Respiratory symptoms and bronchial reactivity among pig and dairy farmers

Curcumin Is an Iconic Ligand for Detecting Environmental Pollutants

The rapid increase in industrial revolution and the consequent environmental contamination demands continuous monitoring and sensitive detection of the pollutants. Nanomaterial-based sensing system has proved to be proficient in sensing environmental pollutants. The development of novel ligands for enhancing the sensing efficiency of nanomaterials has always been a challenge. However, the amendment of nanostructure with molecular ligand increases the sensitivity, selectivity, and analytical performance of the resulting novel sensing platform. Organic ligands are capable of increasing the adsorption efficacy, optical properties, and electrochemical properties of nanomaterials by reducing or splitting of band gap. Curcumin (diferuloylmethane) is a natural organic ligand that exhibits inherent fluorescence and electrocatalytic property. Due to keto-enol tautomerism, it is capable of giving sensitive signals such as fluorescence, luminescence, ultraviolet absorption shifts, and electrochemical data. Curcumin probes were also reported to give enhanced meterological performances, such as low detection limit, repeatability, reproducibility, high selectivity, and high storage stability when used with nanosystem. Therefore, research on curcumin-modified nanomaterials in the detection of environmental pollution needs a special focus for prototype and product development to enable practical use. Hence, this article reviews the role of curcumin as a natural fluorophore in optical and electrochemical sensing of environmentally significant pollutants. This review clearly shows that curcumin is an ideal candidate for developing and validating nanomaterials-based sensors for the detection of environmental pollutants such as arsenic, lead, mercury, boron, cyanide, fluoride, nitrophenol, trinitrotoluene, and picric acid and toxic gases such as ammonia and hydrogen chloride. This review will afford references for future studies and enable researchers to translate the lab concepts into industrial products.

A Novel Multi-Approach Protocol for the Characterization of Occupational Exposure to Organic Dust-Swine Production Case Study

Swine production has been associated with health risks and workers’ symptoms. In Portugal, as in other countries, large-scale swine production involves several activities in the swine environment that require direct intervention, increasing workers’ exposure to organic dust. This study describes an updated protocol for the assessment of occupational exposure to organic dust, to unveil an accurate scenario regarding occupational and environmental risks for workers’ health. The particle size distribution was characterized regarding mass concentration in five different size ranges (PM0.5, PM1, PM2.5, PM5, PM10). Bioburden was assessed, by both active and passive sampling methods, in air, on surfaces, floor covering and feed samples, and analyzed through culture based-methods and qPCR. Smaller size range particles exhibited the highest counts, with indoor particles showing higher particle counts and mass concentration than outdoor particles. The limit values suggested for total bacteria load were surpassed in 35.7% (10 out of 28) of samples and for fungi in 65.5% (19 out of 29) of samples. Among Aspergillus genera, section Circumdati was the most prevalent (55%) on malt extract agar (MEA) and Versicolores the most identified (50%) on dichloran glycerol (DG18). The results document a wide characterization of occupational exposure to organic dust on swine farms, being useful for policies and stakeholders to act to improve workers’ safety. The methods of sampling and analysis employed were the most suitable considering the purpose of the study and should be adopted as a protocol to be followed in future exposure assessments in this occupational environment.

A comprehensive review of levels and determinants of personal exposure to dust and endotoxin in livestock farming

The respiratory health effects of livestock farming have been on debate for more than three decades. Endotoxin-contaminated organic dusts are considered as the most important respiratory hazards within livestock environments. A comprehensive review of the knowledge from studies assessing the exposure status of livestock farmers is still to be published. The present study reviews research published within the last 30 years on personal exposure of livestock farmers to organic dust and endotoxin, focusing on studies on pig, poultry and cattle farmers. Applied measurement methods and reported levels of personal exposure for the total, inhalable and respirable fractions are summarized and discussed, with emphasis on the intensity of exposure and the size and distribution of the reported exposure variability. In addition, available evidence on potential determinants of personal exposure to dust and endotoxin among these farmers are documented and discussed, taking results from exposure determinant studies using stationary sampling approaches into consideration. Research needs are addressed from an epidemiological and industrial hygiene perspective. Published studies have been heterogeneous in design, and applied methodologies and results were frequently inadequately reported. Despite these limitations and the presence of an enormous variability in personal exposure to dust and endotoxin, no clear downward trends in exposure with time were observed, suggesting that working environments within stables remains largely uncontrolled. Exposure control and prevention strategies for livestock farmers are urgently required. These should focus on the development of novel and improved methods of controlling dust and endotoxin exposure within stables based on the currently available knowledge on determinants of exposure.

Use of Recirculating Ventilation With Dust Filtration to Improve Wintertime Air Quality in a Swine Farrowing Room

The performance of a recirculating ventilation system with dust filtration was evaluated to determine its effectiveness to improve the air quality in a swine farrowing room of a concentrated animal feeding operation (CAFO). Air was exhausted from the room (0.47 m(3) sec(-1); 1000 cfm), treated with a filtration unit (Shaker-Dust Collector), and returned to the farrowing room to reduce dust concentrations while retaining heat necessary for livestock health. The air quality in the room was assessed over a winter, during which time limited fresh air is traditionally brought into the building. Over the study period, dust concentrations ranged from 0.005-0.31 mg m(-3) (respirable) and 0.17-2.09 mg m(-3) (inhalable). In-room dust concentrations were reduced (41% for respirable and 33% for inhalable) with the system in operation, while gas concentrations (ammonia [NH3], hydrogen sulfide [H2S], carbon monoxide [CO], carbon dioxide [CO2]) were unchanged. The position of the exhaust and return air systems provided reasonably uniform contaminant distributions, although the respirable dust concentrations nearest one of the exhaust ducts was statistically higher than other locations in the room, with differences averaging only 0.05 mg m(-3). Throughout the study, CO2 concentrations consistently exceeded 1540 ppm (industry recommendations) and on eight of the 18 study days it exceeded 2500 ppm (50% of the ACGIH TLV), with significantly higher concentrations near a door to a temperature-controlled hallway that was typically often left open. Alternative heaters are recommended to reduce CO2 concentrations in the room. Contaminant concentrations were modeled using production and environmental factors, with NH3 related to the number of sow in the room and outdoor temperatures and CO2 related to the number of piglets and outdoor temperatures. The recirculating ventilation system provided dust reduction without increasing concentrations of hazardous gases.

Seasonal variability in airborne biotic contaminants in swine confinement buildings

Little is known about the seasonal dynamics of biotic contaminants in swine confinement buildings (SCBs). The biotic contaminants of seven SCBs were monitored during one visit in the winter and one during the summer. Paired-end Illumina sequencing of the 16S rRNA gene, V3 region, was used to examine seasonal shifts in bacterial community composition and diversity. The abundances of 16S rRNA genes and six tetracycline resistance genes (tetB, tetH, tetZ, tetO, tetQ, and tetW) were also quantified using real-time PCR. Bacterial abundances, community composition and diversity all showed strong seasonal patterns defined by winter peaks in abundance and diversity. Microclimatic variables of SCBs, particularly air speed, PM2.5 and total suspended particles (TSP) were found significantly correlated to abundances, community composition, and diversity of bacterial bioaerosols. Seasonal fluctuations were also observed for four tetracycline resistance genes, tetH, tetO, tetQ, and tetW. The frequency of occurrences of these resistance genes were significantly higher in samples collected during winter and was also significantly correlated with air speed, PM2.5 and TSP. Overall, our results indicate that biotic contaminants in SCBs exhibit seasonal trends, and these could be associated with the microclimatic variables of SCBs. The correlations established in the current study could be helpful in establishing better management strategies to minimize the potential health impacts on both livestock and humans working in this environment.

Bronchial Hyperresponsiveness in Farmers: Severity and Work-Relatedness

OBJECTIVE: To evaluate the prevalence of respiratory symptoms, lung function and bronchial hyperresponsiveness in farmers, with emphasize to their severity and work-relatedness due occupational risk factors and farming characteristics.METHODS: A cross-sectional survey was performed including 60 cow breeders aged 21 to 65 years, compared to an equal number of agricultural farmers matched by age, job exposure duration, and smoking status. We have used a questionnaire to record the chronic respiratory symptoms, detailed work history, specific farming activities and tasks performed, and smoking history. Evaluation of examined subjects also included lung function spirometry tests, and bronchial hyperresponsiveness testing.RESULTS: We found higher prevalence of work related respiratory symptoms in the last 12 months in cow breeders with significant difference for phlegm (P = 0.039), and wheezing (P = 0.026). Mean values of all spirometric parameters were lower in cow breeders, reaching significance for MEF50 (P = 0.001) and MEF75 (P = 0.000). Significant difference was found for mild bronchial hyperresponsiveness among cow breeders with job exposure of more than 15 years. The risk of developing work-related respiratory symptoms increased significantly with full-time farming, exposure to gases and vapors, and keeping more than 10 cows.CONCLUSION: Our data suggest that workplace exposure in farmers may cause respiratory impairment which is closely related to its duration, characteristics, and intensity. The results suggest that cow breeders in general have higher rates of work-related respiratory symptoms and bronchial hyperresponsiveness than agricultural farmers, whereas their severity increases with an increase in frequency and duration of animal contact.

Chronic Respiratory Symptoms and Lung Function in a Sample of Agricultural Workers in Skopje Region

OBJECTIVE: To assess the effect of job exposure and its duration on chronic respiratory symptoms and ventilatory capacity among agricultural workers.METHODS: We performed a cross-sectional study including 120 agricultural workers aged 36 to 53 years, compared to an equal number of office workers matched by age, duration of workplace exposure and smoking status. A questionnaire was used to record the chronic respiratory symptoms, detailed job history, specific job activities and tasks performed, and smoking history. Evaluation of examined subjects also included functional lung testing by spirometry.RESULTS: We found non-significantly higher prevalence of respiratory symptoms in the last 12 months in agricultural workers with significant difference for cough (P = 0.044), and wheezing (P = 0.031). Mean values of all spirometric parameters were lower in agricultural workers, being significantly different for MEF50 (P = 0.001) and MEF75 (P = 0.000). Adverse respiratory effects and lung function deterioration were more expressed in agricultural workers with duration of job exposure more than 20 years than in those exposed less than 20 years.CONCLUSION: Our data suggest that workplace exposure in agricultural workers may lead to respiratory impairment which is close related to its duration.

Agricultural work exposures and pulmonary function among hired farm workers in California (the MICASA study)

Despite California's dependence on hired farm labor, scarce research has been conducted on the respiratory health of hired farm workers. Agricultural exposures to inorganic and organic dusts can adversely affect an individual's respiratory health and differ by farm type and job task. The purpose of the present analysis was to examine associations between agricultural work exposures and pulmonary function among 450 California farm workers. Data were collected as part of the Mexican Immigration to California: Agricultural Safety and Acculturation (MICASA) study, a prospective cohort study examining occupational risk factors and health of hired farm worker families in Mendota, California. Time-weighted self-reported average (TWSRA) dust scores were calculated from assessments of past-12-month agricultural work history. Other dust exposure indicator variables included months worked in agriculture in the past 12 months and years worked in agriculture. Multiple linear regression modeled FEV1 (forced expiratory volume in 1 second), FEF(25-75%) (forced midexpiratory flow rate), FVC (forced vital capacity), FEV6, FEV1/FVC, and FEV1/FEV6 separately. Seventy-six percent of participants had worked in agriculture in the past year. In models conducted for crops and tasks separately, high TWSRA dust score was associated with better FEV6. Crop and task models showed associations between greater months worked in agriculture in the past year and better FEV1, FEF(25-75%), and FEV6. Both models also found greater years worked in agriculture to be associated with worse FEV1/FEV6. Results were generally in the opposite direction as expected given past research but not uncommon. Future research should investigate relationships between pulmonary function and agricultural dust exposure over a lifetime and changes in pulmonary function over time.

Agricultural exposure and asthma risk in the AGRICAN French cohort

Epidemiological studies have reported an increased risk of respiratory diseases in agricultural population, but a protective "farm-effect" has also been reported for asthma. In the AGRICAN cohort, self-reported doctor-diagnosed asthma was analyzed according to allergy, in relation with history of life-time exposure to 13 crops and 5 livestock, pesticide exposure and early life on a farm, taking into account sex, age, education and body mass index. Among the 1246 asthmatics (8.0%), 505 were allergic (3.3%) and 719 non-allergic (4.6%). In multivariate analysis, a significant excess was observed, only for allergic asthma, in vine-growing (OR=1.43, p=0.002), fruit-growing (OR=1.58, p=0.001), greenhouses (OR=1.66, p=0.02), grasslands (OR=1.35, p=0.009), beets (OR=1.52, p=0.003) and horses (OR=1.35, p=0.04). Pesticide use and history of pesticide poisoning were significantly associated with allergic asthma in grassland, vineyards and fruit-growing and with non-allergic asthma in beets. Living on a farm in the first year of life tended to be protective for childhood allergic asthma in farms with livestock (OR=0.72, p=0.07) but deleterious in farms with vineyards, fruit or vegetables (OR=1.44, p=0.07). In AGRICAN, an increased risk of allergic asthma was observed with crop exposure, pesticide use and early life on a farm, especially in vine-growing, grassland, beets, fruit and vegetable-growing.

Fungal contamination in swine: a potential occupational health threat

Poor air quality in a pig-confinement building may potentially place farmers at higher health risk than other workers for exposure to airborne pollutants that may reach infectious levels. The aim of this study was to assess worker exposure to fungi in indoor environments in Portuguese swine buildings. Air samples from 7 swine farms were collected at a flow rate of 140 L/min, at 1 m height, onto malt extract agar supplemented with chloramphenicol (MEA). Surfaces samples of the same indoor sites were obtained by swabbing the surfaces. Samples from the floor covering were also collected from four of seven swine farms. All collected samples were incubated at 27°C for 5-7 days. After lab processing and incubation of obtained samples, quantitative colony-forming units (CFU)/m(3), CFU/cm(2), and CFU/g and qualitative results were determined with identification of isolated fungal species. Aspergillus versicolor was the most frequent species found in air (21%), followed by Scopulariopsis brevicaulis (17%) and Penicillium sp. (14%). Aspergillus versicolor was also the most frequent species noted on surfaces (26.6%), followed by Cladosporium sp. (22.4%) and Scopulariopsis brevicaulis (17.5%). Chrysosporium was the most frequently found genera in the new floor covering (38.5%), while Mucor was the most prevalent genera (25.1%) in used floor covering. Our findings corroborate a potential occupational health threat due to fungi exposure and suggest the need for a preventive strategy.

Assessment of swine worker exposures to dust and endotoxin during hog load-out and power washing

Field measurements of personal and area dust and endotoxin concentrations were obtained while agricultural workers performed two work tasks that have been previously unreported: hog load-out and swine building power washing. Hog load-out involves moving hogs from their pens in finishing buildings into a truck for transport to a meat processor. High pressure power washing is conducted for sanitation purposes after a building has been emptied of hogs to remove surface and floor debris. This debris consists of feed, feces, and hog dander as dust or an encrusted form. The hog load-out process necessarily increases pig activity which is known to increase airborne dust concentrations. An unintended consequence of power washing is that the material covering surfaces is forcibly ejected into the atmosphere, creating the potential for a highly concentrated aerosol exposure to workers. The load-out process resulted in a median personal inhalable mass concentration of 7.14 mg m(-) (3) and median endotoxin concentration of 12 150 endotoxin units (EU) m(-) (3). When converted to an 8-h time-weighted average for a 'total' sampler, one of the 19 samples exceeded a regulatory limit of 15 mg m(-) (3). An impinger was used to sample power washing endotoxin concentrations, which resulted in a median personal concentration of 40 350 EU m(-) (3). These concentrations were among the highest found in the literature for any occupation. With the lack of engineering controls present to reduce airborne contaminant concentrations in swine buildings, either respirator use or a reduction in exposure time is recommended while performing these tasks.

A task-specific assessment of Swine worker exposure to airborne dust

A task-based analysis of personal airborne dust exposures was performed in two swine confinement facilities used to house sows and their litters. Airborne particulate levels were assessed during summer, winter, and spring. Personal aerosol measurements of workers were made with a photometer every 15 sec and corrected to compare with an integrated concentration measurement made with a co-located IOM inhalable dust sampler. Task type and time period were recorded by the workers over an 8-hr work shift. There was a significant difference in dust concentrations between seasons (p < 0.001), with winter months providing the highest levels (geometric mean = 3.76 mg/m(3)). The application of a general linear model of log-transformed task concentrations relative to site, season, and task demonstrated significant differences (P < 0.001) among all three covariates. Tasks performed near moving animals, especially the weaning process, resulted in the greatest concentrations. These results indicate the need to evaluate the concentration levels for separate tasks during multi-task work shifts, such as swine rearing, to optimize efforts to minimize exposures by focusing on high-concentration tasks.

Nasal complaints and signs of disease in farmers--a methodological study

CONCLUSION

The methods used in this study are suitable for field studies that involve examinations of groups of workers. For individual examinations, there is no gold standard method that can discriminate work-related discomfort from other causes of rhinitis.

OBJECTIVES

Studies of the effects of occupation on farmers' health have mainly focused on lower airways; few studies have examined effects on upper airways. This study investigated nasal functions in three groups of farmers (swine, milk and grain producers) and a control group using different methods, suitable for field studies.

SUBJECTS AND METHODS

Health-related complaints were examined and several functional tests, such as expirogram, olfactory threshold test, acoustic rhinometry, nasal lavage with biomarkers of inflammation (eosinophilic cationic proteins (ECP), myeloperoxidase (MPO), tryptase, albumin) and allergy tests were performed. The different tests were correlated to nasal complaints and to each other.

RESULTS

Nasal blockage complaints were more common among farmers; overall, nasal polyps were more frequent in grain producers. Objective parameters showed more pronounced mucosal swelling in farmers and higher concentrations of ECP in nasal lavage compared with controls. Lung function, olfactory threshold, atopy frequency and allergen-specific IgE to the storage mite Lepidoglyphus destructor did not differ between farmers and controls. Mucosal swelling measured with acoustic rhinometry was more pronounced in subjects with nasal complaints, hypersensitivity, nasal polyps and symptoms from lower airways. There was a correlation between biomarkers in nasal lavage (MPO, albumin and ECP).

Lung function and farm size predict healthy worker effect in swine farmers

BACKGROUND

Swine farmers are exposed to a number of airborne contaminants associated with respiratory ill health.

OBJECTIVES

To examine the factors associated with healthy worker effect in the swine industry from a longitudinal follow-up of farmers at 4 years and 13 years.

DESIGN

A prospective study of swine farmers and nonexposed rural residents was conducted using similar questionnaires and same spirometer at each time point.

RESULTS

In the original observations in 1990/1991, we studied 302 swine farmers and 261 nonfarming control subjects. Four years later in 1994/1995, 217 swine farmers and 171 nonfarming control subjects of the original group participated again. In 2003/2004, 163 swine farmers and 118 control subjects were retested. Of the 163 swine farmers, 52 remained active swine farmers and 111 were no longer swine farming, thus providing the opportunity to evaluate work continuity in the industry. Among farmers studied in 2003/2004, mean values for percentage of predicted FEV(1)/FVC ratio and forced expiratory flow between 25% and 75% of FVC were lower in those who had quit swine farming compared to those still swine farming and nonfarming control subjects. The herd size in the barn at baseline in 1990/1991 and at interim follow-up in 1994/1995 was a significant predictor of quitting swine farming. In addition, percentage of predicted FEV(1)/FVC at the interim observation was a significant predictor of quitting swine farming.

CONCLUSIONS

There is a significant healthy worker effect among swine farmers. The continuation of work in the facilities may be predicted by herd size and interim lung function.

Excess respiratory symptoms in full-time male and female workers in large-scale swine operations

BACKGROUND

The respiratory health effects of working in swine operations have been previously investigated mainly in male owner/operators with intermittent exposure to indoor air contaminants.

OBJECTIVES

To examine the respiratory health of male and female workers employed full time in large-scale intensive swine operations in Saskatchewan.

DESIGN

A cross-sectional study of male and female swine workers employed full time and nonfarming control subjects.

RESULTS

In total, 374 swine farmers (240 men and 134 women) and 411 nonfarming rural control subjects (184 men and 227 women) participated in the study. After controlling for age and smoking, male and female workers were significantly more likely to have chronic and usual cough, and chronic and usual phlegm in comparison to male and female nonfarming control subjects, respectively. The risks of these symptoms were greater in female workers (chronic cough: odds ratio [OR], 5.14; 95% confidence interval, 2.67 to 9.89; chronic phlegm: OR, 4.26; 95% confidence interval, 1.86 to 9.73) than in male workers (chronic cough: OR, 3.47; 95% confidence interval, 1.77 to 6.81; chronic phlegm: OR, 3.22; 95% confidence interval, 1.76 to 5.89). These increased risks were not observed for asthma and asthma-like symptoms in female workers. Male workers had an increased risk of shortness of breath in comparison to their nonfarming counter parts.

CONCLUSIONS

Swine workers had increased risk of chronic and usual bronchitis-like symptoms. Female workers in swine operations appear to have greater risk of these symptoms. Future surveillance programs should include both male and female workers.

Prevalence of work-related respiratory symptoms in Iranian farmers

BACKGROUND

Animal exposure may be an important trigger for work-related symptoms among farmers.

OBJECTIVE

To estimate the prevalence of work-related respiratory symptoms (WRS) in sheep breeders and agricultural farmers and to determine work-related risk factors.

METHODS

A family doctor used a questionnaire to interview a cohort of 173 farmers comprised of 127 sheep breeders and 46 agricultural farmers in the rural area of Rokh (northeast Iran). The questionnaire pertained to recurrent wheezing, cough, breathlessness or chronic phlegm while at work (these symptoms define WRS), flu-like illness and physician-diagnosed asthma.

RESULTS

There were 71 subjects (41%) with WRS: 10 of 46 agricultural farmers (21.7%) and 61 of 127 sheep breeders (48.0%). The proportions of sheep breeders with wheezing (16.5%), asthma (14%), cough (29%), breathlessness (31.5%) and flu-like illness (38%) were higher than in agricultural farmers. A significant dose-response relationship among the daily hours worked with animals, the number of animals and the prevalence of symptoms was established for sheep farmers. Sheep shearing and the use of pesticide were associated with an increased risk of wheezing and phlegm.

CONCLUSIONS

The results suggest that sheep farmers in general have higher rates of work-related symptoms than agricultural farmers. The severity of work-related symptoms will increase with an increase in frequency of animal contact; therefore, these results may underestimate the impact of this exposure.

Agricultural dust exposure and respiratory symptoms among California farm operators

OBJECTIVE

To study whether dust exposure in California agriculture is a risk factor for respiratory symptoms.

METHODS

A population-based survey of 1947 California farmers collected respiratory symptoms, occupational and personal exposures. Associations between dust and respiratory symptoms were assessed by logistic regression models.

RESULTS

The prevalence of persistent wheeze was 8.6%, chronic bronchitis 3.8%, chronic cough 4.2%, and asthma 7.8%. Persistent wheeze was independently associated with dust in a dose-response fashion odds ratio, 1.2 (95% confidence interval[CI]=0.8-2.0) and 1.8 (95% CI=1.1-3.2) for low and high time in dust. A borderline significant association between chronic bronchitis and dust exposure was found. Asthma was associated with keeping livestock, but not with dust exposure.

CONCLUSIONS

Occupational dust exposure among California farmers, only one third of whom tended animals, was independently associated with chronic respiratory symptoms.

Allergic rhinitis, asthma, and atopy among grape farmers in a rural population in Crete, Greece

STUDY OBJECTIVE

To measure the prevalence of allergic rhinitis, atopy, and asthma among grape farmers, and to compare the respiratory and atopic status in grape farmers with those of nonexposed control subjects.

DESIGN

Cross-sectional study.

SETTING

Malevisi region in northern Crete, Greece.

SUBJECTS AND METHODS

One hundred twenty grape farmers and 100 control subjects living in the Malevisi region were examined. The protocol comprised a questionnaire, skin prick tests for 16 common allergens, measurement of specific IgE antibodies against 8 allergens, and spirometry before and after bronchodilation.

RESULTS

Grape farmers were found to have an excess of respiratory symptoms. The comparison with the control group, after adjusting for age, sex, and smoking status, showed that the differences were statistically significant for rhinorrhea (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.5 to 5.1; p < 0.001), sneezing (OR, 2.2; 95% CI, 1.2 to 4.0; p < 0.01), and nasal itching (OR, 1.9; 95% CI, 1.0 to 3.6; p < 0.05), but were nonsignificant for asthma-related symptoms. In the multiple logistic regression model, grape farmers were found to have increased work-related symptoms, such as sneezing (OR, 2.9; 95% CI, 1.3 to 6.6; p < 01), rhinorrhea (OR, 2.9; 95% CI, 1.3 to 6.6; p < 0.01), cough (OR, 3.7; 95% CI, 1.2 to 11.4; p < 0.05), and dyspnea (OR, 3.8; 95% CI, 1.1 to 1.3; p < 0.05). The prevalence of allergic rhinitis was 40.8% in grape farmers and 26% in control subjects (OR, 2.0; 95% CI, 1.1 to 3.5; p < 0.02). Increased but statistically nonsignificant values of asthma prevalence were found in grape farmers (6.7%) compared with the control group (2.0%). The prevalence of atopy was 64.2% in grape farmers and 38.0% in the control group (OR, 2.2; 95% CI, 1.2 to 3.5; p < 0.01). Mean FEV1 was significantly lower in grape farmers than in control subjects (p < 0.05), after adjusting for age, sex, and smoking status. Bronchial obstruction was reversible in 23 grape farmers (19.2%) and in 6 control subjects (6%; p < 0.01).

CONCLUSIONS

The study mainly demonstrated the high prevalence of allergic rhinitis and work-related respiratory symptoms in grape farmers compared to control subjects. It also suggested that grape farming is possibly associated with increased allergic sensitization to specific pollens, low baseline FEV1, and increased bronchial hyper-responsiveness. Further studies are needed to determine the potential risk factors for these disorders among the farming population.

Long-term sequelae of Farmer's lung disease in HRCT: a 14-year follow-up study of 88 patients and 83 matched control farmers

The aim of this study was to compare high-resolution computed tomography (HRCT) findings of long-term farmer's lung (FL) patients and control farmers. We studied 88 FL patients and 83 matched control farmers with a mean follow-up time of 14 years. Emphysematous, fibrotic, and miliary changes were recorded by HRCT. The pattern of emphysema and location and distribution of other findings were evaluated in detail. Emphysema was found in 20 (23%) FL patients and in 6 (7%) controls (p=0.005). Recurrences of FL attacks increased (p=0.021) the risk of emphysema. Prevalence of fibrosis (17 vs 10%, p=0.16) and miliary changes (11 vs 4%, p=0.06) did not differ significantly in patients and controls. Among FL patients, emphysematous, fibrous, and miliary changes were more pronounced at the base than in the upper parts of the lung (p<0.02). In slice analysis, the pattern of emphysema was more polymorphous (p=0.001) and the distribution of fibrotic and miliary changes was more variable among FL patients than controls. Emphysema in HRCT is more common in FL patients than matched control farmers, and the occurrence is increased by recurrences of FL. Emphysematous, fibrous, and miliary changes in FL patients HRCT are multiform and predominate in the lower parts of the lung.

Animal production and wheeze in the Agricultural Health Study: interactions with atopy, asthma, and smoking

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.

Sputum cytopathological findings in pig farmers

The purpose of this study is to compare the cytological changes in the respiratory tracts of pig farmers exposed to an environment of swine confinement buildings with control, non-exposed subjects living in the same geographical area. Spontaneously produced sputum specimens were obtained from 133 pig farmers and 120 control subjects, all clinically healthy, and grouped according to smoking habits and sex. The findings of siderophages, eosinophils, abnormal columnar cells and respiratory spirals were significantly more frequent in the pig farmers. Siderophages were noted in 25.6% of pig farmers and in 5% of control subjects. By logistic regression analysis, pig farming is the single predictive factor for siderophages and eosinophils. For other cytological abnormalities, except Creola bodies and granular debris, smoking is the most significant predictive variable, but pig farming, age and male sex also correlate with smoking. Atypical squamous metaplasia was observed in 11.3% of pig farmers and in 5.8% of control subjects. These findings are in concordance with previous epidemiological and clinical studies and also reveal a new aspect of the harmful effect of pig farming exposure to the vascular and epithelial structures of the respiratory tract. It also demonstrates the usefulness of the simple method of sputum cytological analysis.

Respiratory findings in livestock farmworkers

In this cross-sectional study, the prevalence of acute and chronic respiratory symptoms and lung function were investigated in 236 (169 male and 67 female) livestock farmworkers raising domestic animals, including cattle and horses. The prevalence of acute and chronic respiratory symptoms was recorded by administering a modified version of the British Medical Research Council questionnaire on respiratory symptoms. Lung function was measured by recording the maximum expiratory flow-volume curves from which the forced vital capacity, the one-second forced expiratory volume, and the maximum expiratory flow rates at 50% and the last 25% were measured. There was a significantly higher prevalence of almost all chronic respiratory symptoms in farmers compared with controls: highest among men for chronic cough (27.2%) and highest among women for dyspnea (28.3%). Typical symptoms of occupational asthma were diagnosed in 3.6% of the male and 1.5% of the female livestock farmers. A logistic regression analysis performed on chronic respiratory symptoms of livestock workers indicate significant effects of smoking (P < 0.001) on all symptoms except occupational asthma. A large number of male and female livestock farmworkers complained of acute work-related symptoms: highest for dry cough (52.2%) and shortness of breath (44.9%). Lung function data among these workers demonstrated a trend toward lower lung function in general. Multivariate analysis of lung function parameters indicate significant effects of length of employment and smoking in male and length of employment in female livestock farmworkers. The data suggest that employment in livestock farming may be associated in a dose-dependent manner with the development of acute and chronic respiratory symptoms and lung function changes.

Respiratory symptoms in Swiss farmers: an epidemiological study of risk factors

BACKGROUND

The study was undertaken to assess the prevalence and risk factors of self-reported asthma, symptoms of chronic bronchitis, hay fever, and work-related respiratory symptoms in Swiss farmers as well as to compare the prevalence rates of respiratory symptoms with the Swiss population (SAPALDIA-Study).

METHODS

An epidemiological study was performed with a representative sample of 1,542 Swiss farmers using a self-administered questionnaire. To investigate the effect of the type of farming on reported symptoms, the farmers were subdivided into seven groups according to the time farmers spent in different animal confinement buildings. A multivariate analysis was performed by the methods of binary and multivariate logistic regression adjusted for age and smoking habits.

RESULTS

In farmers the prevalence rate was 16.0% for chronic bronchitis, 15.4% for asthma symptoms, and 42.0% for reporting at least one work-related symptom. Using logistic regression analysis, it was established that poultry farming and pig/cattle farming was a risk factor for reporting nasal irritation at work [OR 5.33, (1.57-18.0), OR 3.37 (1.04-10.87)]. Poultry farmers experienced the highest symptom rates. In crop farmers, the prevalence for chronic bronchitis was increased [OR 2.32 (1.03-5.23)]. Over 4 hr spent per day in animal confinement buildings more than doubled the risk for reporting chronic bronchitis [OR 2.61 (1.01-6.76)] and phlegm [OR 2.3 (0.99-5.4)] independent of the type of farming. The comparison of Swiss farmers with the Swiss population showed a twofold elevated risk of reporting chronic bronchitis [OR 1.89 (1.32-2.95)] and a 4.5-fold elevated risk for bringing up phlegm regularly [OR 4.5 (3.25-6.69)] in farmers. In contrast, the risk of farmers to report nasal allergies was less than half as high [OR 0.40 (0.29-0.56)] as that of the general population.

CONCLUSIONS

This study shows that agricultural work in Switzerland is associated with an elevated risk for reporting symptoms of chronic bronchitis and chronic phlegm compared with the general Swiss population. These main results most likely indicate occupational disorders as the exposure-response relationship (hours spent in animal confinements) was particularly obvious for these symptoms.

The concentration of swine production. Effects on swine health, productivity, human health, and the environment

The concern about environmental issues centering around CAFOs is appropriate. The veterinary profession can be an important force in meeting these challenges by broadening its scope of knowledge and practice into the broader environmental field. Although animal agriculture's contribution to environmental concerns is the focus of this article, it is only one of several sectors that contributes to environmental degradation. Crop production, as well as livestock production industries, contribute to pollution. Manufacturing industries, municipalities, private individuals, our consumptive lifestyles, and agriculture all contribute to the degradation of our environment. One must keep in mind the huge importance of our agricultural industry and not single it out to the detriment of its progress. We have an abundance of high-quality foods at the lowest cost to the individual of any industrialized nation. We export over 40 billion dollars in agricultural products yearly. Agriculture sustains our rural economies and provides opportunities for over 2 million private enterprises scattered across the country; however, there is a goal that we have a sustainable agriculture. A big part of that depends on development and enhancement of an agriculture that does not pollute, that sustains its farm operators and workers, and that does not make the area residents ill or degrade their quality of life; however, the current situation is not promising. Much remains to be learned about the actual acute and long-term health consequences of animal agricultural pollution. Many health concerns are speculative, even though based on sound facts. We know that many surface waters have excess N and P that leads to eutrophication and possibly enhanced growth of undesirable organisms such as Pfiesteria piscicida. We know that other animal pathogens, such as cryptosporidia, have caused large community outbreaks. There are other potential pathogens, such as Salmonella sp, for which we do not know the hazard. We know that our soils may become excessively laden with P, Cu, and Zn, which retard plant growth and create toxic conditions for grazing animals. There are concerns about air pollution. Odors have negative sensory and physical health consequences. H2S and dust may cause toxic effects on neighbors. NH3 vaporizing from manure sources may be carried with precipitation to cause eutrophication in lakes or altered ecosystems in natural areas. CH4 escaping from degrading manure contributes to greenhouse gases. Workers in confined livestock structures have high risk for a variety of chronic respiratory conditions. They also are at risk for acute poisoning from H2S in operations where liquid manure is stored in confined spaces. There have been numerous health complaints in recent years from community neighbors of large-scale livestock operations. One study showed adverse altered mood states, and another showed evidence of respiratory illness similar to what workers experience. Although it has not been possible to objectively measure conditions and know toxic levels of substances causing these illnesses, there are so-called extratoxic mechanisms, such as inherent aversion to putrefactive odors and exacerbation of preexisting conditions that lower the tolerance threshold. Environmental concerns regarding livestock production are not new. In the early and mid-1970s, there were many conferences and publications regarding odors and water contamination from livestock operations. Although most of what is known in this area has been known for 20 years, relatively little effective efforts have been made to correct the concerns. In fact, trends over this past decade have increased the concerns. This past decade has seen a tremendous acceleration in the concentration and consolidation of agriculture, capping a slow trend over the past 50 years toward larger, fewer, and more-specialized farms. This trend has gone against the old saying that "dilution is the solution to pollution.

Longitudinal changes in bronchial responsiveness associated with swine confinement dust exposure

STUDY OBJECTIVES

Acute exposure to the air in swine confinement units causes bronchial hyperresponsiveness and inflammation of the airways. This study was performed to assess the longitudinal development of bronchial responsiveness in pig farmers and to establish exposure-response relationships.

METHODS

A cohort of 171 pig farmers was followed over a 3-year period. Bronchial responsiveness was assessed by a histamine provocation test. Long-term average exposure to inhalable dust and endotoxin was determined by personal monitoring in summer and winter, using data on farm characteristics and activities. Time-weighted average (TWA) personal exposure to ammonia was measured. Data on farm characteristics were gathered in the same period.

RESULTS

Mean increase in responsiveness was 2.52 doubling concentrations of histamine for a 10% decrease in FEV(1) and 1.36 doubling concentrations for a 20% decrease in FEV(1). Long-term average exposure to dust was 2.63 mg/m(3) and to endotoxin was 105 ng/m(3). TWA exposure to ammonia was 1.60 mg/m(3). After adjusting for age and smoking behavior, long-term average exposure to inhalable dust was associated with increases in bronchial responsiveness expressed as steps for provocative concentration causing 10% fall in FEV(1). TWA exposure to ammonia, use of wood shavings as bedding, and automated dry feeding were associated with increases in responsiveness expressed as steps for provocative concentration causing a 20% fall in FEV(1).

CONCLUSIONS

Exposure to dust and ammonia in pig farms contributes to chronic inflammation of the airways and should be reduced.

Agravos respiratórios decorrentes da atividade agrícola

As doenças respiratórias são um importante problema crítico para trabalhadores rurais, uma vez constatada evidência de aumento significativo do risco de morbidade e mortalidade, por problemas respiratórios, em trabalhadores agrícolas. Este fato é de grande importância especialmente nos países em desenvolvimento, onde grande parte da população depende da agricultura como fonte de subsistência. Sabidamente, pessoas envolvidas em atividades agrícolas estão potencialmente expostas a vários agentes como poeira inorgânica do solo, poeira orgânica, gases tóxicos, pesticidas, etc. O aparelho respiratório pode reagir a estes insultos ao nível de vias aéreas superiores com rinite, sinusite e otite. As vias aéreas inferiores podem responder desencadeando ou agravando asma brônquica, com o quadro conhecido como síndrome asthma-like, com obstrução crônica e lesões causadas por poeira orgânica, pneumonite por hipersensibilidade e fibrose intersticial. Assim, se faz necessário uma identificação precisa dos possíveis agentes etiológicos e conseqüentes medidas profiláticas das doenças respiratórias decorrentes da atividade agrícola.

Work-related respiratory disorders and farming characteristics among cattle farmers in Northern Germany

BACKGROUND

The aim of this cross-sectional study was to investigate the prevalence of respiratory symptoms among Northern German farmers in relation to cattle farming characteristics.

METHODS

1735 farmers were visited on their farms and were interviewed using a standardized questionnaire on work-related respiratory symptoms and farming details.

RESULTS

84.6% of the farmers were cattle farmers. The prevalence of work-related respiratory symptoms was 40.3%. In a multiple logistic regression model adjusting for response rate, age, gender, and smoking habits, work-related respiratory symptoms were shown to be significantly associated with the ventilation of the cattle house (OR (ventilation via the wall): 0.57), feeding management (OR (feeding once daily): 0.53), and plant crop (OR: 0. 75). Farmers, living inland, showed a significant higher prevalence of work-related respiratory symptoms (OR: 1.34).

CONCLUSIONS

The use of ventilation via the wall might be recommended for new cattle houses in regions with warm winters.

Asthma and allergy in New Zealand farmers

AIMS

To examine the prevalence of symptoms of asthma and allergy in different farming groups in New Zealand.

METHODS

A postal questionnaire was sent to a random sample of 2,500 farmers throughout New Zealand.

RESULTS

The response rate was 77% (1,706 of 2,203 eligibles). The 12-month period prevalence of current asthma was 11.8% overall, compared with 15% in the general population. Asthma prevalence was higher for horse breeders/groomers (16.5%), pig farmers (18.2%), poultry farmers (17.4%), and those working with oats (17.4%). Asthma was also significantly elevated among those working with cleaning powders (14.7%). Women were more likely to report current asthma than were men (OR 1.8, 95% CI 1.3-2.5). Hay fever was significantly higher in deer and crop farmers, and farmers working with horses and goats; eczema was higher for goat and deer farmers.

CONCLUSIONS

The lower overall prevalence of asthma in farmers may be due to the healthy worker effect. Among farmers, the types of farming associated with an elevated prevalence of asthma and allergy in New Zealand are deer and goat farming, working with horses, poultry, pigs, and crop farming. Females reported more current asthma than males.

Prevalence of asthma and respiratory symptoms in dairy farmers in the French province of the Doubs

With the aim of determining whether dairy farming is associated with an excess of asthma and respiratory symptoms, we compared the respiratory status in a sample of dairy farmers (n = 265) and a control group of nonexposed subjects (n = 149). The study protocol comprised a questionnaire, spirometry, and a bronchodilatation test (400 micrograms salbutamol powder), and an allergological evaluation: serum total IgE level, Phadiatop test, and skin prick tests (SPT) for seven inhalant allergens. Cumulative prevalences of self-reported asthma and of current asthma were respectively 5.3% and 1.5% in farmers, and respectively 3.4% and 1.3% in control subjects (both NS). Prevalences of all the respiratory symptoms studied were higher in farmers, with statistically significant differences after adjusting for age, sex, and smoking, for wheezing ever (OR: 2.7, p < 0.05), wheezing within the last year (OR: 5.2, p < 0.025), usual morning cough (OR: 5, p < 10(-)3), usual morning phlegm (OR: 11.3, p < 10(-)4), and chronic bronchitis (OR: 11.8, p < 0.01). The effect of exposure on these symptoms was more pronounced than, or of the same magnitude as that of smoking. Smoking and exposure had an additive effect except for chronic cough for which a positive interaction was observed (p = 0.05). Mean FEV1/VC (percentage of predicted) was statistically negatively correlated to dairy farming (p < 0.025) after adjusting for confounders. Bronchial obstruction was reversible in about 10% of subjects in both groups. In conclusion, this study mainly demonstrated an excess of respiratory symptoms in dairy farmers which is weak and nonsignificant for asthma, and high for cough, phlegm, and chronic bronchitis. It also suggested that the combined effect of farming and smoking was synergistic on chronic cough.

Current issues in the management of chronic obstructive pulmonary diseases

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality, especially among smokers. Many guidelines that have recently been issued emphasize that COPD is not inaccessible to therapeutic measures: although few interventions are capable of affecting its natural history (i.e. smoking cessation and, in patients with severe resting hypoxaemia, oxygen therapy), several others have a demonstrated effect on symptoms and, thereby, quality of life. The effects of inhaled corticosteroids, and alpha 1-antitrypsin replacement therapy in emphysema due to alpha 1-antitrypsin deficiency are currently being studied. When there is a marked increase in mucus production, chest physiotherapy using controlled expiration and directed cough may be useful. Inhaled bronchodilators are frequently effective on dyspnoea, anticholinergic agents being more suitable for continuous symptoms. Rehabilitation, which includes education and psychosocial care, chest physiotherapy, nutritional care and exercise training, also improves quality of life. When there is persistent severe alveolar hypoventilation despite oxygen therapy, long-term mechanical ventilation may be considered. Surgical options in the treatment of emphysema include resection of giant bullae and lung volume reduction surgery. Lung transplantation should be proposed only in patients with end-stage disease, the difficulty here being to define what 'end-stage' means. Finally, all preventive and some therapeutic interventions are likely to be more effective early in the course of the disease. Thus, efforts should be made to detect airways obstruction early in subjects at risk, such as smokers.

Longitudinal evaluation of dose-response relationships for environmental exposures and pulmonary function in swine production workers

Studies describing respiratory health hazards for workers in swine production facilities have been published in the United States, Sweden, Canada, the Netherlands, and Denmark. Up to 50% of these workers experience bronchitis, organic dust toxic syndrome, hyper-reactive airways disease, chronic mucous membrane irritation, and other respiratory effects. These studies clearly point to the fact that this occupational environment poses a significant health risk hazard, and that control methods are needed to protect the worker. Before precise control strategies can be developed, implemented, and evaluated, dose-response studies are required to determine acceptable target levels for exposure. A previous manuscript described the development of multiple regression equations characterizing the relationships between environmental exposures and pulmonary response in a cohort of 207 swine producers. Baseline pulmonary function was included as a significant predictor of cross-shift decrements in pulmonary function in addition to personal measurements of dust, endotoxin, and ammonia concentrations. These equations were then used to predict specific exposure levels of dust and ammonia that could be expected to elicit significant decrements in cross-shift pulmonary function. This paper presents the results from analysis of follow-up data obtained on this same cohort 2 years after the initial measurements. At the second measurement period of the study (time-2), swine workers were found to have a mean cross-shift decrease in FEV1 of 2%. Cross-shift change in FEV1 was significantly correlated with personal exposures to total dust, total endotoxin, respirable endotoxin, and ammonia. The magnitude of the decrease in FEV1 was associated with increasing airborne concentrations of these environmental parameters thus confirming the dose-response relationship observed in the initial study (time-1). The correlation of dust with FEV1 changes in workers with more than 6 years of exposure (time-1 data) and more than 10 years of exposure (time-2 data) suggests that dust exposure is an important factor in chronic respiratory disease. Additionally, the correlation of endotoxins with FEV1 changes in the group with less than 6 years exposure (time-2 data) suggests endotoxins may have more significance for subacute respiratory effects. The agreement between observed cross-shift FEV1 changes measured in time-2 with changes predicted using regression equations derived from time-1 data demonstrates a consistent dose-response relationship over time for this cohort of swine production workers. This finding provides further support for conclusions of the previous study that levels of 2.5 mg/m3 (total dust) and 7.5 ppm (ammonia) are reasonable guidelines for occupational exposure limits in this environment.

Lung function and chronic respiratory symptoms of pig farmers: focus on exposure to endotoxins and ammonia and use of disinfectants

OBJECTIVES

The prevalence of chronic respiratory symptoms among pig farmers is known to be high, but the aetiology of these symptoms is not yet unravelled. Long term average exposure to dust was evaluated, endotoxins and ammonia and use of disinfectants were compared with chronic respiratory symptoms and depressed base line lung function.

METHODS

A cross sectional study was performed among 194 Dutch pig farmers, of whom 100 had not and 94 had chronic respiratory symptoms. Exposure-response relations were evaluated with multiple logistic and linear regression analysis. Estimates of long term average exposure were based on two personal exposure measurements, taken on one day in summer and one day in winter. Information on use of disinfectants and disinfection procedures was assessed by a walk through survey and interview by telephone.

RESULTS

Exposure to dust, endotoxins, and ammonia were not related to chronic respiratory symptoms. Duration of the disinfection procedure and pressure used at disinfection were strongly and positively related to chronic respiratory symptoms. A significant inverse association between base line lung function and endotoxin exposure was found only among asymptomatic farmers. Ammonia exposure and duration of the disinfection procedure were significantly associated with base line lung function in the entire population.

CONCLUSION

Results suggest that use of disinfectants is an important aetiological factor in chronic respiratory health effects of pig farmers. This factor has not been studied before. Results also suggest an aetiological role for exposure to endotoxins and ammonia in development of chronic respiratory health effects, but longitudinal studies with detailed exposure assessment strategies are required to assess their roles.