title: Short term exposure to airborne microbial agents during farm work: exposure-response relations with eye and respiratory symptoms.
abstract: OBJECTIVE
  Exposure to high levels of non-infectious microbial agents is recognised as a cause of respiratory disease in working populations, but except for endotoxins, little is known about exposure-response relations. As these effects do not depend on viability, exposure to non-viable microbial agents is important. Various methods not based on microbial cultures were explored to study the complex microbial exposure of farmers and associations with acute symptoms during work.
  
  
  METHODS
  Airborne exposure was measured when farmers carried out specific tasks. Fungal spores, bacteria, endotoxins, beta(1-->3)-glucans, fungal antigens specific for Penicillium and Aspergillus species, and mites were measured by methods not based on microbial cultures. Also silica, inorganic and organic dust, ammonia, hydrogen sulphide, and nitrogen dioxide were measured. Respiratory, and nose and eye symptoms experienced during measurements were recorded by a short questionnaire. Both univariate and multivariate statistical analyses were applied to assess the relations between exposure and acute symptoms.
  
  
  RESULTS
  106 Farmers and their spouses participated in this study. Prevalences of work related symptoms were: wheezing 3%; chest tightness 7%; cough 14%; eye symptoms 18%; and nose symptoms 22%. Prevalence ratios for nose and eye symptoms were 4-8 after exposure to 20-500x10(3) fungal spores/m(3) and higher, and a prevalence ratio for cough was 4 after exposure to 500-17,000x10(3) fungal spores/m(3). Nose symptoms were also associated with exposure to silica with prevalence ratios of 4-6 after exposure to 0.015-0.075 mg /m(3) and higher.
  
  
  CONCLUSIONS
  Farmers had a high occurrence of symptoms of the nose and eyes as well as cough during work. These symptoms were associated in a dose dependent manner with exposure to fungal spores. Nose symptoms were also associated with exposure to silica.
authors.affiliation: National Institute of Occupational Health, PO Box 8149 Dep, 0033 Oslo, Norway. wijnand.eduard@stami.no
authors.forename: W
authors.initials: W
authors.lastname: Eduard
authors.forename: J
authors.initials: J
authors.lastname: Douwes
authors.forename: R
authors.initials: R
authors.lastname: Mehl
authors.forename: D
authors.initials: D
authors.lastname: Heederik
authors.forename: E
authors.initials: E
authors.lastname: Melbostad
mesh_terms: D000368:Aged; D000382:Agricultural Workers' Diseases / Q000382:microbiology*; D000704:Analysis of Variance; D000946:Antigens, Fungal; D003430:Cross-Sectional Studies; D005128:Eye Diseases / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D012141:Respiratory Tract Infections / Q000382:microbiology*; D013172:Spores, Fungal; D011795:Surveys and Questionnaires
chemical_list: D000946:Antigens, Fungal