Saxophone Lung – That’s A Thing??

Saxophone Lung – That’s A Thing??

Sax player B&W Silhouette“A wheezing Atlanta clarinet player, who had been playing Dixie for 30 years, was diagnosed with saxophone lung after a year of symptoms that did not improve with treatment.  He was playing the clarinet several times a week and he noticed that after he played, his symptoms would get worse”

Maybe you saw this article when it was reported by NBC News back in 2013.  What was the cause of the patient’s Saxophone Lung? His moldy clarinet that hadn’t been cleaned for 30 years.  OK, that’s just pretty disgusting. Not to mention that there was also a type of fungus growing on the guy’s reed.

I want to explore this thing called Saxophone Lung in much the same way I did in my other blog post, Help – My Trombone Is Making Me Sick

Saxophone lung fungus

Other Examples of Saxophone Lung

There are many more examples of players contracting Saxophone Lung.

Sax Player

letter from 1988 in the journal Chest told the tale of a 67-year-old saxophone player with a cough and shortness of breath. He was diagnosed with hypersensitivity pulmonitis from candida, and it turned out the saxophone mouthpiece was contaminated with that fungus. The symptoms disappeared after the musician started washing the instrument’s mouthpiece with soap and water.

Another case: A 56-year-old woman was referred to the Department of Respiratory Diseases and Allergy, Centre for Interstitial Lung Diseases at Aarhus University Hospital in 2016 due to cough and shortness of breath. She had never smoked. Onset of symptoms one year before had been ascribed to the disposal of a moldy carpet. The patient complained of persistent cough and dyspnea of varying intensity, although exposure to molds had stopped one year before and despite anti-asthmatic treatment initiated by her general practitioner. The patient was a professional bassoonist in a symphony orchestra She reported that her respiratory symptoms had disappeared during a four-week summer holiday, where she had not been playing the bassoon.

And in 2010, a patient was a white-collar worker and had no contact with pets, birds, drugs, or molds at home. He used to play the saxophone as a hobby. Molds were detected in the saxophone. An additional study confirmed the frequent colonization of saxophones with potentially pathogenic molds. Respiratory physicians should be aware of the risk of hypersensitivity pneumonia in saxophone or perhaps other wind instrument players

The worst case was a well-known bagpiper from Wiltshire, England, who was hospitalized for weeks in 2012 due to a near-fatal infection of molds that originated inside his bagpipes. Because his pipes, like most others available today, are made of synthetic materials that don’t require cleaning as much as older models made of animal hides, mold and bacteria can build up undetected for months.

These may seem like rare cases, but one study from the Oklahoma State University for Health Sciences suggests otherwise. The researchers in Tulsa swabbed 13 brass and wind instruments in high school band programs, then rubbed the swabs on petri dishes and waited to see what would grow. They found 295 different bacteria as well as yeasts and molds. The parts that musicians put in their mouths were more contaminated than the rest of the instruments, and two clarinets showed more contamination than the other instruments.

What Causes Saxophone Lung

Saxophone lung is a rare type of hypersensitivity pneumonia, in which patients develop allergic pulmonary disease when they’re exposed to fungi that invade instruments — and are never removed. Basically, the musicians have allergic reactions to the mold that won’t let up. It starts with having a runny nose or cough that does not go away, especially during band. It is the continued exposure to your instrument that prolongs and exacerbates the the situation.

What Can You Do

I enlisted the help of some of my colleagues that suggested what they would do to prevent the problem of Saxophone Lung. Here is what they had to say:

Jay Metcalf at Better Sax

Jay has this killer web site, Better Sax, with lessons, tips and strategies for saxophone players. His advice is pretty straightforward:

My advice is to swab out the saxophone, neck and mouthpiece after every playing session. This keeps your saxophone clean, will extend the life of your pads by many years, and keeps your saxophone in adjustment so leaks are less of an issue. Of course hygiene is also a factor. When you do this, your horn and case won’t end up stinking.

Simple but very sound. He also sent me a couple of links to videos which is what I really like.

Jay sent me this link on what he uses to take care of his saxophone.

Here is a list of the products that Jay mentioned in the video:

Did I say I really like the web site, Better Sax? Great tips and saxophone lessons. Speaking of lessons, Jay has some great YouTube videos like the one above. He sent me a link to another one that I really liked, 17 Pro Saxophone Tips: Assembly|Disassembly Good stuff.

Bob van der Poel, Mellowood

Bob has a more down-to-basics approach. He commented:

I think keep the horn and mpc. clean. Run a pull wipe though after playing and let the horn dry outside of the case. I’ve still got most of the original pads on my horn after 20 years of playing.

Bob is one of my ideas of a “Senior Bandsman”; he did not pick up the saxophone until he was in his 40’s. He summed up his philosophy on the overall subject very well with a piece on his website, The Zen Of Saxophone

Pete Thomas at Taming the Saxophone

I have been following this guy for years. You could not meet a better guy in the saxophone business. He has a wealth of knowledge. His advice is in the technical section of his web site. Pete had this to say about taking care of your saxophone:

“…it’s probably best to leave the saxophone out a while to dry before putting it away in it’s case but that is not always practical. The more crucial parts of the instrument for hygiene are the neck and the mouthpiece. For this I find the best thing is to use a bottle brush or toothbrush and then just rinse with clean water.”

He has an article, Saxophone Maintenance, that is full of good tips and advice. In this article, there is one section titled “Which is Best, Swab or Padsaver? ” Maybe you do not realize this, but this is a lively debate in the saxophone world.

Swab Vs Padsaver – Still a Vigorous Debate

In a previous post, How To Clean Your Saxophone, I commented on HW Pad-Savers and even said they were my “My Favorite Saxophone Care Products.” (Light fuse HERE) The debate has been going on for some time and I started it back up. Bob van der Poel of Mellowood commented “… does it make sense to take all those nasty bacteria and give them a nice, damp place to live? That’s what the fuzzy thing is all about … a dumb idea.” My own repair guy, Steve Jackson of SJ Woodwinds said “…they used to be popular but not anymore. Moisture and lint together are not a good idea.”

I take to heart what both Bob and Steve are saying but let me add my $.02. Bob said ” Run a pull wipe though after playing and let the horn dry outside of the case.” If I could always do it, this is what I would do. But I do not think that this is what happens in the real world. There is usually not time to let the horn dry outside the case. In the real world, rehearsal, the gig. or band period is over and you put the horn back in the case and go about the rest of your day. Even the best swab will not remove all of the moisture from the inside of your horn. So there you are, with a horn that is still sorta damp, sitting in a dark airless case.

So let me, for better or worse, throw out there what I do.

Hodge Silk Baritone Saxophone Swab
Hodge Silk Baritone Saxophone Swab

I start with a silk swab. I like silk because it is very absorbent. Since I play bari sax, I use a Hodge Silk Baritone Saxophone Swab to swab out the crook in the bari’s neck. This is where the bulk of the moisture accumulates.

My bari sax with the HW Pad Saver
My bari sax with the HW Pad Saver

Next, I insert into the neck, a HW Pad-Saver for Baritone Saxophone. Then the sax with the Pad Saver goes into my case and I am off on my merry way. If the horn is going to be stored in the case for days, when I get home, I remove the Pad Saver from the neck. I do not store my instrument for a period of time with the Pad Saver in the neck.

I also only recommend the HW Pad Saver, not any other brand. According to the HW Products web site, ” … our HW Pad-Saver de-moisturizers are made from a proprietary micro-fiber that wicks moisture on contact and dries in half the time of cotton or silk”. “Our HW Pad-Saver will not shed, shrink, or bleed…” I think the key phrase here is “wicks moisture”. If my horn is going into the case, when I am do not have time to sufficiently air dry it, I want something in there at least wicking up the leftover moisture inside my horn. Like I said, let the debate begin. (Dismount from soap box)

So Is “Saxophone Lung” a Thing?

I have had a couple of my friends say to me “I haven’t worried about this thing called Saxophone Lung for over 30 years and I’m still alive”. (This is the kind of thing a Senior Bandsman would say) Look, I get it. Some people can be exposed to the same kind of germs; one gets sick and one doesn’t. But a wet saxophone is a breeding ground for fungus and germs. So do the smart thing, take care of your instrument. There are many ways to minimize the moisture in your horn. Just be smart about it.

As always, I welcome all of your comments. Let’s start a discussion. Or if you want to engage in a private conversation, email me at As always, Play On.

7 thoughts on “Saxophone Lung – That’s A Thing??

  1. Great article. That saxophone lung is scary. But a stinky sax, case and mouthpiece are just disgusting. As a repair technician, I have had to smell and handle countless instruments with a serious hygiene problem. Clean your instruments people!

  2. I can say that I used a pad saver all through high school in the 80’s. Worked great. The thing is that I went on to electronics school and stopped playing for a length of a few years. I had forgotten that the pad saver was still in the horn. What happened when I pulled it back out was this. All three palm keys on the top had to have the pads replaced. It look like a moth or some insect had eaten them. It was actually from bacteria but the damage was done. I went ahead and repad the entire Tenor just to make sure nothing was left over and tossed out the pad saver for fear of contamination. So I would heed the words of advice in this article about removing the pad saver if you plan on not playing after a few days. I didn’t and I paid the price.

  3. Would cotton cloth dipped in Listerine help cleaning to reduce the chances of microbes growing inside Sax?

    Would Listerine increase oxidation of the horn?
    Do any other anti microbials work such as dettol, carbolic , hibitane etc ?

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