title: Impact of farm modernity on the prevalence of chronic obstructive pulmonary disease in dairy farmers.
abstract: Dairy farming is associated with an excess of chronic obstructive pulmonary disease (COPD). The dairy industry has been changing for the past three decades with larger, more efficient farms and potentially less exposure to agents involved in COPD development. However, the impact of farm modernisation on COPD prevalence is unknown. We studied respiratory symptoms, respiratory function by spirometry and tobacco smoking in 575 male dairy farmers working either in traditional or in modern farms in the French Doubs region. COPD was defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criterion (forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) <0.70) and by the Quanjer reference equation (FEV1/FVC<lower limit of normal (LLN)). Modern farms were defined either as having a separation between the house and the cowshed (model 1) or as having a loose housing system for the animals (model 2). The prevalence of COPD in dairy farmers was 12.0 ± 2.7% (GOLD), and 5.6 ± 4.1% (LLN definition). By multivariate analysis using the LLN definition, tobacco smoking (OR (95% CI) 3.96 (1.53 to 10.3) and 3.42 (1.32 to 8.84) for models 1 and 2, respectively) and characteristics of traditional farms (1.97 (1.02 to 4.47) and 5.20 (1.73 to 15.64) for models 1 and 2, respectively) were associated with higher COPD prevalence. Working in a traditional farm plus current smoking had an additive effect on COPD prevalence in model 1 and a synergistic effect in model 2. These findings support a positive impact of farm modernity on COPD prevalence in dairy farmers. Occupational and smoking-related risk factors are of nearly the same magnitude.
authors.affiliation: Department of Respiratory Diseases, University Hospital, Besançon, France.
authors.forename: Alexia
authors.initials: A
authors.lastname: Marescaux
authors.affiliation: Department of Physiology, University Hospital, Besançon, France EA 3920, Université de Franche-Comté, Besançon, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Degano
authors.affiliation: Department of Respiratory Diseases, University Hospital, Besançon, France.
authors.forename: Thibaud
authors.initials: T
authors.lastname: Soumagne
authors.affiliation: Department of Occupational Diseases, University Hospital, Vandœuvre-lès-Nancy, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Thaon
authors.affiliation: Mutualité Sociale Agricole, Besançon, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Laplante
authors.affiliation: Department of Respiratory Diseases, University Hospital, Besançon, France UMR CNRS Chrono-Environnement, Université de Franche-Comté, Besançon, France.
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Dalphin
mesh_terms: D000382:Agricultural Workers' Diseases / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D000397:Air Pollution / Q000009:adverse effects / Q000517:prevention & control*; D000818:Animals; D003612:Dairying; D004391:Dust; D000067565:Farmers; D005541:Forced Expiratory Volume; D005602:France / Q000453:epidemiology; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control*; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013147:Spirometry; D014797:Vital Capacity; D014937:Work
chemical_list: D000395:Air Pollutants, Occupational; D004391:Dust