Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America.
National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, United States of America.
Environ Int. 2019 Jun;127:764-772. doi: 10.1016/j.envint.2019.02.049. Epub 2019 Apr 25.
Occupational exposure to animal production is associated with chronic bronchitis symptoms; however, few studies consider associations with chronic obstructive pulmonary disease (COPD). We estimated associations between animal production activities and prevalence of self-reported COPD among farmers in the Agricultural Health Study.
During a 2005-2010 interview, farmers self-reported information about: their operations (i.e., size, type, number of animals, insecticide use), respiratory symptoms, and COPD diagnoses (i.e., COPD, chronic bronchitis, emphysema). Operations were classified as small or medium/large based on regulatory definitions. Farmers were classified as having a COPD diagnosis, chronic bronchitis symptoms (cough and phlegm for ≥3 months during 2 consecutive years), or both. Polytomous logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI).
Of 22,491 participating farmers (median age: 59 years), 922 (4%) reported a COPD diagnosis only, 254 (1%) reported a diagnosis and symptoms, and 962 (4%) reported symptoms only. Compared to raising no commercial animals, raising animals on a medium/large operation was positively associated with chronic bronchitis symptoms with (OR: 1.59; 95% CI: 1.16, 2.18) and without a diagnosis (OR: 1.69; 95% CI: 1.42, 2.01). Ever use of multiple organophosphates, carbaryl, lindane, and permethrin were positively associated with chronic bronchitis symptoms.
Animal production work, including insecticide use, was positively associated with chronic bronchitis symptoms; but not consistently with COPD diagnosis alone. Our results support the need for further investigation into the role of animal production-related exposures in the etiology of COPD and better respiratory protection for agricultural workers.
职业性接触动物生产与慢性支气管炎症状有关；然而，很少有研究考虑与慢性阻塞性肺疾病（COPD）的关系。我们估计了动物生产活动与农业健康研究中农民自我报告的 COPD 患病率之间的关系。
在 2005-2010 年的访谈中，农民报告了以下信息：他们的操作（即规模、类型、动物数量、杀虫剂使用）、呼吸症状和 COPD 诊断（即 COPD、慢性支气管炎、肺气肿）。根据监管定义，将操作分为小型或中型/大型。农民被诊断为 COPD、慢性支气管炎症状（连续两年每个月咳嗽和咳痰超过 3 个月）或两者兼有。多分类逻辑回归用于估计比值比（OR）和 95%置信区间（CI）。
在 22491 名参与农民中（中位数年龄：59 岁），922 名（4%）仅报告 COPD 诊断，254 名（1%）报告诊断和症状，962 名（4%）仅报告症状。与不饲养商业动物相比，饲养中型/大型动物与慢性支气管炎症状（OR：1.59；95%CI：1.16，2.18）和无诊断（OR：1.69；95%CI：1.42，2.01）呈正相关。曾经使用多种有机磷、甲萘威、林丹和氯菊酯与慢性支气管炎症状呈正相关。
动物生产工作，包括杀虫剂的使用，与慢性支气管炎症状呈正相关；但与 COPD 单独诊断不一致。我们的研究结果支持进一步研究动物生产相关暴露在 COPD 发病机制中的作用，并为农业工人提供更好的呼吸保护。
