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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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Is atopy a risk indicator of chronic obstructive pulmonary disease in dairy farmers? Respir Res 2019; 20:124. [PMID: 31208466 PMCID: PMC6580567 DOI: 10.1186/s12931-019-1082-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 05/23/2019] [Indexed: 01/30/2023] Open
Abstract
Abstract Allergic mechanisms related to environmental and occupational exposure have been suggested to contribute to the development of chronic obstructive pulmonary disease (COPD). Objectives To investigate the relationships between atopy markers, persistent airflow limitation (PAL) and occupational exposure in dairy farmers. Methods Clinical and biological (total IgE and 21 allergen specific IgE) markers of atopy were assessed in 101 dairy farmers with PAL (DF-PAL), 85 non-farmers with PAL (NF-PAL) (both groups were prospectively included from a screening program performed between 2011 and 2015), and matched controls, i.e. 98 farmers without PAL (DF-controls) and 89 non-farming subjects without PAL (NF-controls). Occupational exposure in farmers was estimated using a validated questionnaire. Results Prevalence of allergy history was significantly higher in DF-PAL and in NF-PAL than in controls. Polysensitization, and sensitization to seasonal and food allergens were more frequent in DF-PAL than in DF-controls, respectively: 13.8% vs 1% (adjusted odds ratio (aOR): 17.5 (2.2–134), 11.9% vs 3.1% (aOR: 4.4 (1.2–7.2) and 16.8% vs 4.1% (aOR: 5.2 (1.7–7.2)). The prevalence of atopy markers was similar between NF-PAL patients and NF-controls. Conclusions PAL in farmers is associated with a high rate of markers of atopy, supporting atopy as a risk indicator. Clinical trial registered with ClinicalTrials.gov (NCT02540408). Electronic supplementary material The online version of this article (10.1186/s12931-019-1082-2) contains supplementary material, which is available to authorized users.
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Soumagne T, Caillaud D, Degano B, Dalphin JC. [Differences and similarities between occupational and tobacco induced COPD]. Rev Mal Respir 2017; 34:607-617. [PMID: 28506727 DOI: 10.1016/j.rmr.2016.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 07/02/2016] [Indexed: 10/19/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) most often results from the inhalation of toxic agents. Cigarette smoking still remains the principal cause but the pertinence of occupational COPD is now clearly established. After a brief overview of the epidemiology of this "other COPD", the clinical and functional characteristics are summarized, taking into account recent advances in this field. The combined effects of occupational exposure and tobacco are also considered, providing evidence of the need to continuously reinforce campaigns of education and prevention in occupational COPD.
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Affiliation(s)
- T Soumagne
- Service de pneumologie, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France; Service de physiologie-explorations fonctionnelles, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France.
| | - D Caillaud
- Service de pneumologie, université d'Auvergne, CHU Gabriel-Montpied, rue Montalembert, 63003 Clermont-Ferrand, France
| | - B Degano
- Service de physiologie-explorations fonctionnelles, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France; EA 3920, université de Franche-Comté, 25000 Besançon, France
| | - J-C Dalphin
- Service de pneumologie, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France; UMR CNRS 6249, chrono-environnement, université de Franche-Comté, 25000 Besançon, France
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Marescaux A, Degano B, Soumagne T, Thaon I, Laplante JJ, Dalphin JC. Impact of farm modernity on the prevalence of chronic obstructive pulmonary disease in dairy farmers. Occup Environ Med 2015; 73:127-33. [PMID: 26675204 DOI: 10.1136/oemed-2014-102697] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 11/11/2015] [Indexed: 11/04/2022]
Abstract
Dairy farming is associated with an excess of chronic obstructive pulmonary disease (COPD). The dairy industry has been changing for the past three decades with larger, more efficient farms and potentially less exposure to agents involved in COPD development. However, the impact of farm modernisation on COPD prevalence is unknown. We studied respiratory symptoms, respiratory function by spirometry and tobacco smoking in 575 male dairy farmers working either in traditional or in modern farms in the French Doubs region. COPD was defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criterion (forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) <0.70) and by the Quanjer reference equation (FEV1/FVC<lower limit of normal (LLN)). Modern farms were defined either as having a separation between the house and the cowshed (model 1) or as having a loose housing system for the animals (model 2). The prevalence of COPD in dairy farmers was 12.0 ± 2.7% (GOLD), and 5.6 ± 4.1% (LLN definition). By multivariate analysis using the LLN definition, tobacco smoking (OR (95% CI) 3.96 (1.53 to 10.3) and 3.42 (1.32 to 8.84) for models 1 and 2, respectively) and characteristics of traditional farms (1.97 (1.02 to 4.47) and 5.20 (1.73 to 15.64) for models 1 and 2, respectively) were associated with higher COPD prevalence. Working in a traditional farm plus current smoking had an additive effect on COPD prevalence in model 1 and a synergistic effect in model 2. These findings support a positive impact of farm modernity on COPD prevalence in dairy farmers. Occupational and smoking-related risk factors are of nearly the same magnitude.
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Affiliation(s)
- Alexia Marescaux
- Department of Respiratory Diseases, University Hospital, Besançon, France
| | - Bruno Degano
- Department of Physiology, University Hospital, Besançon, France EA 3920, Université de Franche-Comté, Besançon, France
| | - Thibaud Soumagne
- Department of Respiratory Diseases, University Hospital, Besançon, France
| | - Isabelle Thaon
- Department of Occupational Diseases, University Hospital, Vandœuvre-lès-Nancy, France
| | | | - Jean-Charles Dalphin
- Department of Respiratory Diseases, University Hospital, Besançon, France UMR CNRS Chrono-Environnement, Université de Franche-Comté, Besançon, France
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Degano B, Bouhaddi M, Laplante JJ, Botebol M, Annesi-Maesano I, Marescaux A, Roux P, Thaon I, Wolf JP, Regnard J, Dalphin JC. [COPD in dairy farmers: screening, characterization and constitution of a cohort. The BALISTIC study]. Rev Mal Respir 2012. [PMID: 23200591 DOI: 10.1016/j.rmr.2012.08.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND A pilot study from our group suggests that the prevalence of chronic obstructive pulmonary disease (COPD) among dairy farmers is higher than in the general population although dairy workers are less frequently smokers. OBJECTIVES AND METHODS The study presented here aims at (i) determining the prevalence of COPD in a large and representative population of dairy farmers; (ii) characterizing these patients in terms of smoking habits, dyspnoea, quality of life, lung function, bronchial exhaled nitric oxide, systemic inflammation, arterial stiffness and exercise capacity; (iii) comparing characteristics of dairy farmers' COPD with the characteristics of COPD in patients without any occupational exposure; (iv) identifying the etiological factors of COPD in dairy farmers; and (v) constituting a cohort of COPD patients and control subjects for further longitudinal studies. Two groups of COPD patients (dairy farmers or not) and two groups of controls subjects will be selected among a representative panel of 2000 dairy workers and 2000 subjects without any occupational exposure, all aged 40 to 75 years. EXPECTED RESULTS A better knowledge of the epidemiology and pathophysiology of COPD in dairy farmers should guide a specific strategy of prevention. The knowledge of the characteristics of COPD occurring in dairy farmers will help to define the therapeutic modalities that might be different compared with the therapeutic recommendations for COPD secondary to tobacco smoking.
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Affiliation(s)
- B Degano
- Physiologie-explorations fonctionnelles, EA 3920, CHU Jean-Minjoz, Besançon cedex, France.
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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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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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Adhikari A, Sen MM, Gupta-Bhattacharya S, Chanda S. Volumetric assessment of airborne fungi in two sections of a rural indoor dairy cattle shed. ENVIRONMENT INTERNATIONAL 2004; 29:1071-1078. [PMID: 14680890 DOI: 10.1016/s0160-4120(03)00103-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2003] [Accepted: 04/08/2003] [Indexed: 05/24/2023]
Abstract
There is increasing concern about the exposure to fungal aerosols in occupational environments and associated respiratory allergic diseases and asthma. A large number of people work in cattle sheds around the world, pulmonary function impairments and higher frequency of respiratory symptoms have been reported in dairy farmers; however, it appears that adequate information on the fungal aerosols from the cattle sheds are largely lacking. Volumetric assessment of airborne culturable and nonculturable fungal spores was performed in two sections of a large rural indoor cattle shed of West Bengal, India for 2 consecutive years. An Andersen Two Stage Viable Sampler was used for sampling culturable fungi and a Burkard Personal Slide Sampler was used to collect the total airborne fungal spores including both the culturable and nonculturable types. A total of 31 spore types and 35 types of viable colony-forming units were recorded. Average concentration range of total fungal spores was 233-2985/m(3) and concentration of viable colony-forming units ranged between 165 and 2225 CFU/m(3). Burkard Sampler showed higher frequencies of Aspergilli/Penicilli, Cladosporium, Alternaria, and smut spores. Andersen Sampler showed the prevalence of Aspergillus niger, Aspergillus flavus and Cladosporium cladosporioides colonies. Some recorded fungi were earlier reported as allergenic, toxic, and pathogenic for occupational workers as well as cattle population. Higher concentration levels of airborne total and culturable fungal spores were recorded during the months of November through February (winter) and June through September (late summer and rainy season).
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Affiliation(s)
- Atin Adhikari
- Division of Palynology and Environmental Biology, Department of Botany, Bose Institute, 93/1 Acharya Prafulla Chandra Road, Calcutta 700 009, India.
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Chaudemanche H, Monnet E, Westeel V, Pernet D, Dubiez A, Perrin C, Laplante JJ, Depierre A, Dalphin JC. Respiratory status in dairy farmers in France; cross sectional and longitudinal analyses. Occup Environ Med 2003; 60:858-63. [PMID: 14573716 PMCID: PMC1740421 DOI: 10.1136/oem.60.11.858] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To compare respiratory status in dairy farmers with that of non-farming controls. METHODS Longitudinal study in the Doubs (France). From a cohort constituted in 1994 (T1), 215 (81.1%) dairy farmers and 110 (73.8%) controls were reevaluated in 1999 (T2). The protocol comprised a medical and occupational questionnaire, spirometric tests at both evaluations, allergological tests at T1, and a non-invasive measure of blood oxygen saturation (SpO2) at T2. RESULTS In 1999 analyses, the prevalence of chronic bronchitis was higher (p = 0.013), and FEV1/VC (p < 0.025) and SpO2 (-0.7%, p < 0.01) lower in dairy farmers than in controls. In a multiple linear regression model, farming, age, and smoking were significantly and inversely correlated with SpO2. In the whole population, the mean annual decline in FEV1 and FEV1/VC was -13.4 ml and -0.30%, respectively. Farming was associated with an accelerated decline in FEV1/VC (p < 0.025) after adjustment for covariates. No relation between allergy and respiratory function changes was observed, except for FEF25-75. CONCLUSIONS This prospective study shows that dairy farming is associated with an excess of chronic bronchitis, with a moderate degree of bronchial obstruction and a mild decrease in SpO2.
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Affiliation(s)
- H Chaudemanche
- Department of Chest Diseases, University Hospital, Besançon, France
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Portengen L, Hollander A, Doekes G, de Meer G, Heederik D. Lung function decline in laboratory animal workers: the role of sensitisation and exposure. Occup Environ Med 2003; 60:870-5. [PMID: 14573718 PMCID: PMC1740423 DOI: 10.1136/oem.60.11.870] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Little is known about the relation between allergic sensitisation and subsequent long term lung function changes in working populations exposed to sensitising agents. AIMS To investigate whether exposure and work related sensitisation to laboratory animals are associated with lung function decline. METHODS The relation between exposure and sensitisation to laboratory animal allergens and changes in lung function was investigated in a longitudinal study (median follow up 2.0 years) among 319 laboratory animal workers. Subjects who had been working with laboratory animals for less than 4 years (n = 102) were analysed separately, since an earlier cross sectional analysis had suggested a strong healthy worker effect in more experienced workers. RESULTS In multiple regression analyses both sensitisation and exposure appeared to contribute independently to lung function decline in subjects who had been working with laboratory animals for less than 4 years, adjusting for gender, age, smoking, and atopy. Lung function decline was most pronounced in sensitised subjects who continued to be in contact with the animals to which they were sensitised, with estimated average excess declines in FEV1, FVC, and MMEF of 83 ml/y (p < 0.05), 148 ml/y (p < 0.01), and 7 ml/s/y (p = 0.9). CONCLUSIONS We conclude that exposure to laboratory animals is a significant risk factor for accelerated lung function decline, and that sensitised workers are especially at risk.
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Affiliation(s)
- L Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Netherlands.
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Hoppin JA, Umbach DM, London SJ, Alavanja MCR, Sandler DP. Animal production and wheeze in the Agricultural Health Study: interactions with atopy, asthma, and smoking. Occup Environ Med 2003; 60:e3. [PMID: 12883030 PMCID: PMC1740584 DOI: 10.1136/oem.60.8.e3] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Exposure to animals, their feeds, and by-products contribute to respiratory symptoms among farmers. AIMS To investigate the role of animal exposures and wheeze, and to assess whether their impact differs among susceptible subgroups, including atopics, asthmatics, and smokers. METHODS Using the Agricultural Health Study, a cohort of pesticide applicators in Iowa and North Carolina enrolled in 1994-97, wheeze associated with animal production was evaluated and interactions among susceptible subgroups assessed. Logistic regression models were used to examine risk factors for wheeze in the past year among 20 468 farmers. RESULTS Individuals raising animals requiring direct contact had the highest odds ratios (OR) for wheeze (OR(dairy) = 1.26; OR(eggs) = 1.70). A significant dose response was observed for both the number of poultry and the number of livestock on the farm. Farmers who performed veterinary procedures on a daily basis had an OR of 1.51. The odds of wheeze associated with poultry production was greater among atopic than non-atopic individuals. Milking cows daily increased the odds of wheeze in all individuals, with the largest association observed among atopic asthmatic individuals. The impact of dairy, poultry, and egg production varied among smoking groups. Past smokers had the highest odds ratios, followed by never smokers, and then current smokers. The OR(eggs) was 2.88 among past smokers but only 1.46 for never smokers. The OR(eggs) for current smokers of 0.80 might reflect self selection of exposure among smokers. CONCLUSIONS Results are consistent with animal production and respiratory symptoms, and suggest that subgroups may respond differently to exposure.
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Affiliation(s)
- J A Hoppin
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC 27709-2233, USA.
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