In Switzerland, the classic acute form of farmer's lung is rarely reported, probably because it is uncommon rather than because patients fail to seek medical advice. Fibrotic changes are also exceptional [de Haller, 1974 a,b]. In this study, 23 male subjects living in an alpine valley were investigated and followed up to 4 years. According to reports from veterinary surgeons, the hay there is usually moldy because of the climate and inadequate technical assistance in processing.All the farmers had symptoms of chronic bronchitis, 17 with dyspnea. Bronchial obstruction was seen in 15 (65%) and was generally poorly reversible. It was severe (FEV1 50%) in 12 of the farmers with hypoxemia (PO, 70 mmHg) in 30%. Respiratory symptoms appearing shortly after starting work with hay were reported by 65% of the farmers. In seven cases (30%), the follow-up showed some transitory infiltrate in the chest X-rays, but these were not associated with symptoms of acute farmer's lung or development of radiological changes indicating fibrosis. Values of lung function remained fairly constant perhaps because of the installation of hay ventilators in the barns. Despite the presence of potentially disabling respiratory symptoms in more than half of these patients, the subjects were still professionally active.In an epidemiological survey comparing dairy farmers of the same valley with a control population, we could confirm the high prevalence of chronic bronchitis in the farmers (43 % vs 5 %), the difference being even greater when only nonsmokers were considered (3 1 % vs 2 %) .These studies show that symptoms of chronic bronchitis and other potentially disabling additional respiratory conditions were common in mountain farms handling only hay-often moldy-as possible noxious agent. Acute fibrotic forms of farmer's lung were not seen. In regard to prevention and possible compensation, this clinical form of occupational respiratory disease must be recognized [de Haller, 1974 a,b; Hapke et al, 19681. Primary prevention is best done by installation of ventilators in the barns to prevent molding of the hay [de Haller, 1974 a,b]. The beneficial effect of this measure in man can be demonstrated from beneficial effects seen in cattle. In cattle, serum precipitins against farmer's lung antigens and the bovine equivalent of farmer's lung disease rapidly decrease following installation of hay-drying equipment in the barns [de Haller, manuscript in preparation, 1987; Nicolet et al, 19721.