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Seidel J, Magzamen S, Wang YH, Neujahr V, Schaeffer JW. Lessons from Dairy Farmers for Occupational Allergy and Respiratory Disease. Curr Allergy Asthma Rep 2023:10.1007/s11882-023-01081-2. [PMID: 37191901 PMCID: PMC10186320 DOI: 10.1007/s11882-023-01081-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE OF REVIEW Exposure to bioaerosols at dairies has long been associated with allergy, respiratory disease, and decreases in lung function. Recent advancements in exposure assessments have aided our understanding on the size distribution and composition of these bioaerosols, but investigations focusing solely on exposures may overlook important intrinsic factors impacting worker's susceptibility to disease. RECENT FINDINGS In our review, we discuss the most recent studies examining the exposures and genetic factors that contribute to occupational disease in dairy work. We also review more recent concerns in livestock work associated with zoonotic pathogens, antimicrobial resistant genes, and the role of the human microbiome. The studies highlighted in this review demonstrate the need for further research to better understand bioaerosol exposure-response relationships in the context of extrinsic and intrinsic factors, antibiotic-resistant genes, viral pathogens, and the human microbiome to help inform effective interventions that improve respiratory health among dairy farmers.
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Affiliation(s)
- J Seidel
- Department of Environmental and Radiological Health Sciences, Colorado State University, 1681 Campus Delivery, Fort Collins, CO, 80523-1681, USA
| | - S Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, 1681 Campus Delivery, Fort Collins, CO, 80523-1681, USA
| | - Y H Wang
- Department of Environmental and Radiological Health Sciences, Colorado State University, 1681 Campus Delivery, Fort Collins, CO, 80523-1681, USA
| | - V Neujahr
- Department of Environmental and Radiological Health Sciences, Colorado State University, 1681 Campus Delivery, Fort Collins, CO, 80523-1681, USA
| | - J W Schaeffer
- Department of Environmental and Radiological Health Sciences, Colorado State University, 1681 Campus Delivery, Fort Collins, CO, 80523-1681, USA.
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Serya H, El-Helaly M, Mosbah El-Diasty M, Al-Wehedy A, Elsherbeny E. Respiratory Findings in Herd Dairy Farmworkers from the Nile Delta Region. LA MEDICINA DEL LAVORO 2023; 114:e2023004. [PMID: 36790408 PMCID: PMC9987471 DOI: 10.23749/mdl.v114i1.13518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/18/2022] [Indexed: 02/16/2023]
Abstract
BACKGROUND Dairy farmworkers are exposed to a variety of respiratory hazards, including organic and inorganic dust, allergens, disinfectants, and gases emitted by cows and their wastes resulting in a range of adverse health effects. In Egypt, large herd dairy farms (>1000 cattle) are growing in both size and number and thereby more workers are employed. However, there is a lack of studies on the respiratory health status of these workers. Accordingly, the present study aimed to determine the prevalence of respiratory problems, assess ventilatory functions, and highlight the predictors of abnormal spirometry patterns among Egyptian dairy farmworkers. METHODS A cross-sectional study was carried out on 282 male workers, of whom 141 were dairy farmworkers and the other 141, not involved in livestock handling, were enrolled as controls. Full history, clinical examination, and ventilatory function measurements were done for both groups. RESULTS Dairy farmworkers had a significantly higher prevalence of respiratory symptoms (throat irritation and/or sore throat, cough, sputum production, and difficulty breathing) than controls as well as bronchitis, wheezes on chest auscultation, and obstructive ventilatory patterns. Older age (>37 years), longer smoking duration (>10 years), and longer working duration (>4 years) were independent predictors of abnormal spirometry patterns, particularly obstructive patterns, in dairy farmworkers. CONCLUSIONS Large herd dairy farms, despite being open and naturally ventilated, are hazardous to workers' respiratory health. Hence, the provision of personal protective equipment, periodic spirometry examinations as well as mandatory breaks and days off, are highly urged.
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Affiliation(s)
- Hend Serya
- Industrial Medicine and Occupational Health at Public Health and Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Governorate, Egypt.
| | - Mohamed El-Helaly
- Industrial Medicine and Occupational Health at Public Health and Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Governorate, Egypt.
| | | | - Adel Al-Wehedy
- Industrial Medicine and Occupational Health at Public Health and Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Governorate, Egypt.
| | - Enas Elsherbeny
- Industrial Medicine and Occupational Health at Public Health and Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Governorate, Egypt.
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Soumagne T, Degano B, Guillien A, Annesi-Maesano I, Andujar P, Hue S, Adotevi O, Jouneau S, Botebol M, Laplante JJ, Roche N, Dalphin JC. Characterization of chronic obstructive pulmonary disease in dairy farmers. ENVIRONMENTAL RESEARCH 2020; 188:109847. [PMID: 32846639 DOI: 10.1016/j.envres.2020.109847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/19/2020] [Accepted: 06/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Although farming is often considered a risk factor for COPD, data regarding the burden and characteristics of COPD in dairy farmers are sparse and conflicting. OBJECTIVES To characterize COPD in dairy farmers. METHODS 4788 subjects entered two parallel COPD screening programs, one in agricultural workers and one in general practice from 2011 to 2015. Subjects with COPD were invited to participate in the characterization phase of the study. Those who accepted were included in two subgroups: dairy farmers with COPD (DF-COPD) (n = 101) and non-farmers with COPD (NF-COPD) (n = 85). Patients with COPD were frequency-matched with subjects with normal spirometry for age, sex and tobacco smoking (pack-years and status) (DF-controls n = 98, NF-controls n = 89). All subjects from these four groups underwent lung function and exercise testing, questionnaires and blood analysis. RESULTS The frequency of COPD in dairy farmers was 8.0% using the GOLD criterion and 6.2% using the lower limit of normal criterion and was similar in non-farming subjects (7.3% and 5.2%, respectively) although dairy farmers had lower tobacco consumption (screening phase). DF-COPD had better pulmonary function, exercise capacity and quality of life, fewer symptoms and comorbidities than NF-COPD, and higher levels of some Th2 biomarkers (MCP-2, periostin) (characterization phase). In farmers, COPD was not related to occupational exposure factors, supporting the role of host factors. CONCLUSION COPD secondary to organic dust exposure (dairy farming) appears less severe and associated with fewer comorbidities than COPD secondary to tobacco smoking.
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Affiliation(s)
- Thibaud Soumagne
- Service de Pneumologie, Oncologie Thoracique et Allergologie Respiratoire, CHRU de Besançon, France.
| | - Bruno Degano
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, France; Université Grenoble Alpes, Grenoble, France
| | - Alicia Guillien
- Equipe d'Epidémiologie Environnementale, Institute for Advanced Biosciences, Centre de Recherche UGA, INSERM U1209, CNRS UMR 5309, Grenoble, France
| | | | - Pascal Andujar
- Centre Hospitalier Intercommunal de Créteil, Service de Pathologie Professionnelle et de l'Environnement, Créteil, France; INSERM, Unité U955 and Université Paris-Est Créteil, Créteil, France
| | - Sophie Hue
- INSERM, Unité U955 and Université Paris-Est Créteil, Créteil, France; Immunologie-Biologie, Hôpital Henri-Mondor, AP-HP, Paris, France
| | - Olivier Adotevi
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Université de Bourgogne Franche-Comté, Besançon, France
| | - Stéphane Jouneau
- Department of Respiratory Medicine, Rennes University Hospital, Rennes, France; UMR1085, IRSET, Rennes 1 University, Rennes, France
| | - Martial Botebol
- Fédération des Maisons de Santé Comtoises (FéMaSaC), Beure, France
| | | | - Nicolas Roche
- Service de Pneumologie, Hôpital Cochin, AP-HP, Centre Université de Paris, Institut Cochin (UMR1016), Paris, France
| | - Jean-Charles Dalphin
- Service de Pneumologie, Oncologie Thoracique et Allergologie Respiratoire, CHRU de Besançon, France; UMR CNRS Chrono Environnement, Université de Franche-Comté, Besançon, France
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Sigsgaard T, Basinas I, Doekes G, de Blay F, Folletti I, Heederik D, Lipinska-Ojrzanowska A, Nowak D, Olivieri M, Quirce S, Raulf M, Sastre J, Schlünssen V, Walusiak-Skorupa J, Siracusa A. Respiratory diseases and allergy in farmers working with livestock: a EAACI position paper. Clin Transl Allergy 2020; 10:29. [PMID: 32642058 PMCID: PMC7336421 DOI: 10.1186/s13601-020-00334-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/11/2020] [Indexed: 12/13/2022] Open
Abstract
Farmers constitute a large professional group worldwide. In developed countries farms tend to become larger, with a concentration of farm operations. Animal farming has been associated with negative respiratory effects such as work-related asthma and rhinitis. However, being born and raised or working on a farm reduces the risk of atopic asthma and rhinitis later in life. A risk of chronic bronchitis and bronchial obstruction/COPD has been reported in confinement buildings and livestock farmers. This position paper reviews the literature linking exposure information to intensive animal farming and the risk of work-related respiratory diseases and focuses on prevention. Animal farming is associated with exposure to organic dust containing allergens and microbial matter including alive microorganisms and viruses, endotoxins and other factors like irritant gases such as ammonia and disinfectants. These exposures have been identified as specific agents/risk factors of asthma, rhinitis, chronic bronchitis, COPD and reduced FEV1. Published studies on dust and endotoxin exposure in livestock farmers do not show a downward trend in exposure over the last 30 years, suggesting that the workforce in these industries is still overexposed and at risk of developing respiratory disease. In cases of occupational asthma and rhinitis, avoidance of further exposure to causal agents is recommended, but it may not be obtainable in agriculture, mainly due to socio-economic considerations. Hence, there is an urgent need for focus on farming exposure in order to protect farmers and others at work in these and related industries from developing respiratory diseases and allergy.
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Affiliation(s)
- T Sigsgaard
- Department of Environment Occupation & Health, Dept of Public Health, Danish Ramazzini Centre, Aarhus University, Bartholins Allé 2, Build. 1260, 8000 Aarhus C, Denmark
| | - I Basinas
- Institute of Occupational Medicine, Edinburgh, UK
| | - G Doekes
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - F de Blay
- Division of Asthma and Allergy, Department of Chest Diseases, University Hospital, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg University, Strasbourg, France
| | - I Folletti
- Occupational Medicine, Terni Hospital, University of Perugia, Perugia, Italy
| | - D Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - A Lipinska-Ojrzanowska
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - D Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University, Munich, Germany.,Comprehensive Pneumology Center Munich, Member DZL, German Centre for Lung Research, Munich, Germany
| | - M Olivieri
- Unit of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - S Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ) and CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - M Raulf
- IPA Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum, Bochum, Germany
| | - J Sastre
- Department of Allergy, Fundación Jiménez Díaz, CIBER de Enfermedades Respiratorias (Ciberes), Madrid, Spain
| | - V Schlünssen
- Department of Environment Occupation & Health, Dept of Public Health, Danish Ramazzini Centre, Aarhus University, Bartholins Allé 2, Build. 1260, 8000 Aarhus C, Denmark
| | - J Walusiak-Skorupa
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - A Siracusa
- Formerly Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy
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Stoleski S, Minov J, Karadzinska-Bislimovska J, Mijakoski D, Atanasovska A, Bislimovska D. Asthma and Chronic Obstructive Pulmonary Disease Associated With Occupational Exposure in Dairy Farmers - Importance of Job Exposure Matrices. Open Access Maced J Med Sci 2019; 7:2350-2359. [PMID: 31592062 PMCID: PMC6765081 DOI: 10.3889/oamjms.2019.630] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 11/21/2022] Open
Abstract
AIM To evaluate the prevalence of chronic respiratory symptoms, lung function impairment, and chronic obstructive respiratory diseases in dairy farmers. Our objective is to then examine their relation to exposure duration and to explore the usefulness of job exposure matrices as tools for exposure assessment, and predictors for respiratory health impairment. METHODS A cross-sectional study was performed, including 83 dairy farmers (mean age: 52.6 ± 8.7 years; mean exposure duration: 23.7 ± 7.6 years) and 80 office workers as a control group (mean age: 52.7 ± 8.2 years) matched for age, smoking habits, and socioeconomic status. Methods of evaluating examined subjects included a questionnaire on respiratory symptoms in the last 12 months, spirometry and histamine challenge, as well as the use of job exposure matrices (JEM). RESULTS Dairy farmers had a significantly higher prevalence of cough (38.5), phlegm (27.7%), and wheezing (21.7%), than controls (p < 0.05). All mean baseline spirometric parameters were lower in dairy farmers compared to the controls, but statistical significance was confirmed only for MEF25, MEF50, and MEF75% (p = 0.010, p = 0.001, and p = 0.004, respectively). The prevalence of bronchial hyperresponsiveness, asthma, and chronic obstructive pulmonary disease was higher in dairy farmers but without statistical significance. JEM were useful tools for exposure assessment and predictors of factors for asthma and COPD development. CONCLUSION The results suggest that occupational exposure among crop farmers is associated with a higher prevalence of respiratory symptoms, lung function impairment, and a higher prevalence of chronic respiratory diseases. JEM showed good potential for farming exposure evaluation and promoted their applicability within the diagnostic algorithm focused on respiratory health assessment.
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Affiliation(s)
- Saso Stoleski
- Institute for Occupational Health of Republic of Macedonia, WHO Collaborating Center, Galen Collaborating Center, Skopje, Republic of Macedonia
| | - Jordan Minov
- Institute for Occupational Health of Republic of Macedonia, WHO Collaborating Center, Galen Collaborating Center, Skopje, Republic of Macedonia
| | - Jovanka Karadzinska-Bislimovska
- Institute for Occupational Health of Republic of Macedonia, WHO Collaborating Center, Galen Collaborating Center, Skopje, Republic of Macedonia
| | - Dragan Mijakoski
- Institute for Occupational Health of Republic of Macedonia, WHO Collaborating Center, Galen Collaborating Center, Skopje, Republic of Macedonia
| | - Aneta Atanasovska
- Institute for Occupational Health of Republic of Macedonia, WHO Collaborating Center, Galen Collaborating Center, Skopje, Republic of Macedonia
| | - Dragana Bislimovska
- Institute for Occupational Health of Republic of Macedonia, WHO Collaborating Center, Galen Collaborating Center, Skopje, Republic of Macedonia
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Rinsky JL, Richardson DB, Kreiss K, Nylander-French L, Beane Freeman LE, London SJ, Henneberger PK, Hoppin JA. Animal production, insecticide use and self-reported symptoms and diagnoses of COPD, including chronic bronchitis, in the Agricultural Health Study. ENVIRONMENT INTERNATIONAL 2019; 127:764-772. [PMID: 31029031 PMCID: PMC6800065 DOI: 10.1016/j.envint.2019.02.049] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 02/19/2019] [Accepted: 02/19/2019] [Indexed: 06/02/2023]
Abstract
BACKGROUND Occupational exposure to animal production is associated with chronic bronchitis symptoms; however, few studies consider associations with chronic obstructive pulmonary disease (COPD). We estimated associations between animal production activities and prevalence of self-reported COPD among farmers in the Agricultural Health Study. METHODS During a 2005-2010 interview, farmers self-reported information about: their operations (i.e., size, type, number of animals, insecticide use), respiratory symptoms, and COPD diagnoses (i.e., COPD, chronic bronchitis, emphysema). Operations were classified as small or medium/large based on regulatory definitions. Farmers were classified as having a COPD diagnosis, chronic bronchitis symptoms (cough and phlegm for ≥3 months during 2 consecutive years), or both. Polytomous logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS Of 22,491 participating farmers (median age: 59 years), 922 (4%) reported a COPD diagnosis only, 254 (1%) reported a diagnosis and symptoms, and 962 (4%) reported symptoms only. Compared to raising no commercial animals, raising animals on a medium/large operation was positively associated with chronic bronchitis symptoms with (OR: 1.59; 95% CI: 1.16, 2.18) and without a diagnosis (OR: 1.69; 95% CI: 1.42, 2.01). Ever use of multiple organophosphates, carbaryl, lindane, and permethrin were positively associated with chronic bronchitis symptoms. CONCLUSION Animal production work, including insecticide use, was positively associated with chronic bronchitis symptoms; but not consistently with COPD diagnosis alone. Our results support the need for further investigation into the role of animal production-related exposures in the etiology of COPD and better respiratory protection for agricultural workers.
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Affiliation(s)
- Jessica L Rinsky
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
| | - Kathleen Kreiss
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, United States of America
| | - Leena Nylander-French
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
| | - Laura E Beane Freeman
- Occupational and Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD, United States of America
| | - Stephanie J London
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, United States of America
| | - Paul K Henneberger
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, United States of America
| | - Jane A Hoppin
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, United States of America.
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Jouneau S, Marette S, Robert AM, Gouyet T, Guillot S, Chapron A, Mailloux C, Desrues B, Viel JF. Prevalence and risk factors of chronic obstructive pulmonary disease in dairy farmers: AIRBAg study. ENVIRONMENTAL RESEARCH 2019; 169:1-6. [PMID: 30399467 DOI: 10.1016/j.envres.2018.10.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/27/2018] [Accepted: 10/25/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The AIRBAg study was designed to assess the prevalence of chronic obstructive pulmonary disease (COPD) in dairy farmers and to define its associated risk factors. METHODS Between March 2012 and February 2017 randomly selected dairy farmers in the French region of Brittany were asked to complete a self-administered questionnaire and undergo an occupational health check-up with electronic mini-spirometry and standard spirometry. Those having one or more of the following features: chronic cough, chronic bronchitis, wheezing, dyspnea and/or a ratio FEV1/FEV6 < 80% were then referred to a pulmonologist for further check-up including spirometry with a reversibility test. Each COPD case was matched with three controls (dairy farmers and non-farm employees), for sex and age ( ± 5 years). Conditional multivariate logistic regression models were used to estimate the odds ratios between COPD occurrence and various risk factors. RESULTS The 1203 farmers examined included 525 (43.6%) who were "at risk of bronchial obstruction" and 432 (35.9%) of these saw the pulmonologist. This screening identified 16 (1.3%) cases of COPD, including eight non-smokers and five with an FEV1 < 80% of predicted values. Their average age was 54.6 ( ± 7.7) years and 10 of them were men. None complained of illness before the study. Multivariate analyses revealed no significant occupational risk factors for COPD. CONCLUSIONS This unexpected result may be because Breton dairy farms began to modernize early (1950s), giving rise to conditions with much lower exposure to airborne contaminants.
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Affiliation(s)
- Stéphane Jouneau
- Department of Respiratory Medicine, University Hospital, F-35033 Rennes, France; Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Solenne Marette
- Department of Occupational Pathology, University Hospital, F-35033 Rennes, France
| | - Ange-Marie Robert
- Department of Clinical Research, University Hospital, F-35033 Rennes, France
| | - Thomas Gouyet
- Department of Occupational Pathology, University Hospital, F-35033 Rennes, France
| | - Stéphanie Guillot
- Department of Pulmonary Function Tests, University Hospital, F-35033 Rennes, France
| | - Anthony Chapron
- Department of General Practice, Rennes 1 University, F-35000 Rennes, France; INSERM, CIC-1414, Primary Care Research Team, F-35000 Rennes, France
| | - Carole Mailloux
- Mutualité Sociale Agricole des Portes de Bretagne, F-35170 Bruz, France
| | - Benoît Desrues
- Department of Respiratory Medicine, University Hospital, F-35033 Rennes, France; INSERM, U1242-COSS, CLCC Eugène Marquis, Rennes 1 University, F-35000 Rennes, France
| | - Jean-François Viel
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France; Department of Epidemiology and Public Health, University Hospital, F-35033 Rennes, France.
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Guillien A, Soumagne T, Dalphin JC, Degano B. COPD, airflow limitation and chronic bronchitis in farmers: a systematic review and meta-analysis. Occup Environ Med 2018; 76:58-68. [DOI: 10.1136/oemed-2018-105310] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 10/27/2018] [Accepted: 11/06/2018] [Indexed: 01/11/2023]
Abstract
IntroductionThe current definition of chronic obstructive pulmonary disease (COPD) associates persistent airflow limitation and chronic respiratory symptoms. Agricultural work has been associated with an increased risk of developing COPD, but the prevalence and definition of the disease vary greatly between studies. This meta-analysis aimed to assess the association between agricultural work and COPD using the most widely used definitions of the disease.MethodsInclusion criteria were: (1) design: cross-sectional or longitudinal, (2) groups: at least one group of farmers and a control group of non-farmers, (3) outcome: prevalence or unadjusted OR of COPD, airflow limitation and/or chronic bronchitis, (4) study subjects: groups of exposed subjects comprising ≥30 individuals and with a mean age ≥40 years and (5) language: English and French language, full-length, original publications in peer-reviewed journals.ResultsIn total, 22 manuscripts were included in the meta-analysis. Eight studies assessed only the prevalence of airflow limitation, nine assessed only the prevalence of chronic bronchitis and four assessed the prevalence of both these parameters. Only one assessed the prevalence of COPD according to its current definition, and this study also provided the prevalence of airflow limitation. Ten studies showed a positive association between farming exposure and airflow limitation or chronic bronchitis, and 12 showed no association (OR (95% CI)=1.77 (1.50 to 2.08), p<0.001). Cattle, swine, poultry and crop farming were associated with either airflow limitation or chronic bronchitis.ConclusionAlthough some features of COPD are associated with some agricultural work, well-designed studies with appropriate diagnostic criteria should be conducted to draw strong conclusions about the relationship between COPD and farming.
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Spierenburg EAJ, Smit LAM, Krop EJM, Heederik D, Hylkema MN, Wouters IM. Occupational endotoxin exposure in association with atopic sensitization and respiratory health in adults: Results of a 5-year follow-up. PLoS One 2017; 12:e0189097. [PMID: 29211772 PMCID: PMC5718503 DOI: 10.1371/journal.pone.0189097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 11/18/2017] [Indexed: 11/18/2022] Open
Abstract
The objective of the present longitudinal study was to investigate the effects of occupational endotoxin exposure on respiratory health and atopic sensitization in adults. Health outcomes and personal endotoxin exposure estimates were determined for 234 farmers and agricultural workers both at baseline and 5 years later. A questionnaire was used to assess respiratory symptoms, spirometry tests were performed and total and specific IgE levels were measured in serum. A twofold increase in personal endotoxin exposure was associated with less hay fever (OR 0.68, 95%CI 0.54-0.87) and grass IgE positivity (OR 0.81, 95%CI 0.68-0.97) at both time points ("persistent" versus "never"). Although not statistically significant, a consistent protective pattern was observed for an increased loss of hay fever symptoms (OR 2.19, 95%CI 0.96-4.99) and grass IgE positivity (OR 1.24, 95%CI 0.76-2.02), and for less new-onset of hay fever (OR 0.87, 95%CI 0.65-1.17), grass IgE positivity (OR 0.83, 95%CI 0.61-1.12) and atopic sensitization (OR 0.75, 95%CI 0.55-1.02). Endotoxin exposure was not associated with changes in lung function. We showed that occupational endotoxin exposure is associated with a long-term protective effect on hay fever and grass IgE positivity. Results on longitudinal changes in hay fever, atopy and grass IgE positivity in adulthood were consistent with a protective effect of endotoxin exposure, but results need to be confirmed in larger cohorts. An effect of endotoxin exposure on lung function decline was not found.
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Affiliation(s)
- Elisabeth A. J. Spierenburg
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Esmeralda J. M. Krop
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Dick Heederik
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Machteld N. Hylkema
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- GRIAC- Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Inge M. Wouters
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
- * E-mail:
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Bolund AC, Miller MR, Sigsgaard T, Schlünssen V. The effect of organic dust exposure on long-term change in lung function: a systematic review and meta-analysis. Occup Environ Med 2017; 74:531-542. [PMID: 28404791 DOI: 10.1136/oemed-2016-103963] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 02/19/2017] [Accepted: 03/19/2017] [Indexed: 12/19/2022]
Abstract
Lung function is a predictor of morbidity and mortality, and the chronic nature of lung function decline allows for preventive initiatives. Proinflammatory constituents of organic dust are considered a possible cause of compromised respiratory health. The aim of this systematic review was to reveal the impact of organic dust exposure on long-term change in lung function. The literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Predefined criteria concerned study design: longitudinal, ≥1 year follow-up, ≥50 exposed; exposure measures: organic dust, measured or estimated, in different occupational settings; and outcome measures: change in lung function measured by spirometry. Based on these criteria, 1580 potentially relevant publications were narrowed down to 20 included publications. Quality was evaluated and discussed based on six objectively defined criteria. Overall, 14 studies found some type of association between exposure to organic dust and long-term change in lung function. However, the results were inconsistent and no specific work exposure showed more clear associations to change in lung function. Meta-analysis revealed an overall small significant excess loss in forced expiratory volume in the 1st s for exposed compared with controls of 4.92 mL/year (95% CI 0.14 to 9.69). No significant association was seen overall for forced vital capacity. 12 studies revealed a significant exposure-response relation between organic dust and change in lung function. The results were inconsistent across varying study design and different exposure measures and outcomes. We therefore conclude that there is limited evidence of a causal association between general exposure to organic dust and long-term excess decline in lung function.
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Affiliation(s)
- Anneli Cs Bolund
- Section for Environment, Occupation and Health, Department of Public Health and Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark
| | - Martin R Miller
- Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK
| | - Torben Sigsgaard
- Section for Environment, Occupation and Health, Department of Public Health and Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark
| | - Vivi Schlünssen
- Section for Environment, Occupation and Health, Department of Public Health and Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
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11
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Nonnenmann MW, de Porras DGR, Levin J, Douphrate D, Boggaram V, Schaeffer J, Gallagher M, Hornick M, Reynolds S. Pulmonary function and airway inflammation among dairy parlor workers after exposure to inhalable aerosols. Am J Ind Med 2017; 60:255-263. [PMID: 28195657 PMCID: PMC7082837 DOI: 10.1002/ajim.22680] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND Inhalation exposure to organic dust causes lung inflammation among agricultural workers. Due to changes in production and work organization, task-based inhalation exposure data, including novel lung inflammation biomarkers, will inform exposure recommendations for dairy farm workers. METHODS Linear regression was used to estimate the associations of airborne exposure to dust concentration, endotoxin, and muramic acid with pulmonary outcomes (i.e., FEV1 , exhaled nitric oxide). Logistic regression was used to estimate associations with self-reported pulmonary symptoms. RESULTS Mean exposure concentration to inhalable dust, endotoxin, and muramic acid were 0.55 mg/m3 , 118 EU/m3 , and 3.6 mg/m3 , respectively. We found cross-shift differences for exhaled nitric oxide (P = 0.005) and self-reported pulmonary symptoms (P = 0.008) but no association of exposure with respiratory outcomes. CONCLUSIONS Inhalation exposures during parlor tasks, which were lower than previously reported and were not associated with cross-shift measures of pulmonary health among dairy workers. Modern milking parlor designs may be contributing to lower inhalation exposure. Am. J. Ind. Med. 60:255-263, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Matthew W. Nonnenmann
- Department of Occupational and Environmental Health, The University of Iowa, Iowa City, Iowa
| | - David Gimeno Ruiz de Porras
- Department of Epidemiology, Human Genetics and Environmental Sciences, South-west Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, San Antonio, Texas
| | - Jeffrey Levin
- Department of Occupational Health Sciences, UT Health Northeast, Tyler, Texas
| | - David Douphrate
- Department of Epidemiology, Human Genetics and Environmental Sciences, South-west Center for Occupational and Environmental Health, The University of Texas Health Science Center at Houston School of Public Health, San Antonio, Texas
| | - Vijay Boggaram
- Department of Occupational Health Sciences, UT Health Northeast, Tyler, Texas
| | - Joshua Schaeffer
- Department of Cellular and Molecular Biology, UT Health Northeast, Tyler, Texas
| | - Michael Gallagher
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado
| | - Madeleine Hornick
- 3M Purification, Inc., Stafford Springs, Connecticut,Liberty Mutual Insurance, Portland, Oregon
| | - Stephen Reynolds
- Department of Cellular and Molecular Biology, UT Health Northeast, Tyler, Texas
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12
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Andujar P, Dalphin JC. [Occupational chronic obstructive pulmonary diseases. Legal aspects and practical management]. Rev Mal Respir 2015; 33:91-101. [PMID: 26115643 DOI: 10.1016/j.rmr.2015.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 04/05/2015] [Indexed: 11/16/2022]
Abstract
The existence of occupational chronic obstructive pulmonary diseases (COPD) is now well established. Since 1989, several regulations have been progressively introduced, allowing compensation for some cases of occupational COPD. Following a brief review of the main occupational causes of COPD, the authors describe the present context for compensation in France and the procedures to be followed to ensure that patient's interests are supported.
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Affiliation(s)
- P Andujar
- Inserm, unité 955, 94000 Créteil, France; Service de pneumologie et pathologie professionnelle, CHI de Créteil, 94000 Créteil, France; Faculté de médecine, université Paris-Est Créteil Val-de-Marne, 94000 Créteil, France
| | - J-C Dalphin
- Service de pneumologie, CHU de Besançon, 25030 Besançon, France; UMR CNRS 6249, chrono-environnement, université de Franche-Comté, 25000 Besançon, France.
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Stoleski S, Minov J, Karadzinska-Bislimovska J, Mijakoski D. Chronic obstructive pulmonary disease in never-smoking dairy farmers. Open Respir Med J 2015; 9:59-66. [PMID: 25893027 PMCID: PMC4397828 DOI: 10.2174/1874306401509010059] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 02/25/2015] [Accepted: 03/25/2015] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Work-related chronic obstructive pulmonary disease (COPD) represents a considerable part of the disease burden globally. OBJECTIVE To assess the COPD prevalence and characteristics in never-smoking dairy farmers. MATERIALS AND METHODOLOGY We have conducted a cross-sectional study with 75 male dairy farmers aged 26 to 59 years, and compared them with equivalent number of male office workers similar by age, and duration of employment. Data on chronic respiratory symptoms, job history and daily activities were obtained by questionnaire. Lung functional testing of the examined subjects included baseline spirometry, and bronchodilator reversibility measurement. RESULTS Dairy farmers showed higher prevalence of overall respiratory symptoms, but significant difference was noticed for cough, phlegm, and dyspnea. Dairy farmers had more prevalent work-related respiratory symptoms, being significant for overall symptoms, cough, and phlegm. The mean baseline values of spirometric parameters were lower in dairy farmers, but significance was reported for FEV1/FVC%, MEF50, MEF75, and MEF25-75. Dairy farmers had significantly higher COPD prevalence than office controls (10.7% vs 2.7%, P = 0,049). Dairy farmers and office controls showed significant association between COPD and age over 45 years. Dairy farmers had a significant association between COPD and employment duration of over 20 years (P = 0.023), but also between COPD and work-related chronic respiratory symptoms (P = 0.041). CONCLUSION The study findings favor the cause-effect association between job exposure to respiratory hazards, and development of persistent airway obstruction among dairy farmers.
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Affiliation(s)
- Saso Stoleski
- Institute for Occupational Health of R. Macedonia - Skopje, WHO Collaborating Center, GA2LEN Collaborating Center, R. Macedonia
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Jouneau S, Pinault M, Gouyet T, Brinchault G, Guillot S, Viel JF, Presle JC, Desrues B. Étude AIRBAg : résultats préliminaires après un an de dépistage de la BPCO agricole. Rev Mal Respir 2015; 32:240-8. [DOI: 10.1016/j.rmr.2014.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 03/15/2014] [Indexed: 11/28/2022]
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15
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Reynolds SJ, Nonnenmann MW, Basinas I, Davidson M, Elfman L, Gordon J, Kirychuck S, Reed S, Schaeffer JW, Schenker MB, Schlünssen V, Sigsgaard T. Systematic review of respiratory health among dairy workers. J Agromedicine 2014; 18:219-43. [PMID: 23844790 DOI: 10.1080/1059924x.2013.797374] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The dairy industry is changing on a global scale with larger, more efficient operations. The impact of this change on worker health and safety, specifically, associations between occupational lung disease and inhalation exposures, has yet to be reported in a comprehensive review of the scientific literature. Therefore, a three-tier process was used to identify information using a keyword search of online databases of scientific literature. Of the 147 citations reviewed, 52 met initial screening criteria, and 30 were included in this review. Dairy workers experience lung conditions such as asthma, chronic obstructive pulmonary disease, hypersensitivity pneumonitis, chronic bronchitis, and cancer. Recent pulmonary function studies have identified obstructive lung changes among dairy farm workers. The increased scale of dairy production with significant changes in technology and work practices has altered inhalation exposure patterns among dairy workers. The inhalation exposure in the dairy work environment may elicit differing inflammatory responses in relation to timing of initial exposure as well as to repeated exposures. Few studies have measured inhalation exposure while simultaneously assessing the impact of the exposure on lung function of dairy farm workers. Even fewer studies have been implemented to assess the impact of aerosol control technology to reduce inhalation exposure. Future research should evaluate worker exposure to aerosols through a task-based approach while utilizing novel methods to assess inhalation exposure and associated inflammatory responses. Finally, potential solutions should be developed and tested to reduce inhalation exposure to inflammatory agents and respiratory diseases in the dairy farm work environment.
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Affiliation(s)
- Stephen J Reynolds
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado 80523, USA.
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Acute pulmonary function change associated with work on large dairies in California. J Occup Environ Med 2013; 55:74-9. [PMID: 23235464 DOI: 10.1097/jom.0b013e318270d6e4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To study whether dairy workers in California have lower baseline and greater cross-shift decrements in lung function than control employees. METHODS A cross-sectional study of 210 dairy and 47 control workers who completed questionnaires and spirometry before and after the work shift. RESULTS Dairy work was associated with mean baseline differences of -0.132 L (P = 0.07) and -0.131 L (P = 0.13) in forced expiratory volume in 1 second and forced vital capacity, respectively, compared with control employees, adjusting for age, height, smoking status, and days back at work since last day off. Dairy work was associated with a mean cross-shift difference of -65.2 mL (P = 0.02) and -103.1 mL (P < 0.01) in forced expiratory volume in 1 second and forced vital capacity, respectively, adjusting for smoking status and work-shift time. CONCLUSIONS Dairy work in California was associated with mild acute airway obstruction. The unclear long-term effect of dairy work in California merits further investigation.
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17
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Prevalence of Chronic Bronchitis in Farm and Nonfarm Rural Residents in Saskatchewan. J Occup Environ Med 2012; 54:1481-90. [DOI: 10.1097/jom.0b013e3182636e49] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Occupational exposure to particulate matter and endotoxin for California dairy workers. Int J Hyg Environ Health 2012; 216:56-62. [PMID: 22579491 DOI: 10.1016/j.ijheh.2012.04.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2011] [Revised: 03/14/2012] [Accepted: 04/10/2012] [Indexed: 11/23/2022]
Abstract
Occupational exposure of dairy workers to particulate matter (PM) and endotoxin has been considered by some to be of potential concern. This paper reports personal exposure concentrations of PM (μg/m3) and endotoxin (EU/m3) for 226 workers from 13 California dairies. Arithmetic mean personal concentrations for PM2.5, inhalable PM and endotoxin were 48 μg/m3 (N = 222), 987 μg/m3 (N = 225) and 453 EU/m3 (N = 225), respectively. Using mixed effects models, time spent re-bedding of freestall barns versus any other job conducted on a dairy led to the highest exposure for PM2.5, inhalable PM, and endotoxin. Personal exposure concentrations were found to be greater than those reported for ambient area based concentrations at the same dairies. A pseudo R-square approach revealed that one area based measure combined with time spent performing tasks explained a significant portion of variation in personal exposure concentrations.
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Mounchetrou IN, Monnet E, Laplante JJ, Dalphin JC, Thaon I. Predictors of early cessation of dairy farming in the French Doubs province: 12-year follow-up. Am J Ind Med 2012; 55:136-42. [PMID: 22069061 DOI: 10.1002/ajim.21031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2011] [Indexed: 11/06/2022]
Abstract
BACKGROUND A healthy worker effect due to respiratory disability has been noted in the farming population, but other factors may also interfere. Little has been published about factors influencing the early cessation of work in self-employed dairy farmers. METHODS Two hundred and nineteen dairy farmers were included from a cohort constituted in eastern France in 1993-1994 with a 12-year follow-up. Spirometric data, personal, and farm characteristics were registered. Cox models with delayed entry in which age was the time-scale were applied to identify the baseline predictive factors of the early cessation of dairy farming. RESULTS Working in a modern farm was protective against early cessation of dairy farming (hazard ratio: 0.36 [95% CI: 0.16-0.81]), especially in men. Having asthma was a predictive factor of early cessation, especially in women (hazard ratio: 16.12 [95% CI: 3.28-79.12]). CONCLUSIONS The most predictive factors of early cessation of dairy farming were health related in women and farm related in men.
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Affiliation(s)
- Ibrahim Njoya Mounchetrou
- Service de Maladies Professionnelles, Centre Hospitalier Universitaire de Nancy, rue du Morvan, Vandoeuvre lès Nancy, France
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20
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Jouneau S, Boché A, Brinchault G, Fekete K, Guillot S, Bayat S, Desrues B. On-site screening of farming-induced chronic obstructive pulmonary disease with the use of an electronic mini-spirometer: results of a pilot study in Brittany, France. Int Arch Occup Environ Health 2011; 85:623-30. [DOI: 10.1007/s00420-011-0708-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Accepted: 09/23/2011] [Indexed: 12/20/2022]
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21
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Samadi S, Rietbroek NNJ, Dwars RM, Jamshidifard AR, Heederik DJJ, Wouters IM. Endotoxin and β-(1 → 3)-glucan exposure in poultry and ruminant clinics. ACTA ACUST UNITED AC 2011; 13:3254-61. [DOI: 10.1039/c1em10566c] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Environmental and Occupational Health Risks Among Agricultural Workers Living in a Rural Community Near Petroleum Refinery and Motorway in Skopje Region. Arh Hig Rada Toksikol 2010; 61:415-24. [DOI: 10.2478/10004-1254-61-2010-2043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Environmental and Occupational Health Risks Among Agricultural Workers Living in a Rural Community Near Petroleum Refinery and Motorway in Skopje RegionTo assess health risks in agricultural workers associated with environmental exposure to pollutants released from a petroleum refinery and from traffic, we performed a cross-sectional study that included 119 randomly selected subjects divided in two groups. Group 1 included 60 agricultural workers living in a rural community near the petroleum refinery and a motorway overpass, whereas Group 2 consisted of 59 agricultural workers performing similar activities and living in a rural community with no exposure to industrial and traffic pollutants. Risk assessment included a questionnaire, blood pressure measurement, spirometry, laboratory tests, and toxicological analysis. The groups showed a similar prevalence of health problems, with exception of muscle pain in the extremities, headache, and fatigue, which were significantly more common in Group 1. Diastolic blood pressure was higher in Group 1, but not significantly (p=0.057). The same is true for blood carbon monoxide. Significantly higher in Group 1 were blood haemoglobin (p=0.001) and blood lead (p<0.001). Serum cholinesterase activity was similar in both groups. Our findings indicate the need of regular medical exams, ambient monitoring and environmental impact assessment in agricultural population in order to detect individuals at risk and to institute adequate preventive measures.
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23
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Liou TG, Elkin EP, Pasta DJ, Jacobs JR, Konstan MW, Morgan WJ, Wagener JS. Year-to-year changes in lung function in individuals with cystic fibrosis. J Cyst Fibros 2010; 9:250-6. [PMID: 20471331 DOI: 10.1016/j.jcf.2010.04.002] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Revised: 03/10/2010] [Accepted: 04/16/2010] [Indexed: 11/17/2022]
Abstract
BACKGROUND We examined the year-to-year change in FEV(1) for individuals and the overall cystic fibrosis population to better understand how individual trends may differ from population trends. METHODS We calculated individual yearly changes using the largest annual FEV(1) percent predicted (FEV(1)%) measurement in 20,644 patients (6-45years old) included in the Epidemiologic Study of Cystic Fibrosis. We calculated yearly population changes using age-specific medians. RESULTS FEV(1)% predicted decreased 1-3 points per year for individuals, with maximal decreases in 14-15year olds. Population changes agreed with individual changes up to age 15; however after age 30, yearly population change approximated zero while individual FEV(1)% predicted decreases were 1-2 points per year. CONCLUSIONS Adolescents have the greatest FEV(1)% predicted decreases; however, loss of FEV(1) is a persistent risk in 6-45year old CF patients. Recognizing individual year-to-year changes may improve patient-specific care and may suggest new methods for measuring program quality.
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Affiliation(s)
- Theodore G Liou
- University of Utah, 26 North 1900 East, Salt Lake City, UT 84132-4701,USA.
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24
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25
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La bronchopneumopathie chronique obstructive professionnelle : une maladie méconnue. ARCH MAL PROF ENVIRO 2007. [DOI: 10.1016/s1775-8785(07)78222-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Heutelbeck ARR, Janicke N, Hilgers R, Kütting B, Drexler H, Hallier E, Bickeböller H. German cattle allergy study (CAS): public health relevance of cattle-allergic farmers. Int Arch Occup Environ Health 2007; 81:201-8. [PMID: 17636318 DOI: 10.1007/s00420-007-0207-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2006] [Accepted: 05/18/2007] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Allergic reactions caused by animals are a common and significant occupational health concern. In a large population-based study on occupational asthma in Europe, farming has been among the occupations with the highest risk. OBJECTIVES Characteristics of cattle-allergic farmers are described in a retrospective observational design. METHODS The study covers farmers from all regions of Germany which were reported to the Agricultural Institutions for Statutory Accident Insurance and Prevention (Landwirtschaftliche Berufsgenossenschaften, LBGs) between 1990 (January) and 2002 (December) with a suspected occupational cattle-allergic airways disease. For these farmers, the following parameters were considered: age, gender, onset of airways symptoms related to contact with cattle, begin of employment disability, total and specific Immunoglobulin E (IgE) against cattle allergens, and results of lung function measurements. RESULTS A total of 513 patients (age 14-74, mean 40.7 years; 45.6% women, 54.4% men) had been reported for a suspected occupational cattle-allergic airways disease. Of these patients 24.8% showed cattle-related symptoms of asthma, 11.7% of rhinitis, and 60% of both asthma and rhinitis, while only 34.5% of all reported patients showed an airways obstruction in the first documented lung function test. A total of 62.5% out of the group of patients with an officially recognized occupational disease (42.1%, n=216) have an initial employment disability with a rating of 20% or above. CONCLUSIONS Our results underline the high public health relevance of cattle allergy in farmers, especially in the light of the large number of young patients. Considering the known difficulties in diagnosing cattle allergy due to the number of false negative test results, we are convinced that its relevance is even higher than the number of reported cases suggests. The high rate of initial employment disability among the affected patients underlines the need for improved preventive measures.
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Affiliation(s)
- Astrid R R Heutelbeck
- Abteilung Arbeits- und Sozialmedizin, Georg-August-Universität, Waldweg 37, 37073 Göttingen, Germany.
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Valcin M, Henneberger PK, Kullman GJ, Umbach DM, London SJ, Alavanja MCR, Sandler DP, Hoppin JA. Chronic bronchitis among nonsmoking farm women in the agricultural health study. J Occup Environ Med 2007; 49:574-83. [PMID: 17495700 PMCID: PMC2074236 DOI: 10.1097/jom.0b013e3180577768] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to examine agricultural risk factors for chronic bronchitis among nonsmoking farm women. METHODS We used self-reported enrollment data from the 21,541 nonsmoking women in the Agricultural Health Study to evaluate occupational risk factors for prevalent chronic bronchitis among farm women. Odds ratios (ORs) for chronic bronchitis for occupational exposures were adjusted for age, state, and related agricultural exposures. RESULTS Applying manure and driving combines were independently associated with chronic bronchitis. Off-farm job exposures associated with chronic bronchitis were organic dusts, asbestos, gasoline, and solvents. Five pesticides were associated with chronic bronchitis after multivariate adjustment and sensitivity analyses: dichlorvos (OR=1.63, 95% CI=1.01, 2.61), DDT (OR=1.67, 95% CI=1.13, 2.47), cyanazine (OR=1.88, 95% CI=1.00, 3.54), paraquat (OR=1.91, 95% CI=1.02, 3.55), and methyl bromide (OR=1.82, 95% CI=1.02, 3.24). CONCLUSION Pesticides as well as grain and dust exposures were associated with chronic bronchitis among nonsmoking farm women.
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Affiliation(s)
- Martin Valcin
- Epidemiology, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC 27709-2233, USA
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Rushton L. Occupational causes of chronic obstructive pulmonary disease. REVIEWS ON ENVIRONMENTAL HEALTH 2007; 22:195-212. [PMID: 18078004 DOI: 10.1515/reveh.2007.22.3.195] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The relation between Chronic Obstructive Pulmonary Disease (COPD, including chronic bronchitis and emphysema (CBE), and exposure to coal dust is well established. This paper reviews the evidence relating to other occupational causes of COPD, including industries associated with exposure to fumes, chemical substances, and dusts. A review of key literature has been carried out with a focus on the magnitude of risks and levels of exposure causing disabling health effects. The literature suggests that elevated risks of developing COPD are clearly associated with several occupations, with risk estimates being high in some, even after taking into account the effect of confounders, such as smoking. Of particular concern are agricultural workers who can be exposed to a variety of gases and organic dusts, among whom CBE is clearly elevated, particularly for pig farmers and exposure to endotoxins, with an increased annual decline in lung function. Similarly, cotton textile workers are exposed to a mixture of substances affecting development of atopy, byssinosis, and CBE, and across-shift and long-term decline in lung function. Atopy also has an important role in the development of COPD in flour mill workers and bakers, with those sensitized to bakery allergens having a greater lung function decline than non-sensitized individuals. Welding processes involve a range of potential chemical, physical and radiation hazards. The average reduction in FEV1 associated with welding fumes is similar to that associated with smoking. Challenges in assessing the evidence include variation in diagnostic methods; concurrent exposure to cigarette smoke (direct or second-hand) and multiple work-place irritants; healthy worker selection/survivor effects; poor exposure definition. Raising awareness of occupational causes of COPD among employers, employees, and health service professionals is important.
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Affiliation(s)
- Lesley Rushton
- Imperial College London, Department of Epidemiology and Public Health, Faculty of Medicine, St Mary's Campus, Norfolk Place, London.
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Goldberg M, Leclerc A, Bonenfant S, Chastang JF, Schmaus A, Kaniewski N, Zins M. Cohort profile: the GAZEL Cohort Study. Int J Epidemiol 2006; 36:32-9. [PMID: 17101614 PMCID: PMC2258334 DOI: 10.1093/ije/dyl247] [Citation(s) in RCA: 165] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marcel Goldberg
- INSERM Unité 687, 14 rue du Val d'Osne, 99410 Saint Maurice, France.
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Ameille J, Dalphin J, Descatha A, Pairon J. La bronchopneumopathie chronique obstructive professionnelle : une maladie méconnue. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)71803-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Venier AG, Chaudemanche H, Monnet E, Thaon I, Fury R, Laplante JJ, Dalphin JC. Influence of occupational factors on lung function in French dairy farmers. A 5-year longitudinal study. Am J Ind Med 2006; 49:231-7. [PMID: 16550561 DOI: 10.1002/ajim.20278] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Dairy farming is associated with a high prevalence of respiratory disorders but the respective influence of occupational exposures, environmental, and individual factors on lung function remain unclear. METHODS In 1994 and 1999, dairy farmers were examined in the Doubs province, France. Spirometric measures and allergological tests were performed. Medical and professional data were obtained by questionnaires. A multiple linear regression analysis was performed. RESULTS An accelerated decline in lung function parameters was associated with age, male sex, traditional farm (as opposed to modern farms), and a high rate of total IgE (P < 10(-2)). Blood oxygen saturation (SpO2) was significantly positively linked with the modernization of the farm and negatively with age, smoking status, and log IgE (P < 10(-2)). Geographical factors (altitude and climatic conditions) had no significant effect. CONCLUSIONS The modernization of the farm has an important and beneficial impact on lung functiony.
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Affiliation(s)
- A G Venier
- Department of Public Health, Clinical Epidemiology Unit, University Hospital, Besançon, France
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Ameille J, Descatha A, Pairon JC, Dalphin JC. Bronchopneumopathies chroniques obstructives professionnelles. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s1155-1925(05)38960-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Heederik D, Sigsgaard T. Respiratory allergy in agricultural workers: recent developments. Curr Opin Allergy Clin Immunol 2005; 5:129-34. [PMID: 15764902 DOI: 10.1097/01.all.0000162304.66986.7d] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW To review recent evidence on the relationship between occupational exposure to allergens and asthmagens, and risk for developing allergy and asthma and the role of modifying factors in farmers and farm workers. RECENT FINDINGS Recent studies identified agents that have not been associated with allergy or asthma in farming populations before. The most intriguing findings, however, are those that suggest that the development of atopy and asthma might be influenced by exposure to pathogen associated molecular patterns (PAMPs), including endotoxin. SUMMARY The adverse and potentially protective effects of microbial exposures in the farm environment are discussed. Recent findings indicate that it is very likely that the protective effect of exposure to PAMPs such as endotoxin is not limited to childhood age. The protective effects that probably developed during childhood can still be observed at adult age. Furthermore, it even seems likely that exposures at adult age (in occupational environments), which stimulate the innate immune system, have an effect on allergy, independently of childhood exposure. It is hypothesized that reversal of atopy might occur as a result of high exposure to endotoxins and other PAMPs.
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Affiliation(s)
- Dick Heederik
- Institute for Risk Assessment Sciences, Division of Environmental and Occupational Health, IRAS, University Utrecht, Utrecht, The Netherlands.
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