title: A review of bio-aerosol exposures and associated health effects in veterinary practice.
abstract: BACKGROUND
  Occupational exposure to bio-aerosols has been linked to various health effects. This review presents an overview of bio-aerosol exposure levels in veterinary practices, and investigates the possibility of health effects associated with bio-aerosol exposure.
  
  
  METHODS
  A systematic literature search was carried out in PubMed. Publications were included if they provided information on bio-aerosol exposure and related health effects through veterinary practice and other professions with similar exposures, occupationally exposed to animals.
  
  
  RESULTS
  Few studies in veterinary settings showed that substantial bio-aerosol exposure levels (e.g. endotoxin and β(1→3)-glucan) were likely occur when handling farm animals and horses. Exposure levels are comparable to those levels observed in farming which have been associated with respiratory health effects. Animal specific allergen exposures have hardly been studied, but showed to be measurable in companion animal clinics and dairy barns. The Findings of the few studies available among veterinary populations, particularly those working with farm animals and horses, are indicative of an elevated risk for developing respiratory symptoms. Studies among pig farmers, exposed to similar environments as veterinarians, strongly confirm that veterinary populations are at an increased risk of developing respiratory diseases in relation to bio-aerosol exposure, in particular endotoxin. Exposure to animal allergens during veterinary practice may cause allergic inflammation, characterized by IgE-mediated reactions to animal allergens. Nonetheless, the occurrence of sensitization or allergy against animal allergens is poorly described, apart from laboratory animal allergy, especially known from exposure to rats and mice.
  
  
  CONCLUSIONS
  Veterinary populations are likely exposed to elevated levels of bio-aerosols such as endotoxins, β(1→3)-glucans, and some specific animal allergens. Exposures to these agents in animal farmers are associated with allergic and non-allergic respiratory effects, proposing similar health effects in veterinary populations.
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, The Netherlands. s.samadi@uu.nl
authors.forename: Sadegh
authors.initials: S
authors.lastname: Samadi
authors.forename: Inge M
authors.initials: IM
authors.lastname: Wouters
authors.forename: Dick J J
authors.initials: DJ
authors.lastname: Heederik
mesh_terms: D000336:Aerosols / Q000633:toxicity; D000395:Air Pollutants, Occupational / Q000633:toxicity*; D000822:Animal Husbandry; D017750:Animal Technicians; D000818:Animals; D000829:Animals, Domestic; D000830:Animals, Laboratory; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D004784:Environmental Monitoring; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology; D016273:Occupational Exposure; D012120:Respiration Disorders / Q000139:chemically induced / Q000453:epidemiology / Q000382:microbiology; D012377:Rodentia; D018634:Veterinarians; D014777:Virus Diseases / Q000453:epidemiology / Q000821:virology
chemical_list: D000336:Aerosols; D000395:Air Pollutants, Occupational