title: Occupational Exposure to Swine, Poultry, and Cattle and Antibody Biomarkers of Campylobacter jejuni Exposure and Autoimmune Peripheral Neuropathy.
abstract: BACKGROUND
  Foodborne Campylobacter jejuni infection has been associated with an increased risk of autoimmune peripheral neuropathy, but risks of occupational exposure to C. jejuni have received less attention. This study compared anti-C. jejuni IgA, IgG, and IgM antibody levels, as well as the likelihood of testing positive for any of five anti-ganglioside autoantibodies, between animal farmers and non-farmers. Anti-C. jejuni antibody levels were also compared between farmers with different animal herd or flock sizes. The relationship between anti-C. jejuni antibody levels and detection of anti-ganglioside autoantibodies was also assessed.
  
  
  METHODS
  Serum samples from 129 Agricultural Health Study swine farmers (some of whom also worked with other animals) and 46 non-farmers, all from Iowa, were analyzed for anti-C. jejuni antibodies and anti-ganglioside autoantibodies using ELISA. Information on animal exposures was assessed using questionnaire data. Anti-C. jejuni antibody levels were compared using Mann-Whitney tests and linear regression on log-transformed outcomes. Fisher's Exact Tests and logistic regression were used to compare likelihood of positivity for anti-ganglioside autoantibodies.
  
  
  RESULTS
  Farmers had significantly higher levels of anti-C. jejuni IgA (p < 0.0001) and IgG (p = 0.02) antibodies compared to non-farmers. There was no consistent pattern of anti-C. jejuni antibody levels based on animal herd or flock size. A higher percentage of farmers (21%) tested positive for anti-ganglioside autoantibodies compared to non-farmers (9%), but this difference was not statistically significant (p = 0.11). There was no significant association between anti-C. jejuni antibody levels and anti-ganglioside autoantibodies.
  
  
  CONCLUSIONS
  The findings provide evidence that farmers who work with animals may be at increased risk of exposure to C. jejuni. Future research should include longitudinal studies of exposures and outcomes, as well as studies of interventions to reduce exposure. Policies to reduce occupational exposure to C. jejuni should be considered.
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
authors.forename: Leora
authors.initials: L
authors.lastname: Vegosen
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
authors.forename: Patrick N
authors.initials: PN
authors.lastname: Breysse
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Agnew
authors.affiliation: Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, United States of America.
authors.forename: Gregory C
authors.initials: GC
authors.lastname: Gray
authors.affiliation: Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America.
authors.forename: Irving
authors.initials: I
authors.lastname: Nachamkin
authors.affiliation: Department of Neurology, University of Texas Medical School, Houston, TX, United States of America.
authors.forename: Kazim
authors.initials: K
authors.lastname: Sheikh
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Research Triangle Park, NC, United States of America.
authors.forename: Freya
authors.initials: F
authors.lastname: Kamel
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
authors.forename: Ellen
authors.initials: E
authors.lastname: Silbergeld
mesh_terms: D000818:Animals; D001323:Autoantibodies / Q000032:analysis*; D020274:Autoimmune Diseases of the Nervous System / Q000382:microbiology; D002169:Campylobacter Infections / Q000276:immunology*; D016123:Campylobacter jejuni / Q000276:immunology*; D002417:Cattle / Q000382:microbiology; D005260:Female; D005516:Food Microbiology; D005732:Gangliosides / Q000276:immunology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016273:Occupational Exposure / Q000032:analysis* / Q000706:statistics & numerical data; D010523:Peripheral Nervous System Diseases / Q000276:immunology* / Q000382:microbiology; D011200:Poultry / Q000382:microbiology; D013552:Swine / Q000382:microbiology
chemical_list: D001323:Autoantibodies; D005732:Gangliosides