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Steen NA, Krokstad S, Torske MO. A Cross-Sectional Study of Farmer Health and Wellbeing in Norway: The HUNT Study (2017-2019). J Agromedicine 2023; 28:809-820. [PMID: 37382375 DOI: 10.1080/1059924x.2023.2229840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
OBJECTIVES Obtain a broad impression of the health and wellbeing of working farmers in a representative population. METHODS A cross-sectional study using data from a large, general population-based survey, The HUNT Study, Norway (HUNT survey 4, 2017-2019, response rate 54%). The study included 24,313 occupationally active participants aged 19 to 76 years, including 1,188 farmers. Prevalences are estimated for outcomes covering musculoskeletal, respiratory, and mental health as well as general health and life satisfaction, with adjustment for worker age and sex. The estimates for farmers are compared to skilled white collar workers and skilled manual workers. RESULTS Farmers had a higher estimated prevalence of poor overall health (prevalence ratio [PR] 1.56 [95%CI 1.34,1.82]), chronically impaired mobility (PR 1.83 [1.53, 2.20]), long-standing musculoskeletal pain or stiffness (PR 1.29 [1.21, 1.37]), work-related respiratory attack (PR 4.32 [3.67, 5.08]), depression symptoms (PR 1.30 [1.04, 1.61]) and symptoms of psychological distress (PR 1.23 [1.04, 1.47]) than skilled white collar workers. The estimated prevalence of poor overall health (PR 1.19 [1.00, 1.41]) and work-related respiratory attacks (PR 1.44 [1.24, 1.67]) was also higher for farmers than skilled manual workers, after adjustment for age and sex. Farmers had greater odds of rating themselves less satisfied with life in general than skilled white collar workers (adjusted OR 1.17 [1.04, 1.31]). CONCLUSIONS These results are consistent with previous research and add evidence that farm work is associated with high prevalences of a broad range of adverse health outcomes. The associations with chronically impaired mobility, long-standing musculoskeletal pain, and poor self-rated health were strong. The adjusted PRs for work-related respiratory attacks relative to both comparison groups were particularly high. More research is needed to identify and evaluate interventions that can improve farmer health.
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Affiliation(s)
- Natalie A Steen
- Faculty of Biosciences and Aquaculture, Nord University, Steinkjer, Norway
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
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2
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Zhang X, Lei Z, Wu Y, Song Y, Wu X, Yang B, Fan J, Feng S, Wu L, Li L, Dai Q, Zeng Z, Feng M, Zhang T. Prevalence and Risk Factors for COPD in an Urbanizing Rural Area in Western China: A Cross-Sectional Study. Int J Chron Obstruct Pulmon Dis 2023; 18:459-468. [PMID: 37038543 PMCID: PMC10082583 DOI: 10.2147/copd.s400213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/27/2023] [Indexed: 04/07/2023] Open
Abstract
Purpose To investigate the prevalence and risk factors for chronic obstructive pulmonary disease (COPD) in a rural area in western China with severe air pollution. Patients and Methods 10% of local residents aged 40 years and above were included using a convenience sampling method. This was a cross-sectional study. A self-designed questionnaire was used to collect participants' demographic data. The screening program was comprised of two steps: First, a portable electronic spirometer was used for COPD screening. Those participants with FEV1/FVC ratio <0.7 were then referred to a confirmatory pulmonary function (PF) test. COPD was confirmed according to the 2020 Global Initiative for Chronic Obstructive Lung Disease criteria. Results A total of 4577 participants aged 40 years old or above were included in the final analysis. Examination with a mobile spirometer identified 1159 individuals for confirmatory testing; after that, of the 1159 individuals, 889 were diagnosed with COPD by the confirmatory PF test. The prevalence of COPD among the target group was 19.4%. Older age, male sex (odds ratio [OR] = 1.537, 95% confidence interval [CI] 1.246-1.894), smoking history (OR = 1.338, 95% CI 1.069-1.675), family history of respiratory disease (OR = 1.625, 95% CI 1.350-1.957), education level (OR = 0.735, 95% CI 0.617-0.876), overweight (OR = 0.614, 95% CI 0.517-0.730) and obesity (OR = 0.572, 95% CI 0.449-0.721) were identified as independent factors associated with COPD. The screening program helped earlier detection of COPD in 719 participants. Conclusion COPD was highly prevalent in the rural area studied. Rural residents who were older, current or ever-smokers, male and those who had a lower education level were more vulnerable to developing COPD. The COPD screening program may be helpful for earlier disease detection in rural health-care settings.
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Affiliation(s)
- Xiaolong Zhang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Zhiyin Lei
- Department of Respiratory and Critical Care Medicine, Jiajia Central Health Center of Chengdu Eastern New Area, Chengdu Eastern New Area, Sichuan Province, People’s Republic of China
| | - Ying Wu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Yuanyuan Song
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Xiaoling Wu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
- Department of Nursing, Sanya People’s Hospital/West China (Sanya) Hospital, Sichuan University, Sanya, Hainan Province, People’s Republic of China
| | - Bo Yang
- Department of Respiratory and Critical Care Medicine, Jiajia Central Health Center of Chengdu Eastern New Area, Chengdu Eastern New Area, Sichuan Province, People’s Republic of China
| | - Jianmei Fan
- Department of Respiratory and Critical Care Medicine, Jiajia Central Health Center of Chengdu Eastern New Area, Chengdu Eastern New Area, Sichuan Province, People’s Republic of China
| | - Shixu Feng
- Department of Respiratory and Critical Care Medicine, Jiajia Central Health Center of Chengdu Eastern New Area, Chengdu Eastern New Area, Sichuan Province, People’s Republic of China
| | - Liping Wu
- Department of Respiratory and Critical Care Medicine, Jiajia Central Health Center of Chengdu Eastern New Area, Chengdu Eastern New Area, Sichuan Province, People’s Republic of China
| | - Lingyan Li
- Department of Respiratory and Critical Care Medicine, Jiajia Central Health Center of Chengdu Eastern New Area, Chengdu Eastern New Area, Sichuan Province, People’s Republic of China
| | - Qin Dai
- Department of Respiratory and Critical Care Medicine, Jiajia Central Health Center of Chengdu Eastern New Area, Chengdu Eastern New Area, Sichuan Province, People’s Republic of China
| | - Zhen Zeng
- Department of Respiratory and Critical Care Medicine, Jiajia Central Health Center of Chengdu Eastern New Area, Chengdu Eastern New Area, Sichuan Province, People’s Republic of China
| | - Mei Feng
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
| | - Tingting Zhang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China
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3
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Slåstad S, Von Hirsch Svendsen K, Langhammer A. Airway Symptoms among Farmers in Central Norway. A Comparative Study of Risks. The HUNT Study. J Agromedicine 2023; 28:300-308. [PMID: 36239019 DOI: 10.1080/1059924x.2022.2134245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The objective of this study was to compare the risk of developing respiratory symptoms in farmers and other occupational groups over a period of 11 to 23 years. METHODS The study includes data from questionnaires and interviews in HUNT1-3 in The Trøndelag Health study (HUNT). In all three surveys, farmers can be identified. Two control groups are used. Control group 1 consists of all HUNT participants who are not farmers or fishermen. Control group 2 consists of occupational groups who presumably have low exposure to dust, chemicals or gases, but similar educational status as farmers. The data are analysed in SPSS 25 (IBM, Armonk NY), with use of frequency analyses and multiple binary logistic regressions. RESULTS Our main finding is that healthy farmers have increased risk of developing respiratory symptoms as wheezing or breathlessness over a period of 11 and 23 years. This increased risk is statistically significant after 11 years of follow-up (HUNT1 to HUNT2), and also after 23 years (HUNT1 to HUNT3). Corresponding results regarding wheezing and breathlessness are found for healthy farmers in HUNT2 after 12 years of follow-up in HUNT3. In a subgroup analysis, we find a highly significant difference in both wheezing and shortness of breath when at work, in believing that the symptoms are caused by work, and in having to change jobs or quit because of breathing problems. CONCLUSION Farmers have more respiratory symptoms than controls, and the main symptom is attacks of wheezing or breathlessness. Preventive measures such as ventilation and respiratory protection should be implemented on the farm.
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Affiliation(s)
- Siri Slåstad
- Department of Occupational Medicine, Trondheim University Hospital, Trondheim, Norway
| | | | - Arnulf Langhammer
- HUNT Research Centre, University of Science and Technology (NTNU), Levanger, Norway
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4
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O' Brien C, Kingston L, Plant BJ, Coffey A. Lung Health in Farming: A Scoping Review. J Agromedicine 2023; 28:335-345. [PMID: 36773027 DOI: 10.1080/1059924x.2023.2178573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
OBJECTIVE Lung disease is now recognized as an associated occupational hazard among farming and agricultural communities, however limited research surrounds lung health knowledge within our farming population. It is clear from this limited lack of knowledge that farming practices, perceptions and ideas relating to lung health are yet to be uncovered. This scoping review was conducted to identify what is known about lung health within farming and agricultural communities globally and to map the available evidence relating to lung health and lung health decline within this population. The objectives of this review were (1) focus on available lung health research from a global perspective specific to farming and agriculture relating to occupational lung exposures and (2) consolidate current knowledge, clearly identifying gaps within the literature. METHODS This systematic scoping review of the literature is guided by the Joanna Briggs Institute Methodology framework. There were 22 studies eligible for inclusion within the scoping review, providing an up-to-date review of research conducted on lung health and lung disease in farming occupations. RESULTS Results were grouped into three categories emerging from included studies: (1) focused on the prevalence of respiratory symptoms/disease within farming and agricultural occupations, (2) measurements of dust and particulate matter and correlating these with respiratory conditions, (3) common respiratory conditions linked to a decline in lung health among farming and agricultural occupations. Results identified no study focused on or referred to lung health, lung health knowledge or lung health awareness as an outcome, with all studies focusing on respiratory symptoms, development of lung disease and the common occupational hazards this population are exposed to. CONCLUSION This scoping review demonstrates the lack of literature to specifically map available evidence relating to lung health and farming occupations. Many respiratory symptoms and conditions can arise directly and indirectly from agricultural environments, however many of these cases could be prevented by lung health knowledge within the farming population. The results of this scoping review will be used to inform knowledge, awareness, education, health promotion and future research within this population.
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Affiliation(s)
- Ciara O' Brien
- Department of Nursing and Health Care Sciences, Munster Technological University, Kerry, Ireland.,Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Liz Kingston
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Barry J Plant
- Department of Medicine, University College Cork, Cork, Ireland
| | - Alice Coffey
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
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Michel M, Arvis Souaré M, Dindorf C, Danguy V, Chevreul K. Health check-ups for the French under-consuming agricultural population: A pilot evaluation of the Instants santé MSA program. Rev Epidemiol Sante Publique 2023; 71:101420. [PMID: 36610246 DOI: 10.1016/j.respe.2022.101420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 11/17/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The social protection scheme in charge of farmers and agricultural employees (MSA) in France has developed a two-step health promotion program with a nurse appointment followed by a consultation with a doctor of the participant's choosing to reach its under-consuming beneficiaries and enroll them back into a care pathway. Our objective was to carry out a pilot evaluation of this program. METHODS The evaluation was carried out on the population invited during the second semester of 2017 using data from the program's service providers (date of invitation, of nurse appointment…), regional MSA bodies (consultation voucher), and reimbursement data (other care consumption). Participation rates were calculated overall and by participant characteristics. Medical needs were identified during the nurse appointment and new care pathways were assessed using reimbursement data. Multivariable regression models identified factors associated with participation. RESULTS 2366 beneficiaries were included in the analysis. 1559 (65.89%) were men and mean age was 52.41 (standard deviation = 14.86). 409 (17.29%) attended the nurse appointment. There was a significant increase in participation with age, in farmers vs. employees (odds ratio = 1.905, 95% confidence interval = 1.393-2.604), and in people living in the most disadvantaged areas (odds ratio = 1.579, 95% confidence interval=1.079-2.312). Participation to the consultation following the nurse appointment was high (62.35%-73.11%). 87.53% of participants had at least one medical need, and new care pathways were more frequent among those who had attended the nurse appointment (55.50% vs. 34.80%, p < 0.0001). CONCLUSIONS This pilot evaluation shows promising results which need to be confirmed with a national evaluation of the program and longer-term evidence.
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Affiliation(s)
- Morgane Michel
- Université Paris Cité, ECEVE, 75010 Paris, France; Assistance Publique-Hôpitaux de Paris, DRCI, URC Eco Ile-de-France, 75004 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Unité d'épidémiologie clinique, 75019 Paris, France; INSERM, ECEVE UMR 1123, 75010 Paris, France.
| | - Mariam Arvis Souaré
- Direction du contrôle médical et de l'offre de soins, Caisse centrale de la Mutualité Sociale Agricole, 93000 Bobigny, France
| | - Christel Dindorf
- Université Paris Cité, ECEVE, 75010 Paris, France; Assistance Publique-Hôpitaux de Paris, DRCI, URC Eco Ile-de-France, 75004 Paris, France; INSERM, ECEVE UMR 1123, 75010 Paris, France
| | - Véronique Danguy
- Département Études et évaluation en santé, Caisse centrale de la Mutualité Sociale Agricole, 93000 Bobigny, France
| | - Karine Chevreul
- Université Paris Cité, ECEVE, 75010 Paris, France; Assistance Publique-Hôpitaux de Paris, DRCI, URC Eco Ile-de-France, 75004 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Unité d'épidémiologie clinique, 75019 Paris, France; INSERM, ECEVE UMR 1123, 75010 Paris, France
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6
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Plombon S, Henneberger PK, Humann MJ, Liang X, Doney BC, Kelly KM, Cox-Ganser JM. The association of chronic bronchitis and airflow obstruction with lifetime and current farm activities in a sample of rural adults in Iowa. Int Arch Occup Environ Health 2022; 95:1741-1754. [PMID: 35482110 PMCID: PMC10424266 DOI: 10.1007/s00420-022-01866-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/04/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Farmers have an increased risk for chronic bronchitis and airflow obstruction. The objective of this study was to investigate the association of these health outcomes with farm activities. METHODS We evaluated the Keokuk County Rural Health Study (KCRHS) enrollment data for farm activities and the two health outcomes chronic bronchitis based on self-reported symptoms and airflow obstruction based on spirometry. We used logistic regression to model the health outcomes, yielding an odds ratio (OR) and 95% confidence interval (95% CI) for farm activities while adjusting for potential confounders and other risk factors. RESULTS Of the 1234 farmers, 104 (8.4%) had chronic bronchitis, 75 (6.1%) fulfilled the criteria for airflow obstruction, and the two outcomes overlapped by 18 participants. Chronic bronchitis without airflow obstruction (n = 86) had a statistically significant association with crop storage insecticides (OR 3.1, 95% CI 1.6, 6.1) and a low number of years (≤ 3) worked with turkeys (OR 3.3, 95% CI 1.2, 9.4). The latter result should be interpreted with caution because it is based on a small number of cases (n = 5). Airflow obstruction with or without chronic bronchitis (n = 75) was significantly associated with ever working in a hog or chicken confinement setting (OR 2.2, 95% CI 1.0, 4.5). CONCLUSIONS These results suggest that work with crop storage insecticides or turkeys may increase the risk for chronic bronchitis and work in hog or chicken confinement may increase the risk for airflow obstruction.
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Affiliation(s)
- Savanna Plombon
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, MS H2900, 1000 Frederick Lane, Morgantown, WV, 26508, USA
| | - Paul K Henneberger
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, MS H2900, 1000 Frederick Lane, Morgantown, WV, 26508, USA.
| | - Michael J Humann
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, MS H2900, 1000 Frederick Lane, Morgantown, WV, 26508, USA
| | - Xiaoming Liang
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, MS H2900, 1000 Frederick Lane, Morgantown, WV, 26508, USA
| | - Brent C Doney
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, MS H2900, 1000 Frederick Lane, Morgantown, WV, 26508, USA
| | - Kevin M Kelly
- Department of Occupational and Environmental Health, The University of Iowa, Iowa City, IA, USA
| | - Jean M Cox-Ganser
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, MS H2900, 1000 Frederick Lane, Morgantown, WV, 26508, USA
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7
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Dominguez EC, Phandthong R, Nguyen M, Ulu A, Guardado S, Sveiven S, Talbot P, Nordgren TM. Aspirin-Triggered Resolvin D1 Reduces Chronic Dust-Induced Lung Pathology without Altering Susceptibility to Dust-Enhanced Carcinogenesis. Cancers (Basel) 2022; 14:1900. [PMID: 35454807 PMCID: PMC9032113 DOI: 10.3390/cancers14081900] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/28/2022] [Accepted: 04/01/2022] [Indexed: 02/05/2023] Open
Abstract
Lung cancer is the leading cause of cancer-related deaths worldwide, with increased risk being associated with unresolved or chronic inflammation. Agricultural and livestock workers endure significant exposure to agricultural dusts on a routine basis; however, the chronic inflammatory and carcinogenic effects of these dust exposure is unclear. We have developed a chronic dust exposure model of lung carcinogenesis in which mice were intranasally challenged three times a week for 24 weeks, using an aqueous dust extract (HDE) made from dust collected in swine confinement facilities. We also treated mice with the omega-3-fatty acid lipid mediator, aspirin-triggered resolvin D1 (AT-RvD1) to provide a novel therapeutic strategy for mitigating the inflammatory and carcinogenic effects of HDE. Exposure to HDE resulted in significant immune cell influx into the lungs, enhanced lung tumorigenesis, severe tissue pathogenesis, and a pro-inflammatory and carcinogenic gene signature, relative to saline-exposed mice. AT-RvD1 treatment mitigated the dust-induced inflammatory response but did not protect against HDE + NNK-enhanced tumorigenesis. Our data suggest that chronic HDE exposure induces a significant inflammatory and pro-carcinogenic response, whereas treatment with AT-RvD1 dampens the inflammatory responses, providing a strong argument for the therapeutic use of AT-RvD1 to mitigate chronic inflammation.
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Affiliation(s)
- Edward C. Dominguez
- Environmental Toxicology Graduate Program, University of California Riverside, Riverside, CA 92521, USA; (E.C.D.); (P.T.)
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA 92521, USA; (M.N.); (A.U.); (S.G.); (S.S.)
| | - Rattapol Phandthong
- Department of Molecular, Cell and Systems Biology, University of California Riverside, Riverside, CA 92521, USA;
| | - Matthew Nguyen
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA 92521, USA; (M.N.); (A.U.); (S.G.); (S.S.)
| | - Arzu Ulu
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA 92521, USA; (M.N.); (A.U.); (S.G.); (S.S.)
| | - Stephanie Guardado
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA 92521, USA; (M.N.); (A.U.); (S.G.); (S.S.)
| | - Stefanie Sveiven
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA 92521, USA; (M.N.); (A.U.); (S.G.); (S.S.)
| | - Prue Talbot
- Environmental Toxicology Graduate Program, University of California Riverside, Riverside, CA 92521, USA; (E.C.D.); (P.T.)
- Department of Molecular, Cell and Systems Biology, University of California Riverside, Riverside, CA 92521, USA;
| | - Tara M. Nordgren
- Environmental Toxicology Graduate Program, University of California Riverside, Riverside, CA 92521, USA; (E.C.D.); (P.T.)
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, CA 92521, USA; (M.N.); (A.U.); (S.G.); (S.S.)
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523, USA
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8
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Ulu A, Velazquez JV, Burr A, Sveiven SN, Yang J, Bravo C, Hammock BD, Nordgren TM. Sex-Specific Differences in Resolution of Airway Inflammation in Fat-1 Transgenic Mice Following Repetitive Agricultural Dust Exposure. Front Pharmacol 2022; 12:785193. [PMID: 35095496 PMCID: PMC8793679 DOI: 10.3389/fphar.2021.785193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/23/2021] [Indexed: 11/13/2022] Open
Abstract
In agriculture industries, workers are at increased risk for developing pulmonary diseases due to inhalation of agricultural dusts, particularly when working in enclosed confinement facilities. Agricultural dusts inhalation leads to unresolved airway inflammation that precedes the development and progression of lung disease. We have previously shown beneficial effects of the omega-3 polyunsaturated fatty acid (ω-3 PUFA) DHA in protecting against the negative inflammatory effects of repetitive dust exposure in the lung. Dietary manipulation of pulmonary disease risk is an attractive and timely approach given the contribution of an increased ω-6 to ω-3 PUFA ratio to low grade inflammation and chronic disease in the Western diet. To prevent any confounding factors that comes with dietary supplementation of ω-3 PUFA (different sources, purity, dose, and duration), we employed a Fat-1 transgenic mouse model that convert ω-6 PUFA to ω-3 PUFA, leading to a tissue ω-6 to ω-3 PUFA ratio of approximately 1:1. Building on our initial findings, we hypothesized that attaining elevated tissue levels of ω-3 PUFA would attenuate agricultural dust-induced lung inflammation and its resolution. To test this hypothesis, we compared wild-type (WT) and Fat-1 transgenic mice in their response to aqueous extracts of agricultural dust (DE). We also used a soluble epoxide hydrolase inhibitor (sEH) to potentiate the effects of ω-3 PUFA, since sEH inhibitors have been shown to stabilize the anti-inflammatory P450 metabolites derived from both ω-3 and ω-6 PUFA and promote generation of specialized pro-resolving lipid mediators from ω-3 PUFA. Over a three-week period, mice were exposed to a total of 15 intranasal instillations of DE obtained from swine confinement buildings in the Midwest. We observed genotype and sex-specific differences between the WT vs. Fat-1 transgenic mice in response to repetitive dust exposure, where three-way ANOVA revealed significant main effects of treatment, genotype, and sex. Also, Fat-1 transgenic mice displayed reduced lymphoid aggregates in the lung following DE exposure as compared to WT animals exposed to DE, suggesting improved resilience to the DE-induced inflammatory effects. Overall, our data implicate a protective role of ω-3 FA in the lung following repetitive dust exposure.
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Affiliation(s)
- Arzu Ulu
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Jalene V Velazquez
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Abigail Burr
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Stefanie N Sveiven
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Jun Yang
- Department of Entomology and Nematology, University of California Davis Comprehensive Cancer Center, University of California, Davis, Davis, CA, United States
| | - Carissa Bravo
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Bruce D Hammock
- Department of Entomology and Nematology, University of California Davis Comprehensive Cancer Center, University of California, Davis, Davis, CA, United States
| | - Tara M Nordgren
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States.,Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, United States
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9
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Ratanachina J, Amaral A, De Matteis S, Cullinan P, Burney P. Farming, pesticide exposure and respiratory health: a cross-sectional study in Thailand. Occup Environ Med 2021; 79:38-45. [PMID: 34162719 DOI: 10.1136/oemed-2020-107325] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/09/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the association of lung function and respiratory symptoms with farming, particularly pesticide use, in an agricultural province in Thailand. METHODS We undertook a cross-sectional survey of adults aged 40-65 in Nan province, Thailand, between May and August 2019. We randomly recruited 345 villagers and enriched the sample with 82 government employees. All participants performed post-bronchodilator spirometry and completed a questionnaire covering information on respiratory symptoms, farming activities, pesticide use and known risk factors for respiratory disease. Associations of respiratory outcomes with farming and pesticide exposures were examined by multivariable regression analysis. RESULTS The response rate was 94%. The prevalence of chronic airflow obstruction among villagers was 5.5%. Villagers had, on average, a lower percent predicted post-bronchodilator forced expiratory volume in one second/forced vital capacity (FEV1/FVC) than government employees (98.3% vs 100.3%; p=0.04). There was no evidence of association of lung function with farming activities, the use of specific herbicides (glyphosate and paraquat), insecticides (organophosphates and pyrethroids) or fungicides. The exceptions were poultry farming, associated with chronic cough and an increase of FEV1/FVC, and atrazine, for which duration (p-trend <0.01), intensity (p-trend <0.01) and cumulative hours (p-trend=0.01) of use were all associated with higher FEV1/FVC in an exposure-response manner. Cumulative hours (-280 mL/hour), low duration (-270 mL/year) and intensity (-270 mL/hour/year) of atrazine use were associated with lower FVC. CONCLUSIONS Chronic airflow obstruction is uncommon among villagers of an agricultural province in Nan, Thailand. Farming and pesticide use are unlikely to be major causes of respiratory problems there.
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Affiliation(s)
- Jate Ratanachina
- National Heart and Lung Institute, Imperial College London, London, UK .,Department of Preventive and Social Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Andre Amaral
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sara De Matteis
- National Heart and Lung Institute, Imperial College London, London, UK.,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Sardegna, Italy
| | - Paul Cullinan
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Peter Burney
- National Heart and Lung Institute, Imperial College London, London, UK
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10
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Crawford MS, Nordgren TM, McCole DF. Every breath you take: Impacts of environmental dust exposure on intestinal barrier function-from the gut-lung axis to COVID-19. Am J Physiol Gastrointest Liver Physiol 2021; 320:G586-G600. [PMID: 33501887 PMCID: PMC8054554 DOI: 10.1152/ajpgi.00423.2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 01/31/2023]
Abstract
As countries continue to industrialize, major cities experience diminished air quality, whereas rural populations also experience poor air quality from sources such as agricultural operations. These exposures to environmental pollution from both rural and populated/industrialized sources have adverse effects on human health. Although respiratory diseases (e.g., asthma and chronic obstructive pulmonary disease) are the most commonly reported following long-term exposure to particulate matter and hazardous chemicals, gastrointestinal complications have also been associated with the increased risk of lung disease from inhalation of polluted air. The interconnectedness of these organ systems has offered valuable insights into the roles of the immune system and the micro/mycobiota as mediators of communication between the lung and the gut during disease states. A topical example of this relationship is provided by reports of multiple gastrointestinal symptoms in patients with coronavirus disease 2019 (COVID-19), whereas the rapid transmission and increased risk of COVID-19 has been linked to poor air quality and high levels of particulate matter. In this review, we focus on the mechanistic effects of environmental pollution on disease progression with special emphasis on the gut-lung axis.
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Affiliation(s)
- Meli'sa S Crawford
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, California
| | - Tara M Nordgren
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, California
| | - Declan F McCole
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, California
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11
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Pagán-Santana M, Amaya C, Rivera-Gutiérrez R, Caporali S. Chronic Diseases among Agricultural Workers in a Rural Area of Puerto Rico. J Agromedicine 2020; 26:211-219. [PMID: 33143555 DOI: 10.1080/1059924x.2020.1824829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Occupational and environmental exposures in the agricultural industry have been associated with several illnesses and poor health outcomes. Information regarding the characteristics and health status of the labor force working in the agricultural sector in Puerto Rico is limited. The overall objective of this study was to increase the available information on agricultural workers health and needs by ascertaining the potential differences in characteristics and health status of farmworkers when compared to the general population in rural Puerto Rico This cross-sectional study used the collection and analysis of medical records of agricultural workers and non-agricultural workers in Hospital General Castañer, located in Lares, Puerto Rico. The research period was five years, from 2012 to 2016. This research described agricultural workers' demographic and socioeconomic profile and evaluated relationships between one or more demographic variables and farmer's health. Agricultural workers presented alower prevalence of hypertensive disease (69.4%) and ahigher prevalence of cerebrovascular disease (3.4%) when compared to non-agricultural workers. In other words, agricultural workers were 21% less likely to have hypertensive disease as compared to non-agricultural workers. Results for agricultural workers showed that 4.0% of the workers were diagnosed with arthritis, and 48.8% had suffered at least one type of dorsopathy. The results from this research provide useful information for developing an appropriate framework to address Puerto Rican agricultural worker's health while promoting the agricultural industry development on the island. Finally, this study provided insight into the prevalence and demographic characteristics of agriculture workers in acentral region of Puerto Rico. Further efforts are needed to better define the agricultural workers and farming communities in Puerto Rico that may be exposed to related hazards.
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Affiliation(s)
- Marysel Pagán-Santana
- Environmental Health Department, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - C Amaya
- Epidemiology and Biostatistics Department, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - R Rivera-Gutiérrez
- Health Services Administration Department, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - S Caporali
- Environmental Health Department, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
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12
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Meganathan V, Moyana R, Natarajan K, Kujur W, Kusampudi S, Mulik S, Boggaram V. Bacterial extracellular vesicles isolated from organic dust induce neutrophilic inflammation in the lung. Am J Physiol Lung Cell Mol Physiol 2020; 319:L893-L907. [PMID: 32996778 DOI: 10.1152/ajplung.00107.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Inhalation of organic dust is an occupational hazard leading to the development of respiratory symptoms and respiratory diseases. Bioaerosols from concentrated animal feeding operations are rich in bacteria and could carry bacterial extracellular vesicles (EVs) that could induce lung inflammation. It is not known if organic dust contains bacterial EVs and whether they modulate lung inflammation. Herein, we show that poultry organic dust contains bacterial EVs (dust EVs) that induce lung inflammation. Treatment of airway epithelial cells, THP-1-monocytes and -macrophages with dust EVs rapidly induced IL-8, IL-6, ICAM-1, proIL-1β, and TNF-α levels. In airway epithelial cells, induction of inflammatory mediators was due to increased mRNA levels and NF-κB activation. Induction of inflammatory mediators by dust EVs was not inhibited by polymyxin B. Single and repeated treatments of mice with dust EVs increased lung KC, IL-6, and TNF-α levels without significantly altering IL-17A levels. Increases in cytokines were associated with enhanced neutrophil infiltration into the lung. Repeated treatments of mice with dust EVs increased lung mean linear intercept and increased collagen deposition around airways indicating lung remodeling. Peribronchial cell infiltrates and airway epithelial thickening were also observed in treated mice. Because bacterial EVs are nanometer-sized particles, they can reach and accumulate in the bronchiolar and alveolar regions causing lung injury leading to the development of respiratory diseases. Our studies have provided new evidence for the presence of bacterial EVs in organic dust and for their role as one of the causative agents of organic dust-induced lung inflammation and lung injury.
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Affiliation(s)
- Velmurugan Meganathan
- Department of Cellular and Molecular Biology, University of Texas Health Science Center at Tyler, Tyler, Texas
| | - Regina Moyana
- Department of Cellular and Molecular Biology, University of Texas Health Science Center at Tyler, Tyler, Texas
| | - Kartiga Natarajan
- Department of Cellular and Molecular Biology, University of Texas Health Science Center at Tyler, Tyler, Texas
| | - Weshely Kujur
- Department of Pulmonary Immunology, University of Texas Health Science Center at Tyler, Tyler, Texas
| | - Shilpa Kusampudi
- Department of Cellular and Molecular Biology, University of Texas Health Science Center at Tyler, Tyler, Texas
| | - Sachin Mulik
- Department of Pulmonary Immunology, University of Texas Health Science Center at Tyler, Tyler, Texas
| | - Vijay Boggaram
- Department of Cellular and Molecular Biology, University of Texas Health Science Center at Tyler, Tyler, Texas
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13
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Kitjakrancharoensin P, Yasan K, Hongyantarachai K, Ratanachokthorani K, Thammasarn J, Kuwuttiwai D, Ekanaprach T, Jittakarm R, Nuntapravechpun R, Hotarapavanon S, Kulrattanarak S, Tongkaew S, Deemeechai S, Mungthin M, Rangsin R, Wongsrichanalai V, Sakboonyarat B. Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease Among Agriculturists in a Rural Community, Central Thailand. Int J Chron Obstruct Pulmon Dis 2020; 15:2189-2198. [PMID: 32982211 PMCID: PMC7501975 DOI: 10.2147/copd.s262050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 08/31/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose The present study aimed to determine the prevalence and risk factors of chronic obstructive pulmonary disease (COPD) among agriculturists in a remote rural community in central Thailand. Methods A cross-sectional study was conducted in January 2020. Face-to-face interviews were conducted using standardized questionnaires to determine demographic characteristics and risk behaviors. COPD was defined by the spirometric criterion for airflow limitation constituting a postbronchodilator fixed ratio of FEV1/FVC <0.70 following the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines 2019. Multivariable logistic regression analysis was used to determine the risk factors for COPD, and the magnitude of association was presented as adjusted odds ratio (AOR) with 95% confidence interval (95% CI). Results A total of 546 agriculturists were enrolled in the study. The overall prevalence of COPD was 5.5% (95% CI: 3.6–7.4). The prevalence of COPD among males was 8.0% (95% CI: 4.7–11.3), and 3.2% (95% CI: 1.1–5.2) among females. The risk factors of COPD included age ≥60 years old (AOR 2.7, 95% CI: 1.1–7.0), higher intensity of smoking (AOR 1.1, 95% CI: 1.0–1.1), swine farm worker (AOR 4.1, 95% CI: 1.7–10.3), cattle farm worker (AOR 3.3, 95% CI: 1.4–8.2) and home cooking (AOR 2.7, 95% CI: 0.8–9.7). Conclusion Our data emphasized that COPD was one of the significant health problems among agriculturists in a rural community. Agricultural jobs such as animal farmers and behavioral factors such as smoking were associated with COPD. Effective public health interventions, especially, modifying risk behaviors, should be promoted in remote rural areas to prevent the disease and reduce its morbidity and mortality.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Mathirut Mungthin
- Department of Pharmacology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
| | | | - Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
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14
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Soumagne T, Degano B, Guillien A, Annesi-Maesano I, Andujar P, Hue S, Adotevi O, Jouneau S, Botebol M, Laplante JJ, Roche N, Dalphin JC. Characterization of chronic obstructive pulmonary disease in dairy farmers. ENVIRONMENTAL RESEARCH 2020; 188:109847. [PMID: 32846639 DOI: 10.1016/j.envres.2020.109847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/19/2020] [Accepted: 06/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Although farming is often considered a risk factor for COPD, data regarding the burden and characteristics of COPD in dairy farmers are sparse and conflicting. OBJECTIVES To characterize COPD in dairy farmers. METHODS 4788 subjects entered two parallel COPD screening programs, one in agricultural workers and one in general practice from 2011 to 2015. Subjects with COPD were invited to participate in the characterization phase of the study. Those who accepted were included in two subgroups: dairy farmers with COPD (DF-COPD) (n = 101) and non-farmers with COPD (NF-COPD) (n = 85). Patients with COPD were frequency-matched with subjects with normal spirometry for age, sex and tobacco smoking (pack-years and status) (DF-controls n = 98, NF-controls n = 89). All subjects from these four groups underwent lung function and exercise testing, questionnaires and blood analysis. RESULTS The frequency of COPD in dairy farmers was 8.0% using the GOLD criterion and 6.2% using the lower limit of normal criterion and was similar in non-farming subjects (7.3% and 5.2%, respectively) although dairy farmers had lower tobacco consumption (screening phase). DF-COPD had better pulmonary function, exercise capacity and quality of life, fewer symptoms and comorbidities than NF-COPD, and higher levels of some Th2 biomarkers (MCP-2, periostin) (characterization phase). In farmers, COPD was not related to occupational exposure factors, supporting the role of host factors. CONCLUSION COPD secondary to organic dust exposure (dairy farming) appears less severe and associated with fewer comorbidities than COPD secondary to tobacco smoking.
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Affiliation(s)
- Thibaud Soumagne
- Service de Pneumologie, Oncologie Thoracique et Allergologie Respiratoire, CHRU de Besançon, France.
| | - Bruno Degano
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, France; Université Grenoble Alpes, Grenoble, France
| | - Alicia Guillien
- Equipe d'Epidémiologie Environnementale, Institute for Advanced Biosciences, Centre de Recherche UGA, INSERM U1209, CNRS UMR 5309, Grenoble, France
| | | | - Pascal Andujar
- Centre Hospitalier Intercommunal de Créteil, Service de Pathologie Professionnelle et de l'Environnement, Créteil, France; INSERM, Unité U955 and Université Paris-Est Créteil, Créteil, France
| | - Sophie Hue
- INSERM, Unité U955 and Université Paris-Est Créteil, Créteil, France; Immunologie-Biologie, Hôpital Henri-Mondor, AP-HP, Paris, France
| | - Olivier Adotevi
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Université de Bourgogne Franche-Comté, Besançon, France
| | - Stéphane Jouneau
- Department of Respiratory Medicine, Rennes University Hospital, Rennes, France; UMR1085, IRSET, Rennes 1 University, Rennes, France
| | - Martial Botebol
- Fédération des Maisons de Santé Comtoises (FéMaSaC), Beure, France
| | | | - Nicolas Roche
- Service de Pneumologie, Hôpital Cochin, AP-HP, Centre Université de Paris, Institut Cochin (UMR1016), Paris, France
| | - Jean-Charles Dalphin
- Service de Pneumologie, Oncologie Thoracique et Allergologie Respiratoire, CHRU de Besançon, France; UMR CNRS Chrono Environnement, Université de Franche-Comté, Besançon, France
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15
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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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16
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Soumagne T, Guillien A, Roche N, Annesi-Maesano I, Andujar P, Laurent L, Jouneau S, Botebol M, Laplante JJ, Dalphin JC, Degano B. In Patients with Mild-to-Moderate COPD, Tobacco Smoking, and Not COPD, Is Associated with a Higher Risk of Cardiovascular Comorbidity. Int J Chron Obstruct Pulmon Dis 2020; 15:1545-1555. [PMID: 32669840 PMCID: PMC7335866 DOI: 10.2147/copd.s253417] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 05/24/2020] [Indexed: 12/19/2022] Open
Abstract
Background Comorbidities including cardiovascular diseases are very common in chronic obstructive pulmonary disease (COPD) secondary to tobacco smoking and contribute to the overall severity of the disease. In non-smoking COPD, which accounts for about 25% of COPD cases worldwide, current knowledge on the frequency and determinants of comorbidities remains scarce. The aims of the current study were to assess the frequency of major comorbidities and to evaluate their determinants in a group of non-selected patients with mild-to-moderate COPD who were exposed to organic dust (dairy farmers), to tobacco smoking, or to both, and in controls without COPD who were exposed to organic dust (dairy farmers), or to tobacco smoking, or to both, or who were without exposure. Patients and Methods A total of 4665 subjects (2323 dairy farmers and 2342 non-farmers) including 355 patients with COPD and 4310 controls with normal spirometry were recruited through a large COPD screening program. Self-reported physician-diagnosed diseases with plausible links to COPD were recorded in this cross-sectional study. Results Whatever the exposure, cardiovascular comorbidities were not more frequent in patients with COPD than their counterparts without airflow limitation. A higher risk of major cardiovascular comorbidities was associated with tobacco smoking and a lower risk was associated with exposure to organic dusts. Conclusion Tobacco smoking (but not COPD) is associated with higher frequency of cardiovascular comorbidities. By contrast, being a dairy farmer exposed to organic dusts is associated with a lower frequency of the same comorbidities. This reinforces the crucial need for controlling established cardiovascular risk factors even in patients with mild-to-moderate COPD.
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Affiliation(s)
- Thibaud Soumagne
- Service de Pneumologie, Oncologie Thoracique et Allergologie Respiratoire, CHU de Besançon, Besançon, France
| | - Alicia Guillien
- Equipe d'Epidémiologie Environnementale, Institute for Advanced Biosciences, Centre de Recherche UGA, INSERM U1209, CNRS UMR 5309, Grenoble, France
| | - Nicolas Roche
- Service de Pneumologie, Groupe Hospitalier Cochin, Site Val de Grâce, AP-HP and Université Paris Descartes (EA2511), Sorbonne-Paris-Cité, Paris, France
| | - Isabella Annesi-Maesano
- Epidemiology of Allergic and Respiratory Diseases UMR-S 707 Inserm/UPMC, Université Paris 6, Paris, France
| | - Pascal Andujar
- Centre Hospitalier Intercommunal de Créteil, Service de Pathologie Professionnelle et de l'Environnement, Créteil, France.,Université Paris-Est Créteil, Faculté de Médecine, Créteil, France
| | - Lucie Laurent
- Service de Pneumologie, Oncologie Thoracique et Allergologie Respiratoire, CHU de Besançon, Besançon, France
| | - Stéphane Jouneau
- Service de Pneumologie, CHU de Rennes, Rennes, France.,Univ Rennes, CHU Rennes, Inserm, EHESP, Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR-S 1085, Rennes, France
| | - Martial Botebol
- Fédération des Maisons de Santé Comtoises (FéMaSaC), Beure, France
| | | | - Jean-Charles Dalphin
- Service de Pneumologie, Oncologie Thoracique et Allergologie Respiratoire, CHU de Besançon, Besançon, France.,UMR CNRS Chrono Environnement, Université de Franche-Comté, Besançon, France
| | - Bruno Degano
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble, Alpes, France.,Université Grenoble Alpes, INSERM U 1042, Grenoble, France
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17
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Soumagne T, Roche N, Guillien A, Bouhaddi M, Rocchi S, Hue S, Claudé F, Bizard L, Andujar P, Dalphin JC, Degano B. Cardiovascular Risk in COPD. Chest 2020; 157:834-845. [DOI: 10.1016/j.chest.2019.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 10/23/2019] [Accepted: 11/04/2019] [Indexed: 01/21/2023] Open
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18
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Fix J, Annesi-Maesano I, Baldi I, Boulanger M, Cheng S, Cortes S, Dalphin JC, Dalvie MA, Degano B, Douwes J, Eduard W, Elholm G, Ferreccio C, Harding AH, Jeebhay M, Kelly KM, Kromhout H, MacFarlane E, Maesano CN, Mitchell DC, Mwanga H, Naidoo S, Negatu B, Ngajilo D, Nordby KC, Parks CG, Schenker MB, Shin A, Sigsgaard T, Sim M, Soumagne T, Thorne P, Yoo KY, Hoppin JA. Gender differences in respiratory health outcomes among farming cohorts around the globe: findings from the AGRICOH consortium. J Agromedicine 2020; 26:97-108. [PMID: 32182198 DOI: 10.1080/1059924x.2020.1713274] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: Respiratory hazards of farming have been identified for centuries, with little focus on gender differences. We used data from the AGRICOH consortium, a collective of prospective cohorts of agricultural workers, to assess respiratory disease prevalence among adults in 18 cohorts representing over 200,000 farmers, farm workers, and their spouses from six continents.Methods: Cohorts collected data between 1992 and 2016 and ranged in size from 200 to >128,000 individuals; 44% of participants were female. Farming practices varied from subsistence farming to large-scale industrial agriculture. All cohorts provided respiratory outcome information for their cohort based on their study definitions. The majority of outcomes were based on self-report using standard respiratory questionnaires; the greatest variability in assessment methods was associated with chronic obstructive pulmonary disease (COPD).Results: For all three respiratory symptoms (cough, phlegm, and wheeze), the median prevalence in men was higher than in women, with the greatest difference for phlegm (17% vs. 10%). For asthma, women had a higher prevalence (7.8% vs 6.5%), with the difference associated with allergic asthma. The relative proportion of allergic asthma varied among cohorts. In two of eight cohorts for women and two of seven cohorts for men, allergic asthma was more common than non-allergic asthma.Conclusions: These findings indicate that respiratory outcomes are common among farmers around the world despite differences in agricultural production. As women in the general population are at higher risk of asthma, exploring gender differences in occupational studies is critical for a deeper understanding of respiratory disease among agricultural workers.
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Affiliation(s)
- Jonathan Fix
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, NC, USA
| | - Isabella Annesi-Maesano
- Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Pierre Louise Institute of Epidemiology and Public Health (IPLESP UMRS1136), UPMC Univ Paris 06, INSERM, Saint-Antoine Medical School, Sorbonne Universités, Paris
| | - Isabelle Baldi
- INSERM U1086, Caen, France.,Centre de Lutte contre le Cancer François Baclesse, Caen, France
| | - Mathilde Boulanger
- INSERM U1086, Caen, France.,Centre de Lutte contre le Cancer François Baclesse, Caen, France
| | - Soo Cheng
- Centre for Public Health Research, Massey University, PO Box 756, Wellington 6021, New Zealand
| | - Sandra Cortes
- Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, 8330077, Chile
| | - Jean-Charles Dalphin
- Service de Pneumologie, CHU de Besançon, Besançon, France.,UMR 6249 Chrono-environnement, Université de Franche-Comté, Besançon, France
| | - Mohamed Aqiel Dalvie
- Division of Occupational Medicine and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Bruno Degano
- Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa Universitaire (CHRU), Besançon, France.,EA 3920, Université de Franche-Comté, Besançon, France
| | - Jeroen Douwes
- Centre for Public Health Research, Massey University, PO Box 756, Wellington 6021, New Zealand
| | - Wijnand Eduard
- Department of Chemical and Biological Work Environment, STAMI National Institute of Occupational Health, PO Box 5330 Majorstuen, NO-0304 Oslo, Norway
| | - Grethe Elholm
- Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Catterina Ferreccio
- Advanced Center for Chronic Diseases (ACCDiS), Facultad Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, 8330077, Chile
| | | | - Mohamed Jeebhay
- Division of Occupational Medicine and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Kevin M Kelly
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA 52242, United States
| | - Hans Kromhout
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ewan MacFarlane
- Monash Centre for Occupational and Environmental Health (MonCOEH), Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Cara Nichole Maesano
- Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Pierre Louise Institute of Epidemiology and Public Health (IPLESP UMRS1136), UPMC Univ Paris 06, INSERM, Saint-Antoine Medical School, Sorbonne Universités, Paris
| | | | - Hussein Mwanga
- Division of Occupational Medicine and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Saloshni Naidoo
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, South Africa
| | - Beyene Negatu
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.,Department of Pesticide Registration and control, Ministry of Agriculture and Livestock development, Addis Ababa, Ethiopia
| | - Dorothy Ngajilo
- Division of Occupational Medicine and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Christine G Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, North Carolina, USA
| | - Marc B Schenker
- Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehakro, Chongno-gu, Seoul 110-799, Korea
| | - Torben Sigsgaard
- Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Malcolm Sim
- Monash Centre for Occupational and Environmental Health (MonCOEH), Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Thibaud Soumagne
- Service de Pneumologie, CHU de Besançon, Besançon, France.,UMR 6249 Chrono-environnement, Université de Franche-Comté, Besançon, France
| | - Peter Thorne
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA 52242, United States
| | - Keun-Young Yoo
- Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehakro, Chongno-gu, Seoul 110-799, Korea
| | - Jane A Hoppin
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, NC, USA
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Arsyad M, Pulubuhu DAT, Kawamura Y, Maria IL, Dirpan A, Unde AA, Nuddin A, Yusuf S. The role of public health services (PHS) in agricultural poverty alleviation. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2019.07.076] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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20
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Barrera C, Rocchi S, Degano B, Soumagne T, Laurent L, Bellanger AP, Laplante JJ, Millon L, Dalphin JC, Reboux G. Microbial exposure to dairy farmers' dwellings and COPD occurrence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2019; 29:387-399. [PMID: 30461300 DOI: 10.1080/09603123.2018.1545900] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/05/2018] [Indexed: 06/09/2023]
Abstract
Dairy farming is a risk factor for chronic obstructive pulmonary disease (COPD). The aim was to determine predictive markers either in blood samples or in dwelling dust samples by comparing COPD and healthy controls with or without farming activity. Dust was collected and analyzed by real-time quantitative PCR. ELISA and DELFIA® were performed to assay the level of specific IgG and IgE of 10 targeted microorganisms. The dwelling exposure of farmers was higher than in the non-farmers (Especially Eurotium amstelodami and Lichtheimia corymbifera). The IgG response against Wallemia sebi and Saccharopolyspora rectivirgula was more often higher in the farmers than the non-farmers. However, exposure and sensitization to the microorganisms tested cannot explain the occurrence of COPD in the dairy farmers' population. COPD development is probably caused by multiple factors associated with exposure over a period of several years.
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Affiliation(s)
- Coralie Barrera
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
| | - Steffi Rocchi
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
| | - Bruno Degano
- c Department of Functional Explorations , University Hospital , Besançon , France
| | - Thibaud Soumagne
- d Department of Pneumology , University Hospital , Besançon , France
| | - Lucie Laurent
- c Department of Functional Explorations , University Hospital , Besançon , France
| | - Anne-Pauline Bellanger
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
| | - Jean-Jacques Laplante
- e Department of Occupational Diseases , Social and Agricultural Mutual (MSA) of Franche-Comté , Besançon , France
| | - Laurence Millon
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
| | - Jean-Charles Dalphin
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- d Department of Pneumology , University Hospital , Besançon , France
| | - Gabriel Reboux
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
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21
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Quantitative and qualitative evaluation of spirometry for COPD screening in general practice. Respir Med Res 2019; 77:31-36. [PMID: 32035336 DOI: 10.1016/j.resmer.2019.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/06/2019] [Accepted: 07/10/2019] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Proper diagnosis of COPD remains a challenge. Spirometry testing in primary care may help to reduce misdiagnosis, but its reliability as a diagnostic instrument needs to be assessed. OBJECTIVES To investigate (1) the validity of spirometry testing performed in primary care and (2) the accuracy of the diagnostic of airflow limitation obtained by these tests. METHODS Subjects attending a COPD screening programme had screening spirometry performed either by general practitioners (GPs) or by trained nurses or technicians, who had all received two 3-hour training sessions. Subjects with airflow limitation and a subset of subjects with normal spirometry at screening were invited to undergo confirmatory spirometry performed by trained nurses in a pulmonary function laboratory. RESULTS Of the 4610 subjects who attended the screening sessions, 96.5% had a valid screening spirometry test. A total of 392 subjects attended the confirmatory sessions. Values measured by screening spirometry were satisfactory compared with those of confirmatory spirometry (rc=0.83). Taking confirmatory spirometry as reference, the positive predictive value of screening spirometry for the diagnosis of persistent airflow limitation was 93% with a specificity of 95%. Agreement for the diagnosis of persistent airflow limitation was substantial (k=0.80). CONCLUSION Spirometry performed in primary care by trained personnel reliably identifies persistent airflow limitation. This may encourage pulmonologists to collaborate with primary care providers with the aim of improving appropriate diagnosis of COPD.
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Saussereau J, Guillien A, Soumagne T, Laplante JJ, Laurent L, Bouhaddi M, Rocchi S, Annesi-Maesano I, Roche N, Dalphin JC, Degano B. Dietary Patterns and Prevalence of Post-bronchodilator Airway Obstruction in Dairy Farmers Exposed to Organic Dusts. COPD 2019; 16:118-125. [PMID: 31298600 DOI: 10.1080/15412555.2019.1631775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Exposure to organic dusts is an independent causative factor of chronic obstructive pulmonary disease (COPD). Unhealthy dietary patterns have been associated with poor lung function in smokers. This study investigated whether dietary patterns were associated with post-bronchodilator airway obstruction, a hallmark of COPD, in dairy farmers exposed to organic dusts. All subjects were identified by screening programs and patients with airflow obstruction were matched with subjects with normal spirometry. Six groups were compared, defined by their exposures (non-smoking dairy farmers, smokers ≥ 10 pack-years with no occupational exposure, and smoking dairy farmers) and the presence or absence of post-bronchodilator airflow obstruction, resulting in 321 study subjects. The Alternative Healthy Eating Index (AHEI) score was calculated based on an adapted food frequency questionnaire. Mean total AHEI scores were similar in all groups. Comparison between smokers with post-bronchodilator airway obstruction and subjects with post-bronchodilator airway obstruction related to occupational exposure found minimal differences in dietary patterns: dairy farmers had lower scores for the ratio of white to red meat and higher scores for cereal fiber consumption. As in previous studies, smokers with post-bronchodilator airway obstruction exhibited higher lipid intakes and lower carbohydrate intakes than their counterparts with normal spirometry. No evidence of any meaningful difference in dietary patterns was found between subjects with post-bronchodilator airway obstruction detected by screening and healthy controls, either in dairy farmers or in smokers with no occupational exposure.
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Affiliation(s)
- Julien Saussereau
- a Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU) , Besançon , France.,b Service de Pneumologie, CHRU , Besançon , France
| | - Alicia Guillien
- a Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU) , Besançon , France.,c EA 3920, Université de Franche-Comté , Besançon , France
| | | | | | - Lucie Laurent
- a Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU) , Besançon , France.,b Service de Pneumologie, CHRU , Besançon , France
| | - Malika Bouhaddi
- a Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU) , Besançon , France.,c EA 3920, Université de Franche-Comté , Besançon , France
| | - Steffi Rocchi
- e UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques, University of Bourgogne Franche-Comté , Besançon , France.,f Department of Parasitology-Mycology, University Hospital , Besancon , France
| | - Isabella Annesi-Maesano
- g Epidémiologie des Maladies Respiratoires et Allergiques (EPAR), i-PLESP INSERM and UPMC, Medical School Saint-Antoine , Paris , France
| | - Nicolas Roche
- h Service de Pneumologie et Soins Intensifs Respiratoires, Groupe Hospitalier Cochin, AP-HP and Université Paris Descartes (EA2511), Sorbonne-Paris-Cité , Paris , France
| | - Jean-Charles Dalphin
- b Service de Pneumologie, CHRU , Besançon , France.,e UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques, University of Bourgogne Franche-Comté , Besançon , France
| | - Bruno Degano
- i Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes , Grenoble , France.,j Laboratoire HP2, INSERM U1042, Université Grenoble Alpes , Grenoble , France
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Is atopy a risk indicator of chronic obstructive pulmonary disease in dairy farmers? Respir Res 2019; 20:124. [PMID: 31208466 PMCID: PMC6580567 DOI: 10.1186/s12931-019-1082-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 05/23/2019] [Indexed: 01/30/2023] Open
Abstract
Abstract Allergic mechanisms related to environmental and occupational exposure have been suggested to contribute to the development of chronic obstructive pulmonary disease (COPD). Objectives To investigate the relationships between atopy markers, persistent airflow limitation (PAL) and occupational exposure in dairy farmers. Methods Clinical and biological (total IgE and 21 allergen specific IgE) markers of atopy were assessed in 101 dairy farmers with PAL (DF-PAL), 85 non-farmers with PAL (NF-PAL) (both groups were prospectively included from a screening program performed between 2011 and 2015), and matched controls, i.e. 98 farmers without PAL (DF-controls) and 89 non-farming subjects without PAL (NF-controls). Occupational exposure in farmers was estimated using a validated questionnaire. Results Prevalence of allergy history was significantly higher in DF-PAL and in NF-PAL than in controls. Polysensitization, and sensitization to seasonal and food allergens were more frequent in DF-PAL than in DF-controls, respectively: 13.8% vs 1% (adjusted odds ratio (aOR): 17.5 (2.2–134), 11.9% vs 3.1% (aOR: 4.4 (1.2–7.2) and 16.8% vs 4.1% (aOR: 5.2 (1.7–7.2)). The prevalence of atopy markers was similar between NF-PAL patients and NF-controls. Conclusions PAL in farmers is associated with a high rate of markers of atopy, supporting atopy as a risk indicator. Clinical trial registered with ClinicalTrials.gov (NCT02540408). Electronic supplementary material The online version of this article (10.1186/s12931-019-1082-2) contains supplementary material, which is available to authorized users.
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Jouneau S, Marette S, Robert AM, Gouyet T, Guillot S, Chapron A, Mailloux C, Desrues B, Viel JF. Prevalence and risk factors of chronic obstructive pulmonary disease in dairy farmers: AIRBAg study. ENVIRONMENTAL RESEARCH 2019; 169:1-6. [PMID: 30399467 DOI: 10.1016/j.envres.2018.10.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/27/2018] [Accepted: 10/25/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The AIRBAg study was designed to assess the prevalence of chronic obstructive pulmonary disease (COPD) in dairy farmers and to define its associated risk factors. METHODS Between March 2012 and February 2017 randomly selected dairy farmers in the French region of Brittany were asked to complete a self-administered questionnaire and undergo an occupational health check-up with electronic mini-spirometry and standard spirometry. Those having one or more of the following features: chronic cough, chronic bronchitis, wheezing, dyspnea and/or a ratio FEV1/FEV6 < 80% were then referred to a pulmonologist for further check-up including spirometry with a reversibility test. Each COPD case was matched with three controls (dairy farmers and non-farm employees), for sex and age ( ± 5 years). Conditional multivariate logistic regression models were used to estimate the odds ratios between COPD occurrence and various risk factors. RESULTS The 1203 farmers examined included 525 (43.6%) who were "at risk of bronchial obstruction" and 432 (35.9%) of these saw the pulmonologist. This screening identified 16 (1.3%) cases of COPD, including eight non-smokers and five with an FEV1 < 80% of predicted values. Their average age was 54.6 ( ± 7.7) years and 10 of them were men. None complained of illness before the study. Multivariate analyses revealed no significant occupational risk factors for COPD. CONCLUSIONS This unexpected result may be because Breton dairy farms began to modernize early (1950s), giving rise to conditions with much lower exposure to airborne contaminants.
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Affiliation(s)
- Stéphane Jouneau
- Department of Respiratory Medicine, University Hospital, F-35033 Rennes, France; Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Solenne Marette
- Department of Occupational Pathology, University Hospital, F-35033 Rennes, France
| | - Ange-Marie Robert
- Department of Clinical Research, University Hospital, F-35033 Rennes, France
| | - Thomas Gouyet
- Department of Occupational Pathology, University Hospital, F-35033 Rennes, France
| | - Stéphanie Guillot
- Department of Pulmonary Function Tests, University Hospital, F-35033 Rennes, France
| | - Anthony Chapron
- Department of General Practice, Rennes 1 University, F-35000 Rennes, France; INSERM, CIC-1414, Primary Care Research Team, F-35000 Rennes, France
| | - Carole Mailloux
- Mutualité Sociale Agricole des Portes de Bretagne, F-35170 Bruz, France
| | - Benoît Desrues
- Department of Respiratory Medicine, University Hospital, F-35033 Rennes, France; INSERM, U1242-COSS, CLCC Eugène Marquis, Rennes 1 University, F-35000 Rennes, France
| | - Jean-François Viel
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France; Department of Epidemiology and Public Health, University Hospital, F-35033 Rennes, France.
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25
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Guillien A, Soumagne T, Dalphin JC, Degano B. COPD, airflow limitation and chronic bronchitis in farmers: a systematic review and meta-analysis. Occup Environ Med 2018; 76:58-68. [DOI: 10.1136/oemed-2018-105310] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 10/27/2018] [Accepted: 11/06/2018] [Indexed: 01/11/2023]
Abstract
IntroductionThe current definition of chronic obstructive pulmonary disease (COPD) associates persistent airflow limitation and chronic respiratory symptoms. Agricultural work has been associated with an increased risk of developing COPD, but the prevalence and definition of the disease vary greatly between studies. This meta-analysis aimed to assess the association between agricultural work and COPD using the most widely used definitions of the disease.MethodsInclusion criteria were: (1) design: cross-sectional or longitudinal, (2) groups: at least one group of farmers and a control group of non-farmers, (3) outcome: prevalence or unadjusted OR of COPD, airflow limitation and/or chronic bronchitis, (4) study subjects: groups of exposed subjects comprising ≥30 individuals and with a mean age ≥40 years and (5) language: English and French language, full-length, original publications in peer-reviewed journals.ResultsIn total, 22 manuscripts were included in the meta-analysis. Eight studies assessed only the prevalence of airflow limitation, nine assessed only the prevalence of chronic bronchitis and four assessed the prevalence of both these parameters. Only one assessed the prevalence of COPD according to its current definition, and this study also provided the prevalence of airflow limitation. Ten studies showed a positive association between farming exposure and airflow limitation or chronic bronchitis, and 12 showed no association (OR (95% CI)=1.77 (1.50 to 2.08), p<0.001). Cattle, swine, poultry and crop farming were associated with either airflow limitation or chronic bronchitis.ConclusionAlthough some features of COPD are associated with some agricultural work, well-designed studies with appropriate diagnostic criteria should be conducted to draw strong conclusions about the relationship between COPD and farming.
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Abstract
PURPOSE OF REVIEW Agriculture environments contain a variety of inflammatory aerosols that may increase risk for lung inflammation and disease in exposed individuals. In addition, epidemiological studies have also identified protective effects of rural environments and farming exposures. RECENT FINDINGS In this review, we will discuss recent literature published since 2016 that investigates the impact of differing agricultural exposures on respiratory health. Discussions include the impact of farming modernization, education, and personal protective equipment usage among workers, timing and duration in mediating lung health outcomes, and population studies investigating the association between exposure and risk for numerous lung diseases.
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Mirza S, Clay RD, Koslow MA, Scanlon PD. COPD Guidelines: A Review of the 2018 GOLD Report. Mayo Clin Proc 2018; 93:1488-1502. [PMID: 30286833 DOI: 10.1016/j.mayocp.2018.05.026] [Citation(s) in RCA: 259] [Impact Index Per Article: 43.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 04/25/2018] [Accepted: 05/07/2018] [Indexed: 02/06/2023]
Abstract
Global Strategy for the Diagnosis, Management, and Prevention of COPD 2018 is a consensus report published periodically since 2001 by an international panel of health professionals from respiratory medicine, socioeconomics, public health, and education comprising the Global Initiative for Chronic Obstructive Lung Disease (GOLD). The GOLD documents endeavor to incorporate latest evidence and expert consensus and are intended for use as "strategy documents" for implementation of effective care for chronic obstructive lung disease (COPD) on a global level. The GOLD 2018 report defines COPD as a "common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities, usually caused by significant exposure to noxious particles or gases," with the criteria of "persistent respiratory symptoms" being a new and controversial inclusion since 2017. With the availability of newer pharmacotherapy options, treatment recommendations are made on the basis of a review of the latest literature and directed by symptom burden and health care utilization. Apart from the change in definition, a major shift in the recommendations is the exclusion of severity of airflow limitation as one of the major factors in guiding therapy. We review the salient features of the GOLD 2018 document and provide commentary on features that merit further discussion based on our clinical experience and practice as well as literature review current as of February 2018.
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Affiliation(s)
- Shireen Mirza
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | - Ryan D Clay
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | - Matthew A Koslow
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | - Paul D Scanlon
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
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Pfister H, Madec L, Cann PL, Costet N, Chouvet M, Jouneau S, Vernhet L. Factors determining the exposure of dairy farmers to thoracic organic dust. ENVIRONMENTAL RESEARCH 2018; 165:286-293. [PMID: 29758401 DOI: 10.1016/j.envres.2018.04.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 04/26/2018] [Accepted: 04/27/2018] [Indexed: 06/08/2023]
Abstract
Bronchial respiratory diseases are more common in dairy farmers than in the general population, perhaps because the repeated inhalation of organic dust contributes to the development of these disorders. However, the factors determining the exposure of farmers to particles that can enter the lower bronchial tract and interact with it, i.e. the thoracic fraction of the inhalable dust, remain to be identified. We therefore measured the exposure of dairy farmers to thoracic organic dust and identified the farm features and tasks that increased exposure. We measured thoracic particles (n = 110) and farm characteristics and occupational tasks in 29 Brittany dairy farms. The mean (GM) (geometric standard deviation, GSD) concentration of thoracic dust in air inhaled by farmers was 0.24 mg/m3 (2.8) and the concentrations of endotoxins, Gram-positive bacteria and fungi in the thoracic fraction were 128 EU/m3 (4.0), 960 CFU/m3 (6.3) and 690 CFU/m3 (5.4), respectively. Model-based estimates of the association between exposure, farm features and tasks indicated that manual grain and feed handling and mechanical bedding spreading significantly increased exposure to thoracic dust, endotoxins, bacteria and fungi. Exposure to bacteria and fungi was reduced by cowsheds divided into cubicles, whereas using automatic muck scrappers in alleyway and automatic milking tended to increase exposure to bacteria and endotoxins. Finally, exposure to endotoxin and fungi were reduced by warmer farm buildings and well-ventilated buildings having walls with large openings. In conclusions, major occupational tasks and specific farm features determine the exposure of Breton dairy farmers to thoracic organic dust.
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Affiliation(s)
- Hugo Pfister
- Institut technique des gaz et de l'air, Saint-Grégoire, France; Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Laurent Madec
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France; EHESP School of Public Health, Department of Environmental and Occupational Health and Sanitary Engineering, Rennes, France
| | - Pierre Le Cann
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France; EHESP School of Public Health, Department of Environmental and Occupational Health and Sanitary Engineering, Rennes, France
| | - Nathalie Costet
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - Martine Chouvet
- Institut technique des gaz et de l'air, Saint-Grégoire, France
| | - Stéphane Jouneau
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France; Service de Pneumologie, Centre de compétences des maladies pulmonaires rares de Bretagne, Hôpital Pontchaillou, Rennes, France
| | - Laurent Vernhet
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France.
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Burkes RM, Gassett AJ, Ceppe AS, Anderson W, O'Neal WK, Woodruff PG, Krishnan JA, Barr RG, Han MK, Martinez FJ, Comellas AP, Lambert AA, Kaufman JD, Dransfield MT, Wells JM, Kanner RE, Paine R, Bleecker ER, Paulin LM, Hansel NN, Drummond MB. Rural Residence and Chronic Obstructive Pulmonary Disease Exacerbations. Analysis of the SPIROMICS Cohort. Ann Am Thorac Soc 2018; 15:808-816. [PMID: 29584453 PMCID: PMC6207115 DOI: 10.1513/annalsats.201710-837oc] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 03/06/2018] [Indexed: 12/13/2022] Open
Abstract
Rationale: Rural residence is associated with poor outcomes in several chronic diseases. The association between rural residence and chronic obstructive pulmonary disease (COPD) exacerbations remains unclear.Objectives: In this work, we sought to determine the independent association between rural residence and COPD-related outcomes, including COPD exacerbations, airflow obstruction, and symptom burden.Methods: A total of 1,684 SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) participants with forced expiratory volume in 1 second/forced vital capacity < 0.70 had geocoding-defined rural-urban residence status determined (N = 204 rural and N = 1,480 urban). Univariate and multivariate logistic and negative binomial regressions were performed to assess the independent association between rurality and COPD outcomes, including exacerbations, lung function, and symptom burden. The primary exposure of interest was rural residence, determined by geocoding of the home address to the block level at the time of study enrollment. Additional covariates of interest included demographic and clinical characteristics, occupation, and occupational exposures. The primary outcome measures were exacerbations determined over a 1-year course after enrollment by quarterly telephone calls and at an annual research clinic visit. The odds ratio (OR) and incidence rate ratio (IRR) of exacerbations that required treatment with medications, including steroids or antibiotics (total exacerbations), and exacerbations leading to hospitalization (severe exacerbations) were determined after adjusting for relevant covariates.Results: Rural residence was independently associated with a 70% increase in the odds of total exacerbations (OR, 1.70 [95% confidence interval (CI), 1.13-2.56]; P = 0.012) and a 46% higher incidence rate of total exacerbations (IRR 1.46 [95% CI, 1.02-2.10]; P = 0.039). There was no association between rural residence and severe exacerbations. Agricultural occupation was independently associated with increased odds and incidence of total and severe exacerbations. Inclusion of agricultural occupation in the analysis attenuated the association between rural residence and the odds and incidence rate of total exacerbations (OR, 1.52 [95% CI, 1.00-2.32]; P = 0.05 and IRR 1.39 [95% CI, 0.97-1.99]; P = 0.07). There was no difference in symptoms or airflow obstruction between rural and urban participants.Conclusions: Rural residence is independently associated with increased odds and incidence of total, but not severe, COPD exacerbations. These associations are not fully explained by agriculture-related exposures, highlighting the need for future research into potential mechanisms of the increased risk of COPD exacerbations in the rural population.
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Affiliation(s)
| | - Amanda J Gassett
- Department of Environmental and Occupational Health Sciences, School of Public Health, and
| | - Agathe S Ceppe
- Marsico Lung Institute/Cystic Fibrosis Research Center, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Wayne Anderson
- Marsico Lung Institute/Cystic Fibrosis Research Center, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Wanda K O'Neal
- Marsico Lung Institute/Cystic Fibrosis Research Center, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Prescott G Woodruff
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine and Cardiovascular Research Institute, University of California San Francisco, School of Medicine, San Francisco, California
| | - Jerry A Krishnan
- Division of Pulmonary, Critical Care, Sleep, and Allergy, University of Illinois, Chicago, Illinois
| | - R Graham Barr
- Department of Medicine, Columbia University Medical Center, New York, New York
| | - MeiLan K Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, Michigan
| | - Fernando J Martinez
- Department of Medicine, Weill Cornell Medical College, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | | | - Allison A Lambert
- Division of Pulmonary and Critical Care, University of Washington, Seattle, Washington
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, and
| | - Mark T Dransfield
- Division of Pulmonary and Critical Care, University of Alabama at Birmingham, Birmingham, Alabama
| | - J Michael Wells
- Division of Pulmonary and Critical Care, University of Alabama at Birmingham, Birmingham, Alabama
| | - Richard E Kanner
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Robert Paine
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Eugene R Bleecker
- Division of Pulmonary, Critical Care, Allergy and Immunologic Diseases, Wake Forest University, Winston-Salem, North Carolina; and
| | - Laura M Paulin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
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Liu S, Zhou Y, Liu S, Zou W, Li X, Li C, Deng Z, Zheng J, Li B, Ran P. Clinical impact of the lower limit of normal of FEV 1/FVC on detecting chronic obstructive pulmonary disease: A follow-up study based on cross-sectional data. Respir Med 2018; 139:27-33. [PMID: 29857998 DOI: 10.1016/j.rmed.2018.04.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 04/13/2018] [Accepted: 04/17/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Criteria of obstruction that establish a diagnosis of COPD have been debated in recent years. We carried out a follow-up study to assess the impact of the new LLN reference equation for Chinese on detecting COPD compared with the traditional 0.7fixed criteria. METHODS We examined the prevalence and characteristics of airflow limitation for a non-child population using post-bronchodilator airflow with both age-dependent predicted lower limit of the normal value and fixed-ratio spirometric criterion. Questionnaires and spirometry were completed for all eligible subjects during the baseline examination. Participants with inconsistent diagnosis according to the two criteria, normal participants (controls) and COPD patients in stages I or II, were invited to take a cardiopulmonary exercise testing (CPET) examination and follow up for 2-4 years. RESULTS A total of 5448 (mean age 50.51 ± 13.2 yr) study subjects with acceptable spirometry and complete questionnaire data were included in our final analyses. COPD detection based on LLN was consistent with the GOLD 0.7 fixed-ratio in general, as 51 subjects (0.9%) were underdiagnosed, and 61 subjects (1.1%) were overdiagnosed when using LLN as the reference diagnostic criterion. The underdiagnosed subjects were younger, had more symptoms, more exposure to biofuels and worse FEV1 than the normal group; they also demonstrated a damaged cardiopulmonary reserve capacity and significant FEV1 decline. Except for being older, the overdiagnosed subjects differed little from the normal group. CONCLUSIONS Individual-dependent LLN appears to better reveal impacts on detecting airflow limitation. Participants underdiagnosed by GOLD criterion should be paid more attention. CLINICAL TRIAL REGISTRATION ChiCTR-ECS-13004110.
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Affiliation(s)
- Sha Liu
- The State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yumin Zhou
- The State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shiliang Liu
- The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Epidemiology and Community Medicine Faculty of Medicine University of Ottawa, Ottawa, Ontario, Canada
| | - Weifeng Zou
- Guangzhou Chest Hospital, Guangzhou, Guangdong, China
| | - Xiaochen Li
- The State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Chenglong Li
- The State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhishan Deng
- The State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jinzhen Zheng
- The State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Bing Li
- College of Life Science, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Pixin Ran
- The State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
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Guillien A, Laurent L, Soumagne T, Puyraveau M, Laplante JJ, Andujar P, Annesi-Maesano I, Roche N, Degano B, Dalphin JC. Anxiety and depression among dairy farmers: the impact of COPD. Int J Chron Obstruct Pulmon Dis 2017; 13:1-9. [PMID: 29296078 PMCID: PMC5741076 DOI: 10.2147/copd.s143883] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) and farming are two conditions that have been associated with an increased risk of anxiety and depression. Dairy farming is an independent risk factor for COPD. Objective To test the hypotheses that the prevalence of anxiety and/or depression is higher in dairy farmers with COPD than in farmers without COPD, and higher in dairy farmers with COPD than in non-farmers with COPD. Methods Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale in 100 dairy farmers with COPD (DF-COPD), 98 dairy farmers without COPD (DF-controls), 85 non-farming patients with COPD (NF-COPD) and 89 non-farming subjects without COPD (NF-controls), all identified by screening in the Franche-Comté region of France. Anxiety and depression were considered present when the Hospital Anxiety and Depression Scale score was ≥8. COPD was defined by a post-bronchodilator forced expiratory volume in 1 second/forced vital capacity ratio <0.7. Results The crude prevalence of anxiety did not differ between the four groups, ranging from 36% in NF-controls to 47% in NF-COPD (p=0.15 between groups). Similarly, the prevalence of depression did not differ significantly between the four groups (p=0.16 between groups). In dairy farmers (n=198), the only factors associated with anxiety were quality of life and current smoking. Depression in dairy farmers was associated with airflow limitation (lower forced expiratory volume in 1 second and COPD grade 2 or more) as well as with some COPD-related features (dyspnea severity, current smoking, and poorer quality of life). In non-farmers, both anxiety and depression were associated with airflow limitation and COPD-related features. Conclusion In our population, the prevalence of anxiety and/or depression was similar in dairy farmers with and without COPD and in non-farmers with COPD. Nevertheless, the degree of airway obstruction and some COPD-related features were associated with depression among dairy farmers, whereas these factors were not associated with anxiety.
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Affiliation(s)
- Alicia Guillien
- Research Unit EA 3920, Franche-Comté University, Besançon, France
| | - Lucie Laurent
- Department of Clinical Physiology, University Hospital, Besançon, France
| | - Thibaud Soumagne
- Department of Respiratory Diseases, University Hospital, Besançon, France
| | - Marc Puyraveau
- Clinical Methodology Center, University Hospital, Besançon, France
| | | | - Pascal Andujar
- University of Medical Sciences, Paris-est Créteil University, Créteil, France
| | - Isabella Annesi-Maesano
- Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Saint-Antoine Medical School, Paris, France
| | - Nicolas Roche
- Respiratory and Intensive Care Medicine, Cochin Hospital (AP-HP), University Paris Descartes, Paris, France.,Research Unit EA 2511, University Paris Descartes, Paris, France
| | - Bruno Degano
- Research Unit EA 3920, Franche-Comté University, Besançon, France
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Case-Finding for Persistent Airway Obstruction in Farmers: A Questionnaire With Optimal Diagnosis Criteria. Am J Prev Med 2017; 53:837-844. [PMID: 28818418 DOI: 10.1016/j.amepre.2017.06.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/05/2017] [Accepted: 06/29/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Appropriate identification of subjects who are candidates for spirometry through case-finding questionnaires may help solve the problem of chronic obstructive pulmonary disease misdiagnosis. The performance of case-finding questionnaires depends at least partially on the characteristics of the population used for their development. The use of an accurate threshold for the forced expiratory volume in 1 second / forced vital capacity ratio to define persistent airway obstruction is also vital in ascertaining chronic obstructive pulmonary disease. METHODS Using a population examined between October 2012 and May 2013 that included a large subset of agricultural workers both exposed and unexposed to tobacco smoking, the authors aimed to select a combination of items that would identify persons most likely to have persistent airway obstruction defined as forced expiratory volume in 1 second / forced vital capacity less than the lower limit of normal according to the Global Lung Initiative-2012 equations. Two thirds of the population (n=3,397) were randomly selected to develop a questionnaire, and one third (n=1,698) was reserved for questionnaire validation. Statistical analysis was performed in 2016. RESULTS The selected items were sex, dyspnea, BMI, tobacco smoking habits, age, history of respiratory diseases, and history of occupation at risk. The C-index of the model was 0.84 (95% CI=0.80, 0.88) for the development population and 0.76 (95% CI=0.66, 0.86) for the validation population. Using the selected items in combination, the sensitivity and specificity in identifying persistent airway obstruction were 76% and 77%, respectively, in the development population (and 68% and 73%, respectively, in the validation population) for a threshold value of 2.50%. CONCLUSIONS This seven-item questionnaire is the first developed from a population comprising a large subset of agricultural workers and using the Global Lung Initiative-2012 equations.
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Pfister H, Morzadec C, Le Cann P, Madec L, Lecureur V, Chouvet M, Jouneau S, Vernhet L. Granulometry, microbial composition and biological activity of dusts collected in French dairy farms. ENVIRONMENTAL RESEARCH 2017; 158:691-702. [PMID: 28735230 DOI: 10.1016/j.envres.2017.07.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/07/2017] [Accepted: 07/08/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Dairy working increases the prevalence of lower airway respiratory diseases, especially COPD and asthma. Epidemiological studies have reported that chronic inhalation of organic dusts released during specific daily tasks could represent a major risk factor for development of these pathologies in dairy workers. Knowledge on size, nature and biological activity of such organic dusts remain however limited. OBJECTIVE To compare size distribution, microbial composition and cellular effects of dusts liberated by the spreading of straw bedding in five French dairy farms located in Brittany. RESULTS Mechanized distribution of straw bedding generated a cloud of inhalable dusts in the five dairy farms' barns. Thoracic particles having a 3-7.5µm size constituted 58.9-68.3% of these dusts. Analyses of thoracic dusts by next generation sequencing showed that the microbial dust composition differed between the five French farms, although Actinobacteria, Bacteroidetes, Firmicutes and Proteobacteria represent more than 97.5% of the bacterial phyla detected in each sample. Several bacteria genera comprising of human pathogenic species, such as Pseudomonas, Staphylococcus, Thermoactinomyces or Saccharopolyspora were identified. Cladosporium and Alternaria fungal genera, which are potent environmental determinants of respiratory symptoms, were detected in dusts collected in the five farms and their levels reached 15.5-51.1% and 9-24.7% of assignable fungal sequences in each sample, respectively. Finally, all dust samples significantly and strongly increased the expression of the pro-inflammatory TNF-α, IL-1β, IL-6 and IL-8 cytokines at both mRNA and protein levels in human monocyte-derived macrophages. Their effects were dose-dependent and detectable from 1µg/ml. The intensity of the macrophage responses however differed according to the samples. CONCLUSIONS Our results strengthen the hypothesis that organic dusts released during the distribution of straw bedding are mainly constituted of thoracic particles which are small enough to deposit on lower bronchial epithelium of dairy farmers and induce inflammation.
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Affiliation(s)
- Hugo Pfister
- Institut technique des gaz et de l'air, Saint-Gregoire, France; UMR Inserm 1085, Institut de Recherche sur la Santé, l'Environnement et le Travail (IRSET), Université de Rennes 1, 2 avenue du Professeur Léon Bernard, 35043 Rennes, France
| | - Claudie Morzadec
- UMR Inserm 1085, Institut de Recherche sur la Santé, l'Environnement et le Travail (IRSET), Université de Rennes 1, 2 avenue du Professeur Léon Bernard, 35043 Rennes, France
| | - Pierre Le Cann
- UMR Inserm 1085, Institut de Recherche sur la Santé, l'Environnement et le Travail (IRSET), Université de Rennes 1, 2 avenue du Professeur Léon Bernard, 35043 Rennes, France; French School of Public Health, Department of Environmental and Occupational Health and Sanitary Engineering, Rennes, France
| | - Laurent Madec
- UMR Inserm 1085, Institut de Recherche sur la Santé, l'Environnement et le Travail (IRSET), Université de Rennes 1, 2 avenue du Professeur Léon Bernard, 35043 Rennes, France; French School of Public Health, Department of Environmental and Occupational Health and Sanitary Engineering, Rennes, France
| | - Valérie Lecureur
- UMR Inserm 1085, Institut de Recherche sur la Santé, l'Environnement et le Travail (IRSET), Université de Rennes 1, 2 avenue du Professeur Léon Bernard, 35043 Rennes, France
| | - Martine Chouvet
- Institut technique des gaz et de l'air, Saint-Gregoire, France
| | - Stéphane Jouneau
- UMR Inserm 1085, Institut de Recherche sur la Santé, l'Environnement et le Travail (IRSET), Université de Rennes 1, 2 avenue du Professeur Léon Bernard, 35043 Rennes, France; Service de pneumologie, centre de compétences des maladies pulmonaires rares de Bretagne, Hôpital Pontchaillou, Rennes, France
| | - Laurent Vernhet
- UMR Inserm 1085, Institut de Recherche sur la Santé, l'Environnement et le Travail (IRSET), Université de Rennes 1, 2 avenue du Professeur Léon Bernard, 35043 Rennes, France.
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Fontana L, Lee SJ, Capitanelli I, Re A, Maniscalco M, Mauriello MC, Iavicoli I. Chronic Obstructive Pulmonary Disease in Farmers: A Systematic Review. J Occup Environ Med 2017; 59:775-788. [PMID: 28594705 DOI: 10.1097/jom.0000000000001072] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Chronic obstructive pulmonary disease (COPD) is a significant public health problem but it is unclear whether agricultural work causes an increased risk of disease. The aim of this review was to study COPD risk among farmers and analyze occupational exposures in agricultural workplaces. METHODS A systematic literature search was conducted to identify epidemiological studies investigating COPD prevalence in farmers. RESULTS In the 14 studies reviewed, COPD prevalence ranged from 3% to 68% due to different characteristics of study population, working activities, case definition/diagnosis. Livestock farmers were at higher risk and significant associations were observed for exposure to organic dusts, endotoxins, mites, ammonia, and hydrogen sulfide. CONCLUSIONS Farming work was associated with greater risk of developing COPD. However, considering the several variables that may influence the disease prevalence in farmers, we suggest the adoption of a standardized research strategy.
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Affiliation(s)
- Luca Fontana
- Section of Occupational Medicine, Institute of Public Health, Catholic University of Sacred Heart, Rome (Dr Fontana, Dr Capitanelli); Department of Community Health Systems, University of California San Francisco, San Francisco, California (Dr Lee); Unit of Pneumology, Department of Internal Medicine, Hospital of Vittorio Veneto, Vittorio Veneto (Dr Re); Laboratory of Respiratory Inflammation, IRCCS Istituti Clinici Scientifici Maugeri, Telese Terme, Benevento (Dr Maniscalco); Section of Occupational Medicine, Department of Public Health, University of Naples "Federico II", Naples (Dr Mauriello, Dr Iavicoli), Italy
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Soumagne T, Caillaud D, Degano B, Dalphin JC. [Differences and similarities between occupational and tobacco induced COPD]. Rev Mal Respir 2017; 34:607-617. [PMID: 28506727 DOI: 10.1016/j.rmr.2016.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 07/02/2016] [Indexed: 10/19/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) most often results from the inhalation of toxic agents. Cigarette smoking still remains the principal cause but the pertinence of occupational COPD is now clearly established. After a brief overview of the epidemiology of this "other COPD", the clinical and functional characteristics are summarized, taking into account recent advances in this field. The combined effects of occupational exposure and tobacco are also considered, providing evidence of the need to continuously reinforce campaigns of education and prevention in occupational COPD.
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Affiliation(s)
- T Soumagne
- Service de pneumologie, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France; Service de physiologie-explorations fonctionnelles, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France.
| | - D Caillaud
- Service de pneumologie, université d'Auvergne, CHU Gabriel-Montpied, rue Montalembert, 63003 Clermont-Ferrand, France
| | - B Degano
- Service de physiologie-explorations fonctionnelles, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France; EA 3920, université de Franche-Comté, 25000 Besançon, France
| | - J-C Dalphin
- Service de pneumologie, hôpital Jean-Minjoz, CHU de Besançon, 25030 Besançon cedex, France; UMR CNRS 6249, chrono-environnement, université de Franche-Comté, 25000 Besançon, France
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Audi C, Baïz N, Maesano CN, Ramousse O, Reboulleau D, Magnan A, Caillaud D, Annesi-Maesano I. Serum cytokine levels related to exposure to volatile organic compounds and PM 2.5 in dwellings and workplaces in French farmers - a mechanism to explain nonsmoking COPD. Int J Chron Obstruct Pulmon Dis 2017; 12:1363-1374. [PMID: 28503065 PMCID: PMC5426466 DOI: 10.2147/copd.s117866] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Although French farmers smoke less on average than individuals from the general population, they suffer more from COPD. Exposure to biological and chemical air pollutants in the farm may be the cause of these higher COPD rates. This study investigates the role of bio-contaminants, including the relationship of exposure to volatile organic compounds (VOCs) and fine particulate matter (of diameter of 2.5 µm [PM2.5]) objectively measured in the farm settings (dwellings and workplaces) to serum cytokines involved in COPD, in a sample of 72 farmers from 50 farms in the Auvergne region, France. Mean concentrations of VOCs were highest inside the home, while levels of PM2.5 were highest in workplaces (stables and granaries). After adjusting for confounders, high exposure to PM2.5 was significantly associated with a decreased level of serum cytokines (among others, IL13: β: −0.94, CI: −1.5 to −0.2, P-value =0.004; IL8: β: −0.82, CI: −1.4 to −0.2, P-value =0.005) and high exposure to VOCs according to a VOC global score with a decreased IL13 level (β: −0.5, CI: −0.9 to −0.1, P-value =0.01). Moreover, respiratory symptoms and diseases, including COPD, were associated with a decreased level of serum cytokines significantly in the case of IL5. An alteration of immune response balance in terms of cytokine levels in relation to indoor chemical air pollution exposure may contribute to respiratory health impairment in farmers.
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Affiliation(s)
- Christelle Audi
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMRS 1136, Epidemiology of Allergic and Respiratory Diseases Department, Medical School Saint-Antoine, Paris
| | - Nour Baïz
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMRS 1136, Epidemiology of Allergic and Respiratory Diseases Department, Medical School Saint-Antoine, Paris
| | - Cara N Maesano
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMRS 1136, Epidemiology of Allergic and Respiratory Diseases Department, Medical School Saint-Antoine, Paris
| | | | - Damien Reboulleau
- Centre du Thorax de Nantes INSERM, UMR1087, Institut du thorax, Nantes
| | - Antoine Magnan
- Centre du Thorax de Nantes INSERM, UMR1087, Institut du thorax, Nantes
| | - Denis Caillaud
- Respiratory Diseases Department, CHU Clermont-Ferrand, Clermont-Ferrand, Auvergne, France
| | - Isabella Annesi-Maesano
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, UMRS 1136, Epidemiology of Allergic and Respiratory Diseases Department, Medical School Saint-Antoine, Paris
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Obaseki DO, Erhabor GE, Awopeju OF, Adewole OO, Adeniyi BO, Buist EAS, Burney PG. Reduced Forced Vital Capacity in an African Population. Prevalence and Risk Factors. Ann Am Thorac Soc 2017; 14:714-721. [PMID: 28244800 PMCID: PMC5427737 DOI: 10.1513/annalsats.201608-598oc] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 02/22/2017] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Black Africans have reduced FVC compared with white persons, but the prevalence and determinants of reduced values are not well understood. OBJECTIVES To evaluate the prevalence and factors leading to reduced FVC in a Nigerian population and to examine current theories regarding the determinants of this difference. METHODS We studied the ventilatory function of 883 adults aged 40 years or older participating in the Burden of Obstructive Lung Disease Study in Ile-Ife, Nigeria. Respondents completed pre- and post-bronchodilator spirometry test and provided information on their smoking history, respiratory symptoms, risk factors, and diagnoses, including anthropometric details. We used standard categories to define body mass index as either underweight, normal, overweight, or obese. We defined reduced FVC as a post-bronchodilator FVC below the lower limit of normal using National Health and Nutrition Examination Survey (NHANES) equations, Global Lung Function Initiative 2012 equations, and local reference equations based on nonsmoking study participants without a respiratory diagnosis. We fit multivariate linear regression models to FVC as a continuous measure, adjusting for age, sex, height, and other confounders. RESULTS The prevalence of reduced FVC was 70.4% for men and 72.8% for women when using NHANES values for white Americans, 17.8% for men and 14.4% for women using NHANES equations for African Americans, and 15.5% for men and 20.5% for women using the Global Lung Function Initiative 2012 equations. Using the equations derived from nonsmoking respondents in the survey without a respiratory diagnosis, the prevalence of reduced FVC was less than 4% for both men and women. FVC was lower in participants who had less than 7 years of education (FVC, -96 ml; 95% confidence interval [CI], -172 to -19), were underweight (FVC, -269 ml; 95% CI, -464 to -73), were overweight (FVC, -132 ml; 95% CI, -219 to -46), and were obese (FVC, -222 ml; 95% CI, -332 to -112). CONCLUSIONS There is a wide variation in the prevalence of reduced FVC based on the reference standard used. This variation is not satisfactorily explained by factors thought to affect FVC within individual populations. However, the prevalence strongly associates with both education level and body mass index in this population, regardless of the specific standard used.
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Affiliation(s)
- Daniel O. Obaseki
- Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | | | | | | | - Emerita A. Sonia Buist
- Division of Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland, Oregon; and
| | - Peter G. Burney
- Respiratory Epidemiology and Public Health, National Heart & Lung Institute, Imperial College London, London, United Kingdom
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Roux P, Guillien A, Soumagne T, Ritter O, Laplante JJ, Travers C, Dalphin JC, Peiffer G, Laurent L, Degano B. Smoking habits in French farmers: a cross-sectional study. BMC Public Health 2017; 17:166. [PMID: 28160776 PMCID: PMC5292143 DOI: 10.1186/s12889-017-4030-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/12/2017] [Indexed: 11/10/2022] Open
Abstract
Background Farmers are exposed to multiple air contaminants that may interact with tobacco smoking in the development of respiratory diseases. Farmers are currently considered to smoke less than non-farmers, but precise data in different categories of age and farming activities are lacking. Methods Smoking habits were studied in a cross-sectional study involving 4105 farmers and 996 non-farming controls aged 40–74 years in 9 French departments between October 2012 and May 2013. Three age groups were defined (40–54, 55–64 and 65-74years). Farmers were divided into four activity groups, namely cattle breeders, livestock farmers working in confined spaces, crop farmers and others. Smoking prevalence was compared between farmers and controls, and odds ratios (ORs) for smoking adjusted for age were calculated. Results The adjusted OR for ever-smoking was lower among farmers than among non-farmers in all age categories, but the ORs for current smoking were similar in farmers and controls. Smoking prevalence varied according to the type of farming activity, and was lower than in non-farming controls only among cattle breeders and confined livestock farmers. In farmers, the proportion of smokers was higher in the youngest age categories compared with the older age classes. Conclusions Our results confirm that the prevalence of ever-smokers is lower in farmers than in non-farmers. Nevertheless, our data show that active smoking prevalence is similar in farmers and in non-farmers. This suggests that farmers, just like non-farmers, should be targeted by primary prevention campaigns against smoking.
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Affiliation(s)
- Pauline Roux
- Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU), Besançon, France.,Service de Pneumologie, CHRU, Besançon, France
| | | | | | | | | | | | - Jean-Charles Dalphin
- Service de Pneumologie, CHRU, Besançon, France.,Unité Mixte de Recherche, Centre National de la Recherche Scientifique Chrono-Environnement, Université de Franche-Comté, Besançon, France
| | | | - Lucie Laurent
- Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU), Besançon, France.,Service de Pneumologie, CHRU, Besançon, France
| | - Bruno Degano
- Service d'Explorations Fonctionnelles Respiratoires, Centre Hospitalier Régional Universitaire (CHRU), Besançon, France. .,EA 3920, Université de Franche-Comté, Besançon, France. .,Physiologie-Explorations Fonctionnelles, CHU Jean Minjoz, Besançon Cedex, 25030, France.
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Degano B, Guillien A, Soumagne T. Quelle place accorder aux symptômes pour le diagnostic de la BPCO ? Rev Mal Respir 2016; 33:648-651. [DOI: 10.1016/j.rmr.2016.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 05/31/2016] [Indexed: 12/01/2022]
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Affiliation(s)
- Leslie Elliott
- Walden University, College of Health Sciences, Minneapolis, MN, USA Epi-Stat Consulting, Fairview, NC, USA
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Lopez-Campos JL, Marquez-Martin E, Soriano JB. The role of air pollution in COPD and implications for therapy. Expert Rev Respir Med 2016; 10:849-59. [DOI: 10.1080/17476348.2016.1191356] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Soumagne T, Laveneziana P, Veil-Picard M, Guillien A, Claudé F, Puyraveau M, Annesi-Maesano I, Roche N, Dalphin JC, Degano B. Asymptomatic subjects with airway obstruction have significant impairment at exercise. Thorax 2016; 71:804-11. [DOI: 10.1136/thoraxjnl-2015-207953] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 04/28/2016] [Indexed: 11/04/2022]
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High prevalence of obstructive lung disease in non-smoking farmers: The Irish farmers lung health study. Respir Med 2016; 115:13-9. [PMID: 27215498 DOI: 10.1016/j.rmed.2016.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 03/16/2016] [Accepted: 04/17/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Mortality rates within the Irish farming community are increasing, whilst that of the general population falls. The aim of this cross-sectional study was to determine the prevalence of respiratory disease amongst Irish farmers. METHODS All study participants were farming volunteers attending an agricultural exhibition. Data collected by questionnaire included baseline demographics, respiratory history, presence of respiratory symptoms and occupational exposures. Spirometry was performed on all participants. RESULTS Data from 372 farmers was analysed. The majority were male (76%) with median age of 55 years. 61% were never smokers. 13% were previously diagnosed with airway disease (Chronic Obstructive Pulmonary Disease(COPD)/Asthma/Inhaler use) with 14% reporting hayfever/allergies. Almost two-thirds reported one or more chronic respiratory symptom. Forty-four (12%) had obstructive spirometry using fixed FEV1/FVC < 0.70 criterion and 29 (7.8%) using FEV1/FVC < 5% lower limit of normal. The majority, two-thirds, were never smokers. Amongst never smokers with obstruction (13%), there was a significantly higher proportion with a prior diagnosis of airway disease and hayfever/allergies. There was no significant association between specific occupational exposures and obstruction. CONCLUSION The majority of Irish farmers are never smokers. They have a high prevalence of respiratory symptoms. 13% of never smokers have airflow obstruction (FEV1/FVC < 0.70). The presence of airflow obstruction is significantly associated with self-reported allergy history and prior airway disease. Further studies are needed to identify the workplace factors accounting for these findings.
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