Abstract
Respiratory disease is a well known health hazard for farmers, but the long-term prognosis is less well known. This is a 12-year follow-up of an investigation of Swedish farmers, most of them dairy farmers. A questionnaire was mailed to all 418 farmers who were alive of the farmers originally participating in 1982. They were invited to an interview, spirometry, and blood sampling. Ninety-one per cent (380) of the farmers, 321 men and 59 women, responded to the questionnaire. The mean age was 56 years for the men and 55 years for the women. Of the group, 10% were smokers, 25% ex-smokers, and 65% had never smoked. The population estimate for asthma in the farmers was 8.9% in 1994 compared to 2% in 1982, and to 5.4%–6.6% in the general population in the region in 1982. Of the asthmatic subjects, one-third had positive RAST tests (radioallergosorbent tests). Almost 90% of the new onset asthma cases since 1982 had non-IgE-mediated asthma. Most of the IgE-mediated asthmatics had had symptoms for many years, while 70% of the non-IgE-mediated asthmatic farmers had no or only wheezing with colds 1982. Two new cases of hypersensitivity pneumonitis were identified, and 7.3% had experienced inhalation fever during the last 12 years. In general, individuals with asthma and chronic bronchitis who had left farming were in better health in 1994 as compared to 1982. In conclusion, farmers have an enhanced risk to develop asthma increasing with age. Asthma in farmers is often non-IgE-mediated.
Highlights
Due to the large exposure to dust in their work, farmers have a higher morbidity and respiratory disease mortality than expected, and this has been known for centuries [1] it remains a serious problem
In this longitudinal study of respiratory diseases in farmers with a follow-up time of 12 years, asthma prevalence had increased from 2% to 8.9%
That is higher than the asthma prevalence in the general population in the same region in the same age group (50–60 years) investigated with similar techniques during the same time period [12]
Summary
Due to the large exposure to dust in their work, farmers have a higher morbidity and respiratory disease mortality than expected, and this has been known for centuries [1] it remains a serious problem. Farmers may suffer from a number of different work-related diseases of the respiratory organs, such as asthma, chronic bronchitis, irritation of the upper respiratory tract, inhalation fever (organic dust toxic syndrome (ODTS)), and allergic alveolitis, known as farmer’s lung [2,3,4,5]. The present study is a 12-year follow-up of an investigation carried out in 1982 of pulmonary diseases and clinical findings of Swedish farmers [7]. The purpose of the study is to investigate the longterm prognoses of the various symptoms and diseases of the respiratory organs in farmers and the way in which they are related to farm dust exposure, together with the symptoms and survey results noted 12 years ago (precipitins, RAST tests [radioallergosorbent tests], and spirometric data)
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