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Respiratory disease in United States farmers
  1. Jane A Hoppin1,2,
  2. David M Umbach3,
  3. Stuart Long4,
  4. Jessica L Rinsky5,
  5. Paul K Henneberger6,
  6. Paivi M Salo7,
  7. Darryl C Zeldin7,
  8. Stephanie J London1,
  9. Michael C R Alavanja8,
  10. Aaron Blair8,
  11. Laura E Beane Freeman8,
  12. Dale P Sandler1
  1. 1Epidemiology Branch, National Institute of Environmental Health Sciences, NIH/DHHS, Research Triangle Park, North Carolina, USA
  2. 2Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, USA
  3. 3Biostatistics Branch, National Institute of Environmental Health Sciences, NIH/DHHS, Research Triangle Park, North Carolina, USA
  4. 4Westat, Durham, North Carolina, USA
  5. 5Department of Epidemiology, UNC Chapel Hill, Chapel Hill, North Carolina, USA
  6. 6Division of Respiratory Disease Studies, NIOSH, CDC, DHHS, Morgantown, West Virginia, USA
  7. 7Laboratory of Respiratory Biology, National Institute of Environmental Health Sciences, NIH/DHHS, Research Triangle Park, North Carolina, USA
  8. 8Occupational and Environmental Epidemiology Branch, National Cancer Institute, NIH/DHHS, Rockville, Maryland, USA
  1. Correspondence to Dr Jane A Hoppin, Department of Biological Sciences, North Carolina State University, CB 7633, Raleigh, NC 27695, USA; jahoppin{at}ncsu.edu

Abstract

Objectives Farmers may be at increased risk for adverse respiratory outcomes compared with the general population due to their regular exposures to dusts, animals and chemicals. However, early life farm exposures to microbial agents may result in reduced risk. Understanding respiratory disease risk among farmers and identifying differences between farmers and other populations may lead to better understanding of the contribution of environmental exposures to respiratory disease risk in the general population.

Methods We compared the prevalence of self-reported respiratory outcomes in 43548 participants from the Agricultural Health Study (AHS), a prospective cohort of farmers and their spouses from Iowa and North Carolina, with data from adult participants in the National Health and Nutrition Examination Survey (NHANES) over the same period (2005–2010).

Results AHS participants had lower prevalences of respiratory diseases (asthma, adult-onset asthma, chronic bronchitis and emphysema), but higher prevalences of current respiratory symptoms (wheeze, cough and phlegm) even after controlling for smoking, body mass index and population characteristics. The overall prevalence of asthma in the AHS (7.2%, 95% CI 6.9 to 7.4) was 52% of that in NHANES (13.8%, 95% CI 13.3 to 14.3), although the prevalence of adult-onset asthma among men did not differ (3.6% for AHS, 3.7% for NHANES). Conversely, many respiratory symptoms were more common in the AHS than NHANES, particularly among men.

Conclusions These findings suggest that farmers and their spouses have lower risk for adult-onset respiratory diseases compared with the general population, and potentially higher respiratory irritation as evidenced by increased respiratory symptoms.

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