title: A comprehensive review of levels and determinants of personal exposure to dust and endotoxin in livestock farming.
abstract: The respiratory health effects of livestock farming have been on debate for more than three decades. Endotoxin-contaminated organic dusts are considered as the most important respiratory hazards within livestock environments. A comprehensive review of the knowledge from studies assessing the exposure status of livestock farmers is still to be published. The present study reviews research published within the last 30 years on personal exposure of livestock farmers to organic dust and endotoxin, focusing on studies on pig, poultry and cattle farmers. Applied measurement methods and reported levels of personal exposure for the total, inhalable and respirable fractions are summarized and discussed, with emphasis on the intensity of exposure and the size and distribution of the reported exposure variability. In addition, available evidence on potential determinants of personal exposure to dust and endotoxin among these farmers are documented and discussed, taking results from exposure determinant studies using stationary sampling approaches into consideration. Research needs are addressed from an epidemiological and industrial hygiene perspective. Published studies have been heterogeneous in design, and applied methodologies and results were frequently inadequately reported. Despite these limitations and the presence of an enormous variability in personal exposure to dust and endotoxin, no clear downward trends in exposure with time were observed, suggesting that working environments within stables remains largely uncontrolled. Exposure control and prevention strategies for livestock farmers are urgently required. These should focus on the development of novel and improved methods of controlling dust and endotoxin exposure within stables based on the currently available knowledge on determinants of exposure.
authors.affiliation: Section for Environment, Occupation and Health, Department of Public Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Basinas
authors.affiliation: Section for Environment, Occupation and Health, Department of Public Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Sigsgaard
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Kromhout
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.
authors.forename: Dick
authors.initials: D
authors.lastname: Heederik
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.
authors.forename: Inge M
authors.initials: IM
authors.lastname: Wouters
authors.affiliation: Section for Environment, Occupation and Health, Department of Public Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark.
authors.forename: Vivi
authors.initials: V
authors.lastname: Schlünssen
mesh_terms: D000395:Air Pollutants, Occupational / Q000032:analysis*; D000822:Animal Husbandry; D000818:Animals; D002417:Cattle; D004391:Dust / Q000032:analysis*; D004731:Endotoxins / Q000009:adverse effects / Q000032:analysis*; D004784:Environmental Monitoring / Q000379:methods; D006801:Humans; D019570:Inhalation Exposure; D058751:Livestock; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D011200:Poultry; D013552:Swine
chemical_list: D000395:Air Pollutants, Occupational; D004391:Dust; D004731:Endotoxins