Bronchial Hyperresponsiveness in Farmers: Relation to Respiratory Symptoms, Lung Function, and Atopy |
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Authors: | A B Bohadana D B Teculescu S E Megherbi Q T Pham |
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Affiliation: | (1) Institut National de la Santé et de la Recherche Médicale, Unité 420, Epidémiologie Santé Travail, Cedex France, FR;(2) Service de Pneumologie A, Centre Hospitalier Universitaire de Nancy-Brabois, Vandoeuvre-lès-Nancy, Cedex France, FR |
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Abstract: | There is only limited information on the factors associated with nonspecific bronchial hyperresponsiveness (BHR) in farmers.
Our purpose was to examine the relationship between BHR and respiratory symptoms, atopy, and abnormalities of lung function
in a sample of French farmers. Farmers scheduled for a preventive medicine check-up in northeastern France were examined.
Occupational exposure, respiratory symptoms, and work-related symptoms were assessed by questionnaire, sensitization to 34
common and agricultural allergens by skin prick tests, and BHR by the single-dose (1,200 μg) acetylcholine (ACh) challenge
test. Data were obtained from 741 farmers (95% of those invited). Seventy-seven subjects (10.3%) had BHR defined as a fall
in forced expiratory volume in 1 s (FEV1) ≥ 10% after the inhalation of ACh or, for those with a poor lung function, an increase in FEV1 > 10% and > 200 ml after the inhalation of 200 μg of salbutamol. The proportion of asthmalike symptoms, especially wheeze during work,
positive skin tests to acarian (storage mites) and cereal dust allergens, and low levels of lung function was significantly
greater among reactors than among nonreactors. Stepwise logistic regression analysis showed a significant and independent
association between BHR and wheezing during work (OR = 4.99; 95% CI = 2.29–10.89; p= 0.0001) and baseline FEV1 (OR = 1.49; 95% CI = 1.05–2.20; p= 0.026). In conclusion, hyperreactive farmers had significantly more asthmalike symptoms, positive skin tests, and abnormal
lung function than normoreactive farmers. Work-related wheeze and low baseline FEV1 were significantly and independently associated with BHR.
Accepted for publication: 26 January 1999 |
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Keywords: | : Bronchial responsiveness— Farming— Work-related wheeze— Spirometry— Atopy |
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