fungi. Furthermore, mould is only dangerous in case of direct contact, even if there should be mould in the basement or attic, it is not dangerous in another room. Your friend would have to stay in the basement or attic, in order to have a problem. In case he does not stay there, I do not believe that this is a problem for your friend. Concerning mould tests I would be generally very restrained, as there are many "institutes" which offer such tests, but the results that they present are not very reliable and only cost a lot of money (is not covered in Switzerland by the health insurance and I do not suppose in Germany, either).
I understand your insecurity very well, as you only wish the best for your boyfriend, but only because of a very questionalbe risk concerning fungi in the house of his parents it would not be justified to break the contact to his parent's house. As far as I can estimate the situation due to your description, as a next step a lung transplantation should be discussed due to the relatively advanced CF of your boyfriend.
I hope that I was able to help you a bit and send you best regards,
Dr. med. M. Hofer
university hospial Zürich, Switzerland

20.01.2011