Farm work, dust exposure and respiratory symptoms among farmers

OBJECTIVE: Environmental working conditions in rural areas, notably exposure to organic and mineral dusts, have been associated with increases in respiratory diseases. The objective of this study was to evaluate the prevalence of respiratory symptoms among farmers and the associations of these with occupational risk factors. METHODS: This cross-sectional study was undertaken in 1996 with 1,379 farmers from Southern Brazil. Sociodemographic and farming-production parameters were collected, as were levels of exposure to organic and mineral dusts. Respiratory symptoms were assessed by a modified version of American Thoracic Society-Division of Lung Disease questionnaire. Multiple logistic regression analysis was used in analyses, controlling for confounding factors. RESULTS: The majority (52%) of interviewees worked in activities with intense exposure to dust. Workers on farms with better economic indicators had a lower prevalence of respiratory symptoms. Poultry workers showed more symptoms of chronic respiratory disease (OR=1.60; 95% CI: 1.05-2.42). Farmers exposed to high concentrations of dust had more than 70% higher risk of asthma symptoms (OR=1.71; 95% CI: 1.10-2.67) and chronic respiratory disease symptoms (OR=1.77; 95% CI: 1.25-2.50). CONCLUSIONS: The rural workers studied herein were exposed to high levels of organic and mineral dusts. Those exposed to higher dust concentrations, such as poultry workers, showed an increased risk of work-related respiratory symptoms. The implementation of respiratory protection programs is recommended, emphasizing workers involved with poultry production.     

Prevalence and predictors of respiratory symptoms among New York farmers and farm residents

BACKGROUND: Data from telephone interviews with New York farmers and farm residents were used to study the prevalence and risk factors of symptoms that could be related to asthma and allergies. METHODS: Participants were asked if they had wheezing or whistling in the chest in the past year and about the occurrence of stuffy, itchy, runny nose or watery, itchy eyes in the past year. RESULTS: The prevalence of wheeze was 18.2% and of stuffy nose/watery eyes was 57.4% (N = 1,620). Significant risk factors for wheeze were cigarette smoking, a systemic reaction to allergy skin testing, immunotherapy, or insect sting, reactivity to a pet, having goats, and more acreage in corn for silage. Significant risk factors of stuffy nose/watery eyes were younger age, having more than a high school education, being a worker on the farm, and having done spraying. CONCLUSIONS: Wheeze may be indicative of existing or latent asthma, a potentially limiting respiratory illness. Stuffy, itchy, runny nose or watery, itchy eyes, which may cause irritation and discomfort, may also indicate an increased sensitivity to respirable dusts and chemicals. This cohort of New York farmers had significant farm-related risk factors for wheeze and stuffy nose/watery eyes.     

Lung function and respiratory symptoms in pig farmers

In a pilot study to investigate the health effects of swine confinement work on the respiratory tract pulmonary function tests and a questionnaire for respiratory symptoms were used. Complete data, including qualitative exposure information, were gathered for 132 owners of fattening, breeding, or closed pig farms. All measured pulmonary function values, except the FVC, were on average lower than the reference values of the European Committee for Coal and Steel. There were no significant associations between duration of exposure and pulmonary function. About 28% of the farmers had respiratory or flu-like symptoms during or shortly after confinement work; 14% reported symptoms four to eight hours after work. For the fattening farm the following elements of confinement management were negatively correlated with pulmonary function: fully slatted floor, an automatic feeding system, natural ventilation, and the use of dust masks. A significant association between lung disease of the pigs and pulmonary function of the pig farmers was observed.     

Work-related respiratory symptoms in New Zealand farmers

BACKGROUND: The first national survey of the respiratory health of New Zealand farmers looked at the prevalence of respiratory symptoms by farm type and work exposure. METHODS: An 8-page questionnaire was mailed to 2,203 farmers randomly selected from all over New Zealand. RESULTS: Response rate was 77.6% of 2,203, or 1,706 participants. Breathing problems at work were reported by 17.6% of farmers. Working with oats was strongly associated with work-related breathing problems (OR = 3.3, 2.1-5.2). Dyspnea was more common in female farmers, whereas chronic bronchitis was higher in males. Orchardists (OR = 2.3, 1.3-4.0), those growing oat crops (OR = 3.0, 1.7-5.4) and using the grain mill (OR = 2.8, 1.3-6.3) reported the highest symptom rates of ODTS/FL. Having hay fever or eczema, and smoking were risk factors for all respiratory symptoms. CONCLUSIONS: Working in the areas of pigs, poultry, horses, grains, and hay are associated with respiratory symptoms in New Zealand farmers.     

Lung function and respiratory symptoms in pig farmers.

In a pilot study to investigate the health effects of swine confinement work on the respiratory tract pulmonary function tests and a questionnaire for respiratory symptoms were used. Complete data, including qualitative exposure information, were gathered for 132 owners of fattening, breeding, or closed pig farms. All measured pulmonary function values, except the FVC, were on average lower than the reference values of the European Committee for Coal and Steel. There were no significant associations between duration of exposure and pulmonary function. About 28% of the farmers had respiratory or flu-like symptoms during or shortly after confinement work; 14% reported symptoms four to eight hours after work. For the fattening farm the following elements of confinement management were negatively correlated with pulmonary function: fully slatted floor, an automatic feeding system, natural ventilation, and the use of dust masks. A significant association between lung disease of the pigs and pulmonary function of the pig farmers was observed.     

Lung function and respiratory symptoms in male Palestinian farmers

In a cross-sectional study of 250 farmers aged 22 to 77 years, of whom 36.4% are smokers, the authors aimed at describing lung function and respiratory symptoms and to estimate associations with exposures to pesticides and dust. Lung function was measured using a spirometer. Respiratory symptoms and exposure levels were self-reported based on a modified standardized questionnaire. Mean forced vital capacity (FVC) was 4.20 L (SD = 0.93 L), 95.51% of predicted as compared to European standards. Mean forced expiratory volume in one second (FEV(1)) was 3.28 L (SD = 0.80 L), 91.05% of predicted. The authors found high symptom prevalences: 14.0% for chronic cough; 26.4% for wheeze; and 55.2% for breathlessness. There was no clear association between exposure to pesticides or dust and lung function or between such exposures and respiratory symptoms. However, a significant association was found between smoking and respiratory symptoms such as chronic cough, cough with phlegm, and wheezes. The lack of farm exposure associations could be due to improvement in farmers' awareness to pesticides hazards as well as regulations of pesticide import, or because of inherent problems with the experimental design. Farmers who kept animals and poultry seem to have less respiratory symptoms and better lung function.     

Work-related respiratory disorders among Finnish farmers

Several research projects on work-related respiratory diseases have been conducted in Finland. One of the largest, "Farmers' Occupational Health Programme," was conducted by the Social Insurance Institution of Finland during 1973-1983 in cooperation with Kuopio Regional Institute of Occupational Health and the National Board of Health. The main objective of the program was to develop a model for occupational health services for farmers. As a part of the program, postal surveys were conducted in 1979 and 1982. The surveys allowed an analysis of both the prevalence and the mean annual incidence of asthma, farmer's lung, and chronic bronchitis as well as of background variables related to the diseases. More than every tenth farmer suffered from these respiratory diseases. The occurrence of chronic bronchitis (the most common disease) was, in general, related to farming types in which grain crops (including animal feeds) were handled. Chronic bronchitis was most prevalent among farmers who worked in piggeries, implying a combined effect of grain dusts, dusts of animal origin, and development of the disease. Atopy predisposed to and had an additive effect with smoking on chronic bronchitis.     

Low back pain and musculoskeletal symptoms among Kansas farmers

BACKGROUND: Farming continues to rank as one of the most dangerous occupations in the United States. The purpose of this study was to determine the prevalence of low back pain and other musculoskeletal disorders (MSDs) among the farmers and to examine the factors associated with occupational back pain. Farmers in a predominately corn and soybean growing region of Kansas served as the study sample. METHODS: Questionnaires were mailed out to 499 active farmers of a Farmers' Cooperative in Southeast Kansas. The self-administered questionnaire was used to determine the prevalence of self-reported symptoms of back pain and other MSDs and to determine the strength of associations between back pain and work factors. RESULTS: The participation rate was 57.2%. The low back was the anatomical area with the highest prevalence of self-reported work-related pain (37.5%), followed by the shoulders (25.9%), knees (23.6%), and neck (22.4%). Close to 60% of the farmers reported that they experienced farm work-related MSD symptoms in at least one of the nine body areas in the previous year. Nearly one quarter of the farmers reported seeing a physician for their low back symptoms, and one in five farmers had to modify their work habits due to low back symptoms during the previous year. CONCLUSIONS: Low back pain and other musculoskeletal conditions are a significant problem for Kansas farmers. This group of Kansas farmers experienced low back pain at a much higher rate than the general working population and higher than other groups of farmers previously studied.     

Lung function and work-related exposure in pig farmers with respiratory symptoms

The present study was conducted to evaluate characteristics of pig houses that are associated with the development of respiratory morbidity in 100 swine producers with work-related respiratory symptoms. A standardized questionnaire for farm characteristics was used, and lung function was assessed immediately before and after feeding the pigs. Exposure to dust and endotoxin was determined by personal sampling. Among these farmers, baseline lung function results were shown to be negatively associated with duration of employment, number of pigs on the farm, manual feeding, and ventilation. The decrease in forced vital capacity and forced expiratory volume in 1 second over the feeding period was negatively correlated with air velocity, whereas respirable dust concentrations were shown to be significant predictors of maximal midexpiratory flow (MMEF25/75) decline. In conclusion, among symptomatic pig farmers, those with higher numbers of pigs and longer duration of employment are at highest risk for developing functional impairment.     

Skin symptoms and work-related skin symptoms among grape farmers in Crete, Greece

BACKGROUND: Grape farmers are exposed to a variety of agents capable of inducing occupational skin disease. We conducted a study to measure the prevalence of skin symptoms and work-related skin symptoms among grape farmers in the Malevisi region of Crete and to provide data on associated risk factors. METHODS: One hundred twenty grape farmers and 100 controls participated in the study. The protocol consisted of a questionnaire, skin prick tests for 16 common allergens, and measurement of specific IgE antibodies against 8 allergens. RESULTS: Self-reported itchy rash (OR, 2.31; 95%CI, 1.10-4.84, P<0.05) within the last 12 months, and work-related itchy rash (OR, 4.08; 95%CI, 1.01-20.33, P<0.05) were significantly higher in grape farmers than in controls, after adjusting for age and sex. Sensitization to pollens (OR, 4.20; 95% CI, 1.41-12.82, P<0.01) and allergic rhinitis (OR, 3.06; 95% CI, 1.21-8.28, P<0.05) were found to be significantly associated with self-reported itchy rash in the grape farmers group. CONCLUSIONS: Grape farmers reported skin symptoms more frequently than non-exposed controls, and IgE-mediated sensitization to pollens was found to be significantly associated with the reported symptoms. Further studies are needed to evaluate the impact of specific occupational agents on skin diseases among grape farmers.     

Urinary dialkylphosphate metabolites and health symptoms among farmers in Thailand

Using a cross-sectional study, we investigated urinary DAPs levels and health symptoms related to the type of crop cultivation and farm tasks among 84 farmers in Phayao Province of northern Thailand. The results showed that the average of ∑DAPs levels was 10.93 ± 19.64 μg/g creatinine (range 1.48–163.90 μg/g creatinine). The compound found the most was DEP, followed by DETP, DEDTP, DMP, DMTP, and DMDTP, respectively. The type of crop cultivation may be associated with an increasing prevalence of respiratory tract, muscle system, and skin irritation. Farm tasks were associated with an increasing prevalence of muscle system and skin irritation. It was difficult to assess adverse health symptoms associated with urinary DAPs in low levels of exposure; therefore, further investigation is needed using more sensitive biomarkers and more sensitive health symptom measurement.     

Musculoskeletal symptoms among farmers and non-farmers: a population-based study

Farming has been considered a high-risk occupation for musculoskeletal disorders. However, documentation of the increased risk is weak except for hip osteoarthritis. 1,013 full-time farmers in nine Swedish municipalities and 769 non-farmers (referents), matched for age, sex, and residential area, participated in the study. Information about medical history, consultations, and sick leave for musculoskeletal disorders was obtained by questionnaire and interview. The farmers reported significantly more symptoms affecting the hands and forearms, low back, and hips than did the non-farmers, and a non-significant trend in the same direction was found for symptoms from the neck, shoulders, and knees. However, the farmers did not seek medical advice more often than the referents, and they reported significantly less sick leave for these problems. Thus, farmers appear to have more musculoskeletal symptoms than do non-farmers.     

Self-reported symptoms of neurotoxicity and agricultural injuries among Ohio cash-grain farmers

BACKGROUND: In 1993, the Ohio Farm Family Health and Hazard Surveillance Program (OFFHHSP) was initiated to assess the health status of cash-grain farmers and their families. The objective of this study was to examine the postulated relationship between symptoms of neurotoxicity and risk of agriculture-related injury among Ohio cash-grain farmers. METHODS: A reanalysis of the data from a previously published case-control study of cash-grain farmers [Crawford et al. (1998) Am J Ind Med 34:588-599] was performed. The Principal Operator (PO) of each farm was asked to complete a self-administered questionnaire which included items about injuries experienced during the past year. A section of the questionnaire contained a 24-item instrument ("Q24") that queried symptoms of neurotoxicity experienced during the previous 12 months. Design-based multiple logistic regression analyses were conducted to evaluate associations between neuropsychological subsets ("domains") of the 24-item instrument and injury risk among the white male POs (who accounted for >99% of all POs). RESULTS: Significantly elevated odds ratios (ORs) were found in 8 of 11 domains. POs answering in the affirmative to the single item "Have you been bothered by lack of coordination or loss of balance?" were 3.12 times more likely to have reported an injury than POs responding negatively (95% CI 1.68-5.81). CONCLUSIONS: Farmers with higher scores on several Q24 domains, and for particular questionnaire items, appear to be at increased risk of agricultural injury.     

Risk factors to pesticide exposure and associated health symptoms among cut-flower farmers

The study looked into the risk factors associated with pesticide exposure among cut-flower farmers. A survey questionnaire was given to 102 respondents in Barangay Bahong in La Trinidad, the center of cut-flower production in the Philippines. Results showed that 32% were symptomatic or had experienced pesticide-related illnesses since their first use of pesticides. The majority of the pesticides used by the farmers were Categories Ib and II which are moderately or highly hazardous chemicals. Individuals with signs and symptoms most often centered on the eye, ear, nose and throat (EENT) (44 respondents reporting these symptoms) followed by general and neuralgic (16 respondents) and the integumentary (14 respondents). The most common general signs and symptoms manifested were weakness followed by fatigue and muscle pain then by chills and fever. The most common EENT manifestations were eye itchiness and blurring of vision. For neurological signs and symptoms, dizziness followed by headache was reported. Logistic regression showed that illnesses for the past 12 months were associated with certain risk factors such as farm use of pesticides, exposure to pesticide while applying it, respiratory inhalation of pesticide vapours and mists (p = 0.05). Moreover, those who re-entered a recently sprayed area were 20 times more likely to get ill during the past 12 months than those who did not. Those who used pesticide-contaminated pieces of fabric to wipe sweat off their faces were 2% more likely to get ill, and those who had spills on their bodies while applying pesticide were 26 times more likely to get ill. The study suggested that the risk factors to pesticide exposure should be considered in policy formulations for the cut-flower farmers in the country.