[Lung function and symptoms in employees of poultry farms]

Chronic Ammonia Inhalation and Interstitial Pulmonary Fibrosis: A Case Report and Review of the Literature

Ammonia is an irritant gas with a characteristic pungent odor, which is widely used in industry. Inasmuch as ammonia is highly soluble in water and, upon inhalation, is deposited in the upper airways, occupational exposures to ammonia have commonly been associated with sinusitis, upper airway irritation, and eye irritation. Acute exposures to high levels of ammonia have also been associated with diseases of the lower airways and interstitial lung. In this study, the authors report on a patient with long-term, repetitive occupational exposure to ammonia at levels at or above odor recognition who developed interstitial lung disease. The scientific literature on inhaled ammonia exposure is reviewed and discussed. The authors conclude that the taking of a careful occupational exposure history for patients presenting with shortness of breath associated with ammonia exposure may assist with an early diagnosis, thus allowing for treatment early in the disease process and prevention of further exposure.

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.

Airway responses in naive subjects to exposure in poultry houses: comparison between cage rearing system and alternative rearing system for laying hens

BACKGROUND

Workers in the poultry industry have increased frequencies of respiratory health problems. The aim of the present study was to investigate acute health effects from exposure in poultry houses and to compare the health effects observed in a cage rearing system and the alternative "cage-less" rearing system for laying hens.

METHODS

Thirty-four subjects were exposed for 3 hr in confined poultry houses. The subjects were randomized into three groups: one was exposed in a building with a cage rearing system and the two other groups were exposed in buildings with a cage-less system, with either young hens and fresh bedding material or with older hens and old bedding material.

RESULTS

Inhalable dust levels were approximately 4 mg/m3 in the buildings with the cage-less system and 2 mg/m3 in the building with cage rearing system; the endotoxin concentration was approximately 100 ng/m3 in both systems. Bronchial responsiveness to methacholine increased approximately fivefold in all groups following exposure. The concentration of the proinflammatory cytokine interleukin-6 (IL-6) increased in nasal lavage fluid and in peripheral blood as a result of the exposure. The number of leukocytes in peripheral blood increased only in the groups exposed among loose laying hens.

CONCLUSION

In the present study, we have demonstrated among previously non-exposed subjects, that 3-hr exposure in confined buildings for egg production induces an acute inflammatory reaction in the upper airways and increased bronchial responsiveness. There is a tendency towards stronger reactions in the groups exposed in the buildings with loose housing for laying hens.