Nasal complaints and signs of disease in farmers--a methodological study.
CONCLUSIONS
The methods used in this study are suitable for field studies that involve examinations of groups of workers. For individual examinations, there is no gold standard method that can discriminate work-related discomfort from other causes of rhinitis.


OBJECTIVE
Studies of the effects of occupation on farmers' health have mainly focused on lower airways; few studies have examined effects on upper airways. This study investigated nasal functions in three groups of farmers (swine, milk and grain producers) and a control group using different methods, suitable for field studies.


METHODS
Health-related complaints were examined and several functional tests, such as expirogram, olfactory threshold test, acoustic rhinometry, nasal lavage with biomarkers of inflammation (eosinophilic cationic proteins (ECP), myeloperoxidase (MPO), tryptase, albumin) and allergy tests were performed. The different tests were correlated to nasal complaints and to each other.


RESULTS
Nasal blockage complaints were more common among farmers; overall, nasal polyps were more frequent in grain producers. Objective parameters showed more pronounced mucosal swelling in farmers and higher concentrations of ECP in nasal lavage compared with controls. Lung function, olfactory threshold, atopy frequency and allergen-specific IgE to the storage mite Lepidoglyphus destructor did not differ between farmers and controls. Mucosal swelling measured with acoustic rhinometry was more pronounced in subjects with nasal complaints, hypersensitivity, nasal polyps and symptoms from lower airways. There was a correlation between biomarkers in nasal lavage (MPO, albumin and ECP).
Holmström
Mats
M
Department of Otorhinolaryngology, Uppsala University Hospital, Uppsala, Sweden. mats.holmstrom@surgsci.uu.se
Thelin
Anders
A
Kolmodin-Hedman
Birgitta
B
Van Hage
Marianne
M
D000328:Adult; D000382:Agricultural Workers' Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D000418:Albumins / Q000032:analysis; D000822:Animal Husbandry; D003430:Cross-Sectional Studies; D002523:Edible Grain; D047150:Eosinophil Cationic Protein / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017817:Nasal Lavage Fluid / Q000737:chemistry; D009297:Nasal Mucosa / Q000503:physiopathology; D015508:Nasal Obstruction / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D009298:Nasal Polyps / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D009195:Peroxidase / Q000032:analysis; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D023842:Rhinometry, Acoustic; D013548:Sweden
D000418:Albumins; D009195:Peroxidase; D047150:Eosinophil Cationic Protein