Bronchial Hyperresponsiveness in Farmers: Severity and Work-Relatedness

Prevalence and Characteristics of Chronic Obstructive Pulmonary Disease in Dairy Farmers

Objective: To assess the prevalence and characteristics of chronic obstructive pulmonary disease (COPD) in dairy farmers, and evaluate the role of job exposure and smoking as predictors for respiratory health impairment. Methods: A cross-sectional study was performed, including 83 dairy farmers (mean age: 52.6±8.7 years; mean exposure duration: 23.7±7.6 years) and 80 office workers as a control group (mean age: 52.7±8.2 years) matched for age, smoking habits, and socioeconomic status. Methods for evaluation of study participants included a questionnaire on respiratory symptoms in the last 12 months, baseline spirometry and bronchodilator reversibility testing, and diagnostic criteria for COPD. Results: The mean post-bronchodilator values of spirometric parameters are significantly lower in subjects among EG with negative bronchodilator test compared to those in CG, while the mean post-bronchodilator values of spirometric parameters are lower in dairy farmers with negative BD tests exposed more than 20 years compared to those with exposure less than 20 years, being statistically significant for FEV1/FVC%, MEF25, MEF50 and MEF75. The COPD prevalence is non-significantly higher in dairy farmers compared to controls, and is significantly associated with age over 40 years in dairy farmers (P=0.035). The risk for COPD development in dairy farmers is about 36 fold higher in subjects exposed more than 20 years (OR = 36.00 (1.21-37.77) CI 95%) compared to those with exposure duration less than 20 years, and is about 6 fold higher in dairy farmers who are current smokers (OR = 6.12 (0.95-37.77) CI 95%). COPD is significantly associated with smoking duration among smokers in both groups, while combined effect of smoking, smoking duration, and number of cigarettes smoked daily has a significant impact on COPD development in dairy farmers. According to the GOLD classification, depending on the degree of airflow limitation, mild and moderate types of COPD are detected in dairy farmers, and only mild type in controls, showing no significant difference between the two groups. Conclusion: The study findings recognized the role of farming exposure, and smoking as well, as predictors for respiratory health impairment, and furthermore confirmed their potential to be a predictive factor in the COPD development. These facts should be helpful in detection of critical points for action, indicate the need of adverse occupational exposures reduction through adequate preventive measures and regular health examinations, implementation of relevant engineering controls, smoking cessation programs, and complete and efficient respiratory health assessment.

Specific work activities and exposure to respiratory hazards - predictors of lung function impairment among crop farmers

OBJECTIVE: The objective of the study was to evaluate the specific work activities and occupational exposure to respiratory hazards as predictors of chronic respiratory symptoms development, lung function decline, and respiratory health impairment among crop farmers. METHODS: A cross-sectional survey was performed, including 87 crop farmers (mean age: 53.4 ± 7.8 years; and mean exposure duration: 22.9 ± 7.8 years) and 80 office workers as a control group (mean age: 52.7 ± 8.2 years) matched for age, smoking habits, and socioeconomic status. Subjects were evaluated by a questionnaire on respiratory symptoms in the past 12 months and spirometry testing. RESULTS: Crop farmers had a significantly higher prevalence of cough (41.4), phlegm (28.7%), and dyspnea (21.8%), than controls (p < 0.05). All mean baseline spirometric parameters were lower in crop farmers, but statistical significance was confirmed only for MEF25, MEF50, and MEF75 (p = 0.003, p = 0.000, and p = 0.001, respectively). Most of the respiratory symptoms were significantly associated with common work activities of crop farmers and all-day exposure to certain respiratory hazards. Age, exposure duration, and their combined effect with smoking habit had a significant effect on forced expiratory volume in one second FEV1 and FEV1/forced vital capacity. CONCLUSION: The results confirm that occupational exposure among crop farmers is associated with higher prevalence of respiratory symptoms and lung function decline and, together with specific workflow activities, may not only be a predictors of respiratory health impairment, but also a key tool in the creation of preventive strategies.

Occupational risk factors among Iranian farmworkers: a review of the available evidence

Farming is one of the most important components of most economies. No comprehensive picture exists of the health status of Iranian farmers and the work-related hazards that affect them. We aimed to determine the gaps in the current knowledge regarding the occupational health of Iranian farmworkers. Electronic databases including Medline, Web of Science, Scopus, and Embase, as well as national databases including the Scientific Information Database, MagIran, and Barakat Knowledge System, were searched for articles published through March 2017. All epidemiologic studies regarding the occupational health of farmworkers in Iran were reviewed, regardless of their design, language, time of publication, and location. Of the 86 retrieved articles, 39 studies were ultimately analyzed. Most studies were conducted in Fars, Kerman, and Mazandaran provinces. According to the results of this review, chemical, physical, and biological hazards, along with work-related injuries, may be the main factors threatening the health of farmworkers. The unsafe use of pesticides was related to male infertility, eye and digestive complications, pesticide poisoning, pesticide absorption, hematological changes, non-Hodgkin lymphoma, and multiple myeloma. Chemical hazards (e.g., the unsafe use of pesticides), physical hazards, injuries, and biological hazards (e.g., work-related infectious diseases) threaten the health of Iranian farmworkers. Moreover, farmworkers lack adequate knowledge about the occupational hazards they face and the relevant risk factors.

Chronic Respiratory Symptoms and Lung Function in Agricultural Workers - Influence of Exposure Duration and Smoking

INTRODUCTION

Job exposure in agricultural workers often leads to respiratory impairment.

AIM

To assess the influence of exposure duration and smoking on chronic respiratory symptoms and ventilatory capacity in agricultural workers.

METHODS

A cross-sectional study covered 75 agricultural workers, compared with an equal number of office workers matched by age, exposure duration and smoking status. Standardized questionnaire was used to obtain data on chronic respiratory symptoms, job and smoking history. Lung functional testing was performed by spirometry.

RESULTS

The prevalence of respiratory symptoms was higher in agricultural workers, with significant difference for cough (P = 0.034), and dyspnea (P = 0.028). Chronic respiratory symptoms among agricultural workers were significantly associated with duration of exposure (P < 0.05) and daily smoking (P < 0.01), as well as with daily smoking in controls (P < 0.01). The average values of spirometric parameters in exposed workers were significantly different for MEF50 (P = 0.002), MEF75 (P = 0.000), and MEF25-75 (P = 0.049). Obstructive changes in small airways in exposed workers were strongly related to exposure duration (P < 0.05) and smoking (P < 0.01). Agricultural workers with job exposure more than 15 years had more expressed adverse respiratory symptoms and lung function decline.

CONCLUSION

The results confirmed the influence of agricultural exposure and daily smoking on chronic respiratory symptoms and airflow limitation, primarily targeting the small airways.