title: Chronic obstructive pulmonary disease in never-smoking dairy farmers.
abstract: BACKGROUND
  Work-related chronic obstructive pulmonary disease (COPD) represents a considerable part of the disease burden globally.
  
  
  OBJECTIVE
  To assess the COPD prevalence and characteristics in never-smoking dairy farmers.
  
  
  METHODS
  We have conducted a cross-sectional study with 75 male dairy farmers aged 26 to 59 years, and compared them with equivalent number of male office workers similar by age, and duration of employment. Data on chronic respiratory symptoms, job history and daily activities were obtained by questionnaire. Lung functional testing of the examined subjects included baseline spirometry, and bronchodilator reversibility measurement.
  
  
  RESULTS
  Dairy farmers showed higher prevalence of overall respiratory symptoms, but significant difference was noticed for cough, phlegm, and dyspnea. Dairy farmers had more prevalent work-related respiratory symptoms, being significant for overall symptoms, cough, and phlegm. The mean baseline values of spirometric parameters were lower in dairy farmers, but significance was reported for FEV1/FVC%, MEF50, MEF75, and MEF25-75. Dairy farmers had significantly higher COPD prevalence than office controls (10.7% vs 2.7%, P = 0,049). Dairy farmers and office controls showed significant association between COPD and age over 45 years. Dairy farmers had a significant association between COPD and employment duration of over 20 years (P = 0.023), but also between COPD and work-related chronic respiratory symptoms (P = 0.041).
  
  
  CONCLUSIONS
  The study findings favor the cause-effect association between job exposure to respiratory hazards, and development of persistent airway obstruction among dairy farmers.
authors.affiliation: Institute for Occupational Health of R. Macedonia - Skopje, WHO Collaborating Center, GA2LEN Collaborating Center, R. Macedonia.
authors.forename: Saso
authors.initials: S
authors.lastname: Stoleski
authors.affiliation: Institute for Occupational Health of R. Macedonia - Skopje, WHO Collaborating Center, GA2LEN Collaborating Center, R. Macedonia.
authors.forename: Jordan
authors.initials: J
authors.lastname: Minov
authors.affiliation: Institute for Occupational Health of R. Macedonia - Skopje, WHO Collaborating Center, GA2LEN Collaborating Center, R. Macedonia.
authors.forename: Jovanka
authors.initials: J
authors.lastname: Karadzinska-Bislimovska
authors.affiliation: Institute for Occupational Health of R. Macedonia - Skopje, WHO Collaborating Center, GA2LEN Collaborating Center, R. Macedonia.
authors.forename: Dragan
authors.initials: D
authors.lastname: Mijakoski
keywords: Airflow limitation; bronchodilator testing; farming; job exposure; questionnaire; spirometry