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Minisymposium 11

M11.1 NEW TOPICS IN AGRICULTURAL RESPIRATORY DISEASE

M. Schenker.Department of Public Health Sciences, University of California at Davis, CA, USA

Most studies of agricultural lung disease have focused on the adverse effects of organic dusts, with a particular focus on airway diseases such as bronchitis, asthma, asthma-like syndrome, and toxic and hypersensitivity pneumonitis. Newer studies have begun to focus on the effects of inorganic dust or mixed exposures on the lung. This talk will cover exposures to silica and silicates in different agricultural settings, including data on preventive behaviours and practices. Research on the health effects of these exposures will be presented, including chronic respiratory symptoms, silicosis, and mixed dust pneumoconiosis. Analogous studies of dust exposure and respiratory effects in other occupational and community based studies will be described. The association of idiopathic pulmonary fibrosis and agricultural exposures will be reviewed, and new research on the association of chronic low level paraquat exposure and lung disease described. Recent research on non-occupational asbestos exposure and mesothelioma will be presented, and implications for agricultural workers addressed. Most studies of agricultural respiratory disease have been performed predominantly in farmers, for whom the exposures may be different than those for hired farmworkers. Recent research on respiratory disease among hired farmworkers will be reviewed, including reports on respiratory disease in this population.

M11.2 DOES FARMING PREVENT ATOPY AND ALLERGIC ASTHMA?

J. Douwes.Centre for Public Health Research, Massey University, Wellington, New Zealand

Studies conducted in Europe, Canada, Australia, and New Zealand have shown a reduced risk of atopy, hay fever, and asthma in farmer’s children and adolescents, and in first year university students with a farming background. The specific protective factors were not conclusively determined, although it was indicated that contact with livestock was particularly protective. This is consistent with previous observations showing that pigs and cattle in the home in Guinea-Bissau and Nepal, respectively, and presence of pets in the home in Europe and the US were inversely associated with atopy. Increased exposure to bacterial endotoxin, which is associated with animal and pet keeping, has been suggested to play an important role. It is commonly assumed that these protective exposures have their effects during the first years of life. However, recent epidemiological and animal studies suggest that “immune deviation” may take place throughout life. Therefore the protective effect may not only be limited to farmers’ children but may also occur in adult farmers. Indeed, several studies indicated a low prevalence of allergic symptoms and/or atopic sensitisation in adult farmers. In addition, recent studies in adult farmers showed that current exposure to endotoxin was associated with a reduction in atopy and atopic asthma. These observations could be due to childhood exposures, but one study also showed a decreased prevalence among adolescent farmers who were not raised on a farm. In contrast, other studies have shown an increased risk of farming on adult respiratory morbidity and mortality including asthma (despite the lower prevalence of smoking in farmers). However, there is some evidence that this may be associated with non-allergic mechanisms. In fact, it has been speculated that some farming exposures (bacterial endotoxin, and other microbial agents) that may protect against allergies and allergic asthma may at the same time induce non-allergic respiratory symptoms. The apparent discrepancy in the potential role of farming on the development on asthma requires further study. In future studies it is essential to differentiate between atopic and non-atopic asthma.

M11.3 INJURY IN THE AGRICULTURE SECTOR IN AUSTRALIA

L. Fragar.Australian Centre for Agricultural Health and Safety, University of Sydney, Moree, NSW, Australia

In 1995 the Australian National Occupational Health and Safety Commission estimated that the costs of work related farm injury and illness cost the agriculture industries and community between A$0.52 and A$1.29 billion per annum across Australia. This represented more than 2% of the annual gross value of agricultural and horticultural production. More recent statistics issued by the National Farm Injury Data Centre relating to farm deaths and workers compensation claims indicates that there has been little change in those industries’ occupational health and safety (OHS) performance over the past decade. Key causes of death and serious injury include tractors and mobile machinery, animals, vehicles (including farm utilities, all terrain vehicles, and motorcycles), and drowning of toddlers in dams and other bodies of water. Common causes of injury resulting in workers compensation claims include animals, tractors, mobile machinery, motorcycles, trucks, manual handling, and foreign bodies in eyes. Among the key impediments to adoption of improved OHS risk management is the small business structure of the agriculture and horticulture industry. While workers in the larger enterprises have benefited from provisions of OHS legislation that require workplace safety committees and programsme, and training of committee members, small businesses have had no such attention. Further, it has to be recognised that the agricultural industries face a wide range of occupational hazards in their production processes. This paper will describe strategic interventions being implemented by the Farmsafe Australia network using evidence based programmes for action and propose key factors for successful change in this complex at risk population.

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