Each day, thousands of music students head to band practice with their trumpets, trombones and saxophones. But they may want to pay a bit more attention to the way they clean out their instruments when rehearsal is over. One musician in Connecticut learned the hard way about the dangers of not cleaning his horn — after he developed a condition that's being called "trombone players' lung."
Diane Orson For NPR
"I coughed. I had a horrible deep barking cough — especially when I played trombone," Scott Bean says. It turned out that his trombone, or what was inside it, was making him sick.
"I coughed. I had a horrible deep barking cough — especially when I played trombone," Scott Bean says. It turned out that his trombone, or what was inside it, was making him sick. Diane Orson For NPR
Scott Bean spends hours each day performing, practicing and teaching the trombone. But for years, Bean struggled with health problems that made it hard to play his instrument.
"I coughed. I had a horrible deep barking cough — especially when I played trombone. I had a sore throat, lost 60 pounds at a time, had a low-grade fever," he says. "It was a huge hindrance."
The Stuff Inside
Doctors thought Bean had asthma, but none of the usual therapies worked. After 15 years, Bean went on vacation for the first time without his trombone — and felt better. He began to wonder if the instrument could be making him sick.
A doctor at the University of Connecticut took a culture from inside his horn.
"Then he calls me up and says, 'Scott, we know what's in your trombone,'" Bean says.
It was a mold called fusarium, says Mark Metersky, a professor at the University of Connecticut Medical School's division of pulmonary and critical care.
Dr. Mark Metersky
Dr. Mark Metersky took this picture of what's living in Scott Bean's trombone. The pink rods are Mycobacterium chelonae-abscessus species organisms. The round blue things are cells from the mucus membranes of Bean's mouth.
Dr. Mark Metersky took this picture of what's living in Scott Bean's trombone. The pink rods are Mycobacterium chelonae-abscessus species organisms. The round blue things are cells from the mucus membranes of Bean's mouth. Dr. Mark Metersky
"He also grew a type of bacteria called a mycobacterium, sort of a cousin of tuberculosis," Metersky says.
This stuff inside the trombone was causing an allergic reaction, which led to hypersensitivity pneumonitis, a severe inflammation of the lungs. Microscopic organisms were breaking off and getting into Bean's lungs each time he inhaled.
Bean admits brass players are often lax about cleaning their horns.
"You talk about cleaning out your instrument, and they laugh and make some funny remark about it," he says. "I never cleaned out my trombone — maybe once every other year. We never clean it out."
Mold and bacteria could grow in any brass instrument. And for most players, it wouldn't matter much, except maybe aesthetically. But for a subset of people who react to these organisms, it's no joke. Metersky set out to see how common a problem it was. He asked several professional musicians if he could culture the insides of their trombones and trumpets for a pilot study.
"Things plopped out," Metersky says. "It was disgusting. Imagine the worst thing you've found in your refrigerator in food that you've left for a few months, and that was coming out of these instruments."
Metersky stopped testing after 10 instruments, because they all were contaminated. His findings are published in this month's issue of the pulmonary journal Chest. There's also a separate case report on hypersensitivity pneumonitis from a contaminated saxophone.
Doctors have known about this disease for a while, but Cecile Rose, a hypersensitivity pneumonitis expert at National Jewish Health in Colorado, says no one has ever thought to connect it to musical instruments.
"I think it probably hasn't been figured out because doctors don't ask the right questions," Rose says, "and because this disease has symptoms that are identical to symptoms of more common diseases."
Now Bean is diligent about cleaning out his trombone.
"I use a rod with a cloth and use alcohol — rubbing alcohol or isopropyl alcohol — pour it down, and it cleans out the germs," Bean says.
And he finds playing his horn a lot easier.