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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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Erlandson G, Magzamen S, Sharp JL, Mitra S, Jones K, Poole JA, Bradford M, Nonnenmann M, Reynolds SJ, Schaeffer JW. Preliminary investigation of a hypertonic saline nasal rinse as a hygienic intervention in dairy workers. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2023; 20:14-22. [PMID: 36260509 PMCID: PMC10958439 DOI: 10.1080/15459624.2022.2137297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Livestock workers experience an increased burden of bioaerosol-induced respiratory disease including a high prevalence of rhinosinusitis. Dairy operations generate bioaerosols spanning the inhalable size fraction (0-100 μm) containing bacterial constituents such as endotoxin. Particles with an aerodynamic diameter between 10 and 100 μm are known to deposit in the nasopharyngeal region and likely affect the upper respiratory tract. We evaluated the effectiveness of a hypertonic saline nasal lavage in reducing inflammatory responses in dairy workers from a high-volume dairy operation. Inhalable personal breathing zone samples and pre-/post-shift nasal lavage samples from each participant over five consecutive days were collected. The treatment group (n = 5) received hypertonic saline while the control group (n = 5) received normotonic saline. Personal breathing zone samples were analyzed for particulate concentrations and endotoxin using gravimetric and enzymatic methods, respectively. Pro- and anti-inflammatory cytokines (i.e., IL-8, IL-10, and TNF-α) were measured from nasal lavage samples using a multiplex assay. Inhalable dust concentrations ranged from 0.15 to 1.9 mg/m3. Concentrations of both pro- and anti-inflammatory cytokines, specifically IL-6, IL-8, and IL-10, were significantly higher in the treatment group compared to the control group (p < 0.02, p < 0.04, and p < 0.01, respectively). Further analysis of IL-10 anti-inflammatory indicates a positive association between hypertonic saline administration and IL-10 production. This pilot study demonstrates that hypertonic saline nasal lavages were successful in upregulating anti-inflammatory cytokines to support larger interventional studies.
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Affiliation(s)
- Grant Erlandson
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado
| | - Julia L Sharp
- Department of Statistics, Colorado State University, Fort Collins, Colorado
| | - Sanchayita Mitra
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado
| | - Kenneth Jones
- Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado
- Department of Cell Biology, University of Oklahoma Health Science Campus, Oklahoma City, Oklahoma
| | - Jill A Poole
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Mary Bradford
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado
| | - Matthew Nonnenmann
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa
| | - Stephen J Reynolds
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado
- Department of Environmental and Occupational Health, Colorado School of Public Health, Denver, Colorado
- High Plains Intermountain Center for Agricultural Health and Safety, Colorado State University, Fort Collins, Colorado
| | - Joshua W Schaeffer
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado
- Department of Environmental and Occupational Health, Colorado School of Public Health, Denver, Colorado
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Duquette-Lozeau K, Létourneau V, Lemieux J, Fournel S, Côté C, Godbout S, Duchaine C. Production of composted recycled manure solids from a Canadian dairy farm: Impact on microbial air quality in experimental conditions. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2021; 71:413-421. [PMID: 33030410 DOI: 10.1080/10962247.2020.1832620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Abstract
Recycled manure solids (RMS) produced in dairy farms from fresh manure need to be sanitized before using them as bedding material. However, the impact on air quality of composting RMS remains unknown. Four RMS composting methods were tested during a 10-day aging of piles in experimental chambers: static windrow (SW), turned windrow (TW), SW following drum composting for 24 h (DC24) or SW following drum composting for 72 h (DC72). Air samples were collected using a SASS®3100 Dry Air Sampler on days 0 (pilling of the RMS), 5, and 10. Bacteria (16S rRNA genes), Penicillium/Aspergillus, A fumigatus, and 11 human pathogenic bacteria (e.g. Klebsiella pneumonia) were quantified by qPCR while endotoxins and dust particles were, respectively, measured by LAL assays and with a DustTrakTM DRX Aerosol Monitor. On day 0, RMS produced by SW and TW yielded the lowest concentrations of airborne bacteria, while DC24 resulted in the lowest levels of Penicillium/Aspergillus and dust particles. SW method led on day 5 to the lowest concentration of bacteria and Penicillium/Aspergillus, and DC24 and DC72 to the lowest concentration of airborne dust. On day 10, SW and TW piles were associated with the lowest levels of Penicillium/Aspergillus and dust particles. A significant difference was observed between concentration of airborne bacteria, Penicillium/Aspergillus and endotoxins before and during the turnover of TW piles. None of the studied human pathogens was detected in the air samples. Results of the present study suggest that SW and TW are the most promising methods for the production of composted RMS with respect to microbial air quality. However, the experimental chambers do not accurately represent commercial dairy barns and further research on these composting methods is necessary. Finally, the study highlights that bedding material and its management may be determinant factors for air quality in dairy barns.Implications: The research evaluated the impact on microbial air quality of composting recycled manure solids (RMS) produced from fresh cow manure. RMS need to be composted or sanitized before using them as bedding material for animals. The impact on animal health of RMS still needs to be confirmed, while the effect on air quality and the health of dairy farmers is unknown. In the present study, microbial air quality associated with four RMS composting methods was investigated. Data revealed that two methods resulted in lower aerosolization of dust particles, endotoxins, molds, and bacteria.
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Affiliation(s)
- Karine Duquette-Lozeau
- Département de biochimie, de microbiologie et de bio-informatique, Université Laval, Québec, Canada
| | - Valérie Létourneau
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
| | - Joanie Lemieux
- Département de biochimie, de microbiologie et de bio-informatique, Université Laval, Québec, Canada
| | - Sébastien Fournel
- Département des sols et de génie agroalimentaire, Université Laval, Québec, Canada
| | - Caroline Côté
- Research and Development Institute for the Agri-Environment (IRDA), Québec, Canada
| | - Stéphane Godbout
- Research and Development Institute for the Agri-Environment (IRDA), Québec, Canada
| | - Caroline Duchaine
- Département de biochimie, de microbiologie et de bio-informatique, Université Laval, Québec, Canada
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, Canada
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Driscoll M, Dalton D, Jenkins P, Tinc P, Murphy D, Douphrate DI, Lundqvist P, Pate M, Lindahl C, Meyerhoff A, Scott E, Carrabba J, Hagevoort GR, Sorensen J. A Scoping Review of Safety and Health Interventions in the High-Risk Dairy Industry: Gaps in Evidence Point to Future Directions in Research. J Agromedicine 2020; 27:51-63. [PMID: 33191879 DOI: 10.1080/1059924x.2020.1837703] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The occupational injury rate of the dairy industry (6.6 per 100 full-time workers) is twice that of the national average across all industries (3.3 per 100 full-time workers). While dairy farms are becoming larger in size and fewer in number, this rate has not changed. A scoping review was conducted to identify published reports of occupational safety interventions in the dairy industry. An additional criterion was that the study included an evaluation of the intervention. Out of 22 articles that met the first criterion (discussion of interventions specific to the dairy industry), 19 met the second of having an evaluative component. These 19 articles corresponded to 16 unique studies, because 4 articles corresponded to the same study. Of the 16 unique studies, only 3 had a comparison of treatment vs. control effects, and none measured the impact of the intervention on injuries and fatalities. Of the 16 interventions, 6 were focused on training or informational campaigns in which the evaluations primarily measured knowledge acquisition. Additionally, none of these studies had a sufficient sample size to compare injury rates as an outcome. Our study demonstrates that the literature lacks any rigorous evaluation of whether dairy safety interventions are making an impact on injury prevention. Given this, it is not possible to determine how work-related injuries and deaths can be prevented in the dairy industry. Recommendations for future research include incorporating rigorous evaluation into research designs and attempting to develop low-cost, unobtrusive methods for collecting data on intermediate and final outcomes.
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Affiliation(s)
- Maryellen Driscoll
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
| | - Deborah Dalton
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
| | - Paul Jenkins
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
| | - Pamela Tinc
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
| | - Dennis Murphy
- Department of Agricultural & Biological Engineering, Penn State University, University Park, PA, USA
| | - David I Douphrate
- Southwest Center for Occupational and Environmental Health, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health in San Antonio, the University of Texas Health Science Center at Houston, San Antonio, TX, USA
| | - Peter Lundqvist
- Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, Alnarp, Sweden
| | - Michael Pate
- Department of Agricultural & Biological Engineering, Penn State University, University Park, PA, USA
| | - Cecilia Lindahl
- Department of Work Science, Business Economics and Environmental Psychology, Swedish University of Agricultural Sciences, Alnarp, Sweden
| | - Anna Meyerhoff
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
| | - Erika Scott
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
| | - James Carrabba
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
| | - G Robert Hagevoort
- Extension Animal Sciences and Natural Resources Department, College of Consumer and Environmental Sciences, New Mexico State University, Dairy Extension, Clovis, NM, USA
| | - Julie Sorensen
- Agriculture, Forestry, and Fishing, The Northeast Center for Occupational Health and Safety, Cooperstown, NY, USA
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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: 25] [Impact Index Per Article: 6.3] [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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Davidson ME, Schaeffer J, Clark ML, Magzamen S, Brooks EJ, Keefe TJ, Bradford M, Roman-Muniz N, Mehaffy J, Dooley G, Poole JA, Mitloehner FM, Reed S, Schenker MB, Reynolds SJ. Personal exposure of dairy workers to dust, endotoxin, muramic acid, ergosterol, and ammonia on large-scale dairies in the high plains Western United States. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2018; 15:182-193. [PMID: 29157144 PMCID: PMC8641559 DOI: 10.1080/15459624.2017.1403610] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Dairy workers experience a high degree of bioaerosol exposure, composed of an array of biological and chemical constituents, which have been tied to adverse health effects. A better understanding of the variation in the magnitude and composition of exposures by task is needed to inform worker protection strategies. To characterize the levels and types of exposures, 115 dairy workers grouped into three task categories on nine farms in the high plains Western United States underwent personal monitoring for inhalable dust, endotoxin, 3-hydroxy fatty acids (3-OHFA), muramic acid, ergosterol, and ammonia through one work shift. Eighty-nine percent of dairy workers were exposed to endotoxin at concentrations exceeding the recommended exposure guidelines (adjusted for a long work shift). The proportion of workers with exposures exceeding recommended guidelines was lower for inhalable dust (12%), and ammonia (1%). Ergosterol exposures were only measurable on 28% of samples, primarily among medical workers and feed handlers. Milking parlor workers were exposed to significantly higher inhalable dust, endotoxin, 3-OHFA, ammonia, and muramic acid concentrations compared to workers performing other tasks. Development of large modern dairies has successfully made progress in reducing worker exposures and lung disease prevalence. However, exposure to endotoxin, dust, and ammonia continues to present a significant risk to worker health on North American dairies, especially for workers in milking parlors. This study was among the first to concurrently evaluate occupational exposure to assayable endotoxin (lipid A), 3-hydroxy fatty acids or 3-OHFA (a chemical measure of cell bound and noncell-bound endotoxins), muramic acid, ergosterol, and ammonia among workers on Western U.S. dairies. There remains a need for cost-effective, culturally acceptable intervention strategies integrated in OHS Risk Management and production systems to further optimize worker health and farm productivity.
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Affiliation(s)
- Margaret E Davidson
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
- f Edith Cowan University , Perth , Western Australila , Australia
| | - Joshua Schaeffer
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Maggie L Clark
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Sheryl Magzamen
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Elizabeth J Brooks
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Thomas J Keefe
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Mary Bradford
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Noa Roman-Muniz
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- c Department of Animal Science , Colorado State University, Colorado State University , Fort Collins , Colorado
| | - John Mehaffy
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Gregory Dooley
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
| | - Jill A Poole
- d University of Nebraska Medical Center , Omaha , Nebraska
| | - Frank M Mitloehner
- e Western Center for Agricultural Health and Safety , UC Davis , Davis , California
| | - Sue Reed
- f Edith Cowan University , Perth , Western Australila , Australia
| | - Marc B Schenker
- e Western Center for Agricultural Health and Safety , UC Davis , Davis , California
| | - Stephen J Reynolds
- a Department of Environmental & Radiological Health Sciences , Colorado State University , Fort Collins , Colorado
- b High Plains Intermountain Center for Agricultural Health and Safety , Colorado State University , Fort Collins , Colorado
- f Edith Cowan University , Perth , Western Australila , Australia
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Kanjiyangat V, Hareendran M. Engineering intervention to reduce API dust exposure during milling operation. ACS CHEMICAL HEALTH & SAFETY 2018. [DOI: 10.1016/j.jchas.2017.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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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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Basinas I, Sigsgaard T, Bønløkke JH, Andersen NT, Omland Ø, Kromhout H, Schlünssen V. Feedback on Measured Dust Concentrations Reduces Exposure Levels Among Farmers. ANNALS OF OCCUPATIONAL HYGIENE 2016; 60:812-24. [PMID: 27245773 DOI: 10.1093/annhyg/mew032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 05/10/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND The high burden of exposure to organic dust among livestock farmers warrants the establishment of effective preventive and exposure control strategies for these workers. The number of intervention studies exploring the effectiveness of exposure reduction strategies through the use of objective measurements has been limited. OBJECTIVE To examine whether dust exposure can be reduced by providing feedback to the farmers concerning measurements of the exposure to dust in their farm. METHODS The personal dust levels of farmers in 54 pig and 26 dairy cattle farms were evaluated in two measurement series performed approximately 6 months apart. Detailed information on work tasks and farm characteristics during the measurements were registered. Participating farms were randomized a priori to a control (n = 40) and an intervention group (n = 40). Shortly after the first visit, owners of intervention farms only received a letter with information on the measured dust concentrations in the farm together with some general advises on exposure reduction strategies (e.g. use of respirators during certain tasks). Relationships between measured dust concentrations and intervention status were quantified by means of linear mixed effect analysis with farm and worker id as random effects. Season, type of farming, and work tasks were treated as fixed effects. Changes in exposure over time were explored primarily at a farm level in models combined, as well as separate for pig and cattle farmers. RESULTS After adjustment for fixed effects, an overall reduction of 23% in personal dust exposures was estimated as a result of the intervention (P = 0.02). Exposure reductions attributable to the intervention were similar across pig and cattle farmers, but statistically significant only for pig farmers. Intervention effects among pig farmers did not depend on the individuals' information status; but among cattle farmers a significant 48% reduction in exposure was found only among individuals that reported to have been informed. No systematic differences in changes over time considering the use of respiratory protection between the intervention and control groups were observed. CONCLUSION The results of the present study suggest reductions between 20 and 30% in personal exposure to inhalable dust to be feasible through simple information provided to the farm owners regarding actual levels of exposure together with instructions on basic measures of prevention. The exact reasons for these effects are unclear, but likely they involve changes in behavior and working practices among intervention farmers.
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Affiliation(s)
- Ioannis Basinas
- 1.Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Center, Aarhus University, Bartholins Allé 2, bg 1260, 8000 Aarhus C, Denmark;
| | - Torben Sigsgaard
- 1.Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Center, Aarhus University, Bartholins Allé 2, bg 1260, 8000 Aarhus C, Denmark
| | - Jakob Hjort Bønløkke
- 1.Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Center, Aarhus University, Bartholins Allé 2, bg 1260, 8000 Aarhus C, Denmark
| | - Nils Testrup Andersen
- 1.Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Center, Aarhus University, Bartholins Allé 2, bg 1260, 8000 Aarhus C, Denmark
| | - Øyvind Omland
- 2.Department of Occupational Medicine, Danish Ramazzini Center, Aalborg University Hospital, Havrevangen 1, 9000 Aalborg, Denmark; 3.Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7 D2, DK-9220 Aalborg, Denmark
| | - Hans Kromhout
- 4.Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Yalelaan 2, 3584 CM Utrecht, the Netherlands
| | - Vivi Schlünssen
- 1.Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Center, Aarhus University, Bartholins Allé 2, bg 1260, 8000 Aarhus C, Denmark; 5.National Research Center for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
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11
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Basinas I, Sigsgaard T, Kromhout H, Heederik D, Wouters IM, Schlünssen V. A comprehensive review of levels and determinants of personal exposure to dust and endotoxin in livestock farming. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2015; 25:123-37. [PMID: 24280684 DOI: 10.1038/jes.2013.83] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 06/24/2013] [Indexed: 05/21/2023]
Abstract
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.
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Affiliation(s)
- Ioannis Basinas
- Section for Environment, Occupation and Health, Department of Public Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
| | - Torben Sigsgaard
- Section for Environment, Occupation and Health, Department of Public Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
| | - Hans Kromhout
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Dick Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Inge M Wouters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Vivi Schlünssen
- Section for Environment, Occupation and Health, Department of Public Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
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12
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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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13
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Basinas I, Sigsgaard T, Erlandsen M, Andersen NT, Takai H, Heederik D, Omland Ø, Kromhout H, Schlünssen V. Exposure-affecting factors of dairy farmers' exposure to inhalable dust and endotoxin. ACTA ACUST UNITED AC 2014; 58:707-23. [PMID: 24748620 DOI: 10.1093/annhyg/meu024] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Studies on determinants of dairy farmers' exposure to dust and endotoxin have been sparse and so far none has addressed the combined effect of tasks and farm characteristics. OBJECTIVE To study whether and how work tasks and specific stable characteristics influence the level of dairy farmers' personal exposure to inhalable dust and endotoxin. METHODS We applied an observational design involving full-shift repeated personal measurements of inhalable dust and endotoxin exposure among 77 subjects (owners and farm workers) from 26 dairy farms. Performed tasks were self-registered in activity diaries, and information on stable characteristics was collected through personal interviews and walk-through surveys. Associations between exposure, tasks, and stable characteristics were examined in linear mixed-effect models with individual and farm treated as random effects. Separate as well as combined models for tasks and stable characteristics were elaborated. RESULTS The 124 personal samples collected had a geometric mean level (geometric standard deviation) of 360 EU m(-3) (3.8) for endotoxin exposure and of 1.0mg m(-3) (2.7) for dust exposure. Identified factors that increased endotoxin exposure included a lower outdoor temperature and use of slope-based or back-flushed slurry systems along with milking, distribution of bedding, and handling of feed and seeds in barns. For dust, exposure was higher when fully automatic (robotic) milking was used and during re-penning of animals, handling of feed and seeds, handling of silos and when distributing bedding. Dust exposure increased also as a result of use of rail feed dispensers in a model without fully automatic milking. CONCLUSIONS The current exposure to dust and in particular endotoxin among Danish dairy farmers demand effective strategies to reduce their exposure. The present findings suggest that future interventions should focus on feeding and manure handling systems. Use of respirators during handling of feed and distribution of bedding should be advised until adequate risk management measures have been established. The expected increased use of fully automatic milking in the future might increase dust exposure of dairy farmers.
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Affiliation(s)
- Ioannis Basinas
- 1.Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Center, Aarhus University, Bartholins Allé 2, bg 1260, 8000 Aarhus C, Denmark
| | - Torben Sigsgaard
- 1.Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Center, Aarhus University, Bartholins Allé 2, bg 1260, 8000 Aarhus C, Denmark
| | - Mogens Erlandsen
- 2.Department of Public Health, Institute of Biostatistics, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark
| | - Nils T Andersen
- 1.Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Center, Aarhus University, Bartholins Allé 2, bg 1260, 8000 Aarhus C, Denmark
| | - Hisamitsu Takai
- 3.Department of Engineering, Aarhus University, Finlandsgade 22, 8200 Aarhus N, Denmark
| | - Dick Heederik
- 4.Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, PO Box 80178, 3508 TD Utrecht, The Netherlands
| | - Øyvind Omland
- 1.Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Center, Aarhus University, Bartholins Allé 2, bg 1260, 8000 Aarhus C, Denmark 5.Department of Occupational Medicine, Danish Ramazzini Center, Aalborg University Hospital, Havrevangen 1, 9000 Aalborg, Denmark
| | - Hans Kromhout
- 4.Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, PO Box 80178, 3508 TD Utrecht, The Netherlands
| | - Vivi Schlünssen
- 1.Department of Public Health, Section for Environment, Occupation and Health, Danish Ramazzini Center, Aarhus University, Bartholins Allé 2, bg 1260, 8000 Aarhus C, Denmark 6.Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark
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