Abstract

Problem/ConditionMany rural residents work in the field of agriculture; however, employment in nonagricultural jobs also is common. Because previous studies in rural communities often have focused on agricultural workers, much less is known about the occupational exposures in other types of jobs in rural settings. Characterizing airborne occupational exposures that can contribute to respiratory diseases is important so that differences between rural and urban working populations can be assessed.Reporting Period1994–2011.Description of SystemThis investigation used data from the baseline questionnaire completed by adult rural residents participating in the Keokuk County Rural Health Study (KCRHS). The distribution of jobs and occupational exposures to vapor-gas, dust, and fumes (VGDF) among all participants was analyzed and stratified by farming status (current, former, and never) then compared with a cohort of urban workers from the Multi-Ethnic Study of Atherosclerosis (MESA). Occupational exposure in the last job was assessed with a job-exposure matrix (JEM) developed for chronic obstructive pulmonary disease (COPD). The COPD JEM assesses VGDF exposure at levels of none or low, medium, and high.ResultsThe 1,699 KCRHS (rural) participants were more likely to have medium or high occupational VGDF exposure (43.2%) at their last job than their urban MESA counterparts (15.0% of 3,667 participants). One fifth (20.8%) of the rural participants currently farmed, 43.1% were former farmers, and approximately one third (36.1%) had never farmed. These three farming groups differed in VGDF exposure at the last job, with the prevalence of medium or high exposure at 80.2% for current farmers, 38.7% for former farmers, and 27.4% for never farmers, and all three percentages were higher than the 15.0% medium or high level of VGDF exposure for urban workers.InterpretationRural workers, including those who had never farmed, were more likely to experience occupational VGDF exposure than urban workers.Public Health ActionThe occupational exposures of rural adults assessed using the COPD JEM will be used to investigate their potential association with obstructive respiratory health problems (e.g., airflow limitation and chronic bronchitis). This assessment might highlight occupations in need of preventive interventions.

Highlights

  • Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease that impedes airflow and is a major cause of morbidity and mortality worldwide [1,2,3]

  • One fifth (20.8%) of the rural participants currently farmed, 43.1% were former farmers, and approximately one third (36.1%) had never farmed. These three farming groups differed in VGDF exposure at the last job, with the prevalence of medium or high exposure at 80.2% for current farmers, 38.7% for former farmers, and 27.4% for never farmers, and all three percentages were higher than the 15.0% medium or high level of VGDF exposure for urban workers

  • Public Health Action: The occupational exposures of rural adults assessed using the COPD job-exposure matrix (JEM) will be used to investigate their potential association with obstructive respiratory health problems

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Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease that impedes airflow and is a major cause of morbidity and mortality worldwide [1,2,3]. The American Thoracic Society estimated that 15% of COPD cases in the general population can be attributed to occupational exposures [4,5]. Occupational exposures to vaporgas, dust, and fumes (VGDF) have been associated with COPD [4,6]. Investigating differences between rural and urban workers in respiratory disease outcomes (including COPD) first requires characterization of occupational VGDF exposures overall. Rural communities have many agriculturerelated jobs, which have received the focus of previous studies, employment in nonagricultural jobs is common; VGDF exposures both in agricultural and nonagricultural jobs in rural communities should be assessed.

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