Work-related Asthma in Crop Farmers

Sasho Stoleski; Jordan Minov; Jovanka Karadzinska-Bislimovska; Dragan Mijakoski; Aneta Atanasovska; Dragana Bislimovska

doi:10.3889/oamjms.2020.5255

Authors

Sasho Stoleski Center for Respiratory Functional Diagnostics, Institute for Occupational Health - Skopje, WHO Collaborating Center, Ga2len Collaborating Center, Skopje, Republic of Macedonia http://orcid.org/0000-0003-1278-903X
Jordan Minov Center for Respiratory Functional Diagnostics, Institute for Occupational Health - Skopje, WHO Collaborating Center, Ga2len Collaborating Center, Skopje, Republic of Macedonia
Jovanka Karadzinska-Bislimovska Center for Respiratory Functional Diagnostics, Institute for Occupational Health - Skopje, WHO Collaborating Center, Ga2len Collaborating Center, Skopje, Republic of Macedonia
Dragan Mijakoski Center for Respiratory Functional Diagnostics, Institute for Occupational Health - Skopje, WHO Collaborating Center, Ga2len Collaborating Center, Skopje, Republic of Macedonia
Aneta Atanasovska Center for Respiratory Functional Diagnostics, Institute for Occupational Health - Skopje, WHO Collaborating Center, Ga2len Collaborating Center, Skopje, Republic of Macedonia
Dragana Bislimovska Center for Respiratory Functional Diagnostics, Institute for Occupational Health - Skopje, WHO Collaborating Center, Ga2len Collaborating Center, Skopje, Republic of Macedonia

DOI:

https://doi.org/10.3889/oamjms.2020.5255

Keywords:

asthma, chronic respiratory symptoms, spirometry, crop farming, questionnaire, work-relatedness, allergic occupational asthma

Abstract

AIM: The objective of the study was to evaluate the influence of occupational exposure on asthma development among crop farmers.

METHODS: A cross-sectional study was performed, comprising 87 crop farmers, and 80 office workers, matched by gender and age. Evaluation of subjects included completion of a standard questionnaire on chronic respiratory symptoms, spirometry tests, histamine challenge, serial peak expiratory flow rates (PEFR) measurements, and skin prick tests to occupational and common inhalant allergens.

RESULTS: The prevalence of chronic respiratory symptoms in the past 12 months was higher, while the mean values of spirometric parameters were lower in crop farmers. Sensitization to workplace and common inhalant allergens was similar in both groups, whereas frequencies of bronchial hyperresponsiveness (BHR) and asthma were non-significantly higher in crop farmers. The prevalence of allergic was significantly higher compared to non-allergic asthma in both groups. Asthma was registered in 8% of crop farmers and was significantly associated with atopy, and positive family history of asthma. Occupational allergic asthma (OA) was registered in 2.3% of crop farmers, while the frequency of work-aggravated asthma was 5.7%. A causal relationship between workplace and asthma, suggesting allergic OA, was documented in two crop farmers with asthma, based on serial PEFR monitoring, but specific workplace agent causing asthma in the affected subjects was not identified.

CONCLUSION: The obtained results can contribute in the detection of critical points for action, and serve as a predictive factor in the development of work-related asthma, indicating the need for reduction of adverse occupational exposures through adequate preventive measures, regular health examinations, obligatory use of respiratory protective equipment, and implementation of engineering controls.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

Author Biography

Sasho Stoleski, Center for Respiratory Functional Diagnostics, Institute for Occupational Health - Skopje, WHO Collaborating Center, Ga2len Collaborating Center, Skopje, Republic of Macedonia

Sasho Stoleski graduated at the Medical Faculty in Skopje in 2002 and obtained a Master degree in 2009, and PhD degree in 2016. He is actively engaged in the educational process of the students of medicine, nurses, physiotherapists, and logopedists. He is employed in the Institute of occupational Health of Republic of Macedonia in the Center for respiratory functional diagnostics. At present he is Scientific Research Associate within the Chair of Occupational Medicine, Medical Faculty inSkopje. He is specialist in Occupational Medicine, and sub-specialist in pulmology and allergology. Actively involved in the research, expertâ€™s and scientific work of the Institute, dealing with actual challenges in occupational health, principles of functional diagnostics of respiratory system, occupational pulmology and allergology, industrial toxicology, ecology of work, and workplace risk assessment. He is a National Secretary of International Commission on Occupational Health (ICOH), and member of Macedonian Society of Occupational Health, Macedonian Respiratory Society, Macedonian Society of Basic, Clinical Immunology and Allergology, European Respiratory Society,EuropeanAcademyof Allergy and Clinical Immunology. Author and co-author of more than 180 titles published in domestic and international journals.

References

Tarlo SM, Balmes J, Balkisson R, Beach J, Beckett W, Bernstein D, et al. Diagnosis and management of work-related asthma. American college of chest physicians consensus statement. Chest. 2008;134(3):15-41. PMid:18779187 DOI: https://doi.org/10.1378/chest.08-0201

Tarlo SM, Lemiere C. Occupational asthma. N Engl J Med. 2014;370(7):640. PMid:24521110 DOI: https://doi.org/10.1056/NEJMra1301758

Dykewicz MS. Occupational asthma: Current concepts in pathogenesis, diagnosis, and management. J Allergy Clin Immunol. 2009;123:519. PMid:19281900 DOI: https://doi.org/10.1016/j.jaci.2009.01.061

Cvetanov V. Allergic Diseases in Republic of Macedonia. Skopje: Institute for Occupational Health, Macedonian Society of Basic and Clinical Immunology, Allergology; 2006.

Henneberger PK, Redlich CA, Callahan DB, Harber P, Lemière C, Martin J, et al. An official American thoracic society statement: Work-exacerbated asthma. Am J Respir Crit Care Med. 2011;184(3):368. https://doi.org/10.1164/rccm.812011st PMid:21804122 DOI: https://doi.org/10.1164/rccm.812011ST

Lemière C, Boulet LP, Chaboillez S, Forget A, Chiry S, Villeneuve H, et al. Work-exacerbated asthma and occupational asthma: Do they really differ? J Allergy Clin Immunol. 2013;131(3):704. https://doi.org/10.1016/j.jaci.2012.08.024 PMid:23058644 DOI: https://doi.org/10.1016/j.jaci.2012.08.024

Bernstein IL, Bernstein DI, Chan-Yeung M, Malo JL. Definition and classification of asthma in the workplace. In: Malo JL, Chan-Yeung M, Bernstein DI, editors. Asthma in the Workplace. 4th ed. Boca Raton, FL: CRC Press; 2013. p. 1-5. https://doi. org/10.1201/b15116-2 DOI: https://doi.org/10.1201/b15116-2

Cartier A, Bernstein D. Occupational Asthma: Definitions, Epidemiology, Causes and Risk Factors. United States; UpToDate; 2019.

Toren K, Blanc J. Asthma caused by occupational exposures is common: A systematic analysis of the population attribute able fraction. BMC Pulm Med. 2009;9:7. https://doi. org/10.1186/1471-2466-9-7 PMid:19178702 DOI: https://doi.org/10.1186/1471-2466-9-7

Mapp CE, Boschetto P, Maestrelli P, Fabbri L. Occupational asthma. Eur Respir Crit Care Med. 2005;172(3):280-305. https://doi.org/10.1164/rccm.200311-1575so PMid:15860754 DOI: https://doi.org/10.1164/rccm.200311-1575SO

Janson C, Anto J, Burney P, Chinn S, De Marco R, Heinrich J, et al. The European community respiratory health survey: What are the main results so far? European community respiratory health survey II. Eur Respir J. 2001;18(3):598-611. https://doi. org/10.1183/09031936.01.00205801 PMid:11589359 DOI: https://doi.org/10.1183/09031936.01.00205801

Minov J, Karadzinska-Bislimovska J, Vasilevska K, Risteska-Kuc S, Stoleski S. Occupational asthma in subjects occupationally exposed to herbal and fruit tea dust. Arh Hig Rada Toksikol. 2007;58(2):211-21. https://doi.org/10.2478/ v10004-007-0016-4 PMid:17562605 DOI: https://doi.org/10.2478/v10004-007-0016-4

Stoleski S, Minov J, Mijakoski D, Atanasovska A, Bislimovska D, Karadzinska-Bislimovska J. Specific work activities and exposure to respiratory hazards-predictors of lung function impairment among crop farmers. Open Access Maced J Med Sci. 2020;8:41-51. https://doi.org/10.3889/oamjms.2020.4641 DOI: https://doi.org/10.3889/oamjms.2020.4641

Tarlo SM, Malo JL. An official ATS proceedings: Asthma in the workplace. Proc Am Thorac Soc. 2009;6(4):339-49. PMid:19675344 DOI: https://doi.org/10.1513/pats.200810-119ST

Schenker MB. Farming and asthma. Occup Environ Med. 2005;62(4):211-2. PMid:15778250 DOI: https://doi.org/10.1136/oem.2004.019109

Arif AA. Occupational exposures associated with work-related asthma and work-related wheezing among US workers. Am J Ind Med. 2003;44(4):368-76. https://doi.org/10.1002/ajim.10291 PMid:14502764 DOI: https://doi.org/10.1002/ajim.10291

Chan-Yeung M, Malo JL. Table of major inducers of occupational asthma. In: Bernstein M, Chan-Yeung J, Malo L, Bernstein DI, editors. Asthma in the Workplace. New York: Marcel Dekker; 1993. p. 595-624. https://doi.org/10.1201/b15116

Beach J, Russel K, Blitz S, Hooton N, Spooner C, Lemiere C, et al. A systematic review of the diagnosis of occupational asthma. Chest. 2007;131(2):569-78. https://doi.org/10.1378/ chest.06-0492 PMid:17296663 DOI: https://doi.org/10.1378/chest.06-0492

Leduc D, Gris P, Lheureux P, Gevenois PA, DeVuyst P, Yernault PJ. Acute and long term respiratory damage following inhalation of ammonia. Thorax. 1992;47(9):755-7. https://doi. org/10.1136/thx.47.9.755 PMid:1440475 DOI: https://doi.org/10.1136/thx.47.9.755

Official Gazette of R.M. Rulebook on the List of Occupational Diseases. Geneva: Official Gazette of R.M; 2004. p. 88.

Minette A. Questionnaire of the European community for coal and steel (ECSC) on respiratory symptoms. 1987-updating of the 1962 and 1967 questionnaires for studying chronic bronchitis and emphysema. Eur Respir J. 1989;2(2):165-77. PMid:2703044 DOI: https://doi.org/10.1183/09031936.93.02020165

European Community Respiratory Health Survey. Variations in the prevalence of respiratory symptoms, self-reported asthma attacks, and use of asthma medication in the European respiratory health survey (ECRHS). Eur Respir J. 1996;9(4):687- 95. https://doi.org/10.1183/09031936.96.09040687 PMid:8726932 DOI: https://doi.org/10.1183/09031936.96.09040687

World Health Organization. Guidelines for Controlling and Monitoring the Tobacco Epidemic. Geneva: World Health Organization; 1998.

Smoking Pack-years; 2013. Available from: http://www. smokingpackyears.com/calculate. [Last accessed on 2020 Feb 15].

US Department of Health and Human Services. The Health Consequences of Smoking: Chronic Obstructive Pulmonary Disease. A report of the Surgeon General; 1984. Available from: http://www.profiles.nlm.nih.gov/ps/access/NNBCCS.pdf. [Last accessed on 2020 Feb 16].

van Kampen V, de Blay F, Folletti I, Kobierski P, Moscato G, Olivieri M, et al. EAACI position paper: Skin prick testing in the diagnosis of occupational Type I allergies. Allergy. 2013;34:580- 4. https://doi.org/10.1111/all.12120 DOI: https://doi.org/10.1111/all.12120

Quajner H, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows: Official statement of the European respiratory society. Eur Respir J. 1993;16(1):1-100. DOI: https://doi.org/10.1183/09041950.005s1693

Sterk PJ, Fabbri LM, Quanjer PH, Cockcroft DW, O’Byrne PM, Anderson SD, et al. Standardized challenge testing with pharmacological, physical and sensitizing stimuli in adults. Report working party for the standardization of lung function tests. European community for steel and coal. Official statement of the European respiratory society. Eur Respir J. 1993;6(S16):53-83. https://doi.org/10.1183/09041950.053s1693 PMid:8499055 DOI: https://doi.org/10.1183/09041950.053s1693

Crapo RO, Casaburi R, Coates AL, Enright PL, Hankinson JL, Irvin CG, et al. Guidelines for metacholine and exercise challenge testing-1999. Official statement of the American thoracic society. Am Respir Crit Care Med. 2000;161(1):309-29. https://doi.org/10.1164/ajrccm.161.1.ats11-99 PMid:10619836 DOI: https://doi.org/10.1164/ajrccm.161.1.ats11-99

National Institutes of Health, National Heart, Lung, and Blood Institute. Definition, description, and diagnosis of asthma. In: Global Initiative for Asthma: Global Strategy for Asthma Management and Prevention. United States: National Institutes of Health, National Heart, Lung, and Blood Institute; 2019. p. 1-11.

Gannon PF, Burge PS. Serial peak expiratory flow measurement in the diagnosis of occupational asthma. Eur Respir J Suppl. 1997;10:57-63. PMid:9098712

Kogevinas M, Anto J, Soriano JB, Tobias A, Burney P. The risk of asthma attributable to occupational exposures. A population based study in Spain. Am J Respir Crit Care Med. 1996;154(1):137-43. https://doi.org/10.1164/ ajrccm.154.1.8680669 PMid:8680669 DOI: https://doi.org/10.1164/ajrccm.154.1.8680669

Fishwick D, Perace N, D’Souza W, Lewis S, Town I, Armstrong R, et al. Occupational asthma in New Zealanders: A population based study. Occup Environ Med. 1997;54(5):301-6. PMid:9196450 DOI: https://doi.org/10.1136/oem.54.5.301

Crane J, Lewis S, Slater T, Crossland L, Robson B, D’Souza W, et al. The self-reported prevalence of asthma symptoms amongst adult New Zealanders. N Z Med J 1994;107(988):417-21. PMid:7970336

de Meer G, Kerkhof M, Kromhout H, Schouten JP, Heederik D. Interaction of atopy and smoking on respiratory effects of occupational dust exposure: A general populationbased study. Environ Health. 2004;3(1):6. https://doi. org/10.1186/1476-069x-3-6 PMid:15175108 DOI: https://doi.org/10.1186/1476-069X-3-6

Romanet-Manent S, Charpin D, Magnan A, Lanteaume A, Vervloet D. Allergic vs. non-allergic asthma; what makes the difference? Allergy. 2002;57(7):607-13. https://doi. org/10.1034/j.1398-9995.2002.23504.x PMid:12100301 DOI: https://doi.org/10.1034/j.1398-9995.2002.23504.x

Karadzinska-Bislimovska J, Cvetanov V, Petrovska J, Todorov S, Risteska-Kuc S. Respiratory symptoms and positive skin prick test in a prospective asthma study in republic of Macedonia (initial results). Eur Respir J. 1999;14(30):78.

Wieringa MH, Weiler JJ, van Bastelaer FJ, Nelen VJ, Van Sprundel MP, Vermeire PA, et al. Higher asthma occurrence in an urban than a suburban area: Role of house dust mite skin allergy. Eur Respir J. 1997;10(7):1460-6. https://doi.org/10.1183 /09031936.97.10071460 PMid:9230231 DOI: https://doi.org/10.1183/09031936.97.10071460

Malo JL, Chan-Yeung M, Bernstein D. Asthma in the Workplace. 4th ed. United States: CRC Press, Taylor & Francis Group; 2013. DOI: https://doi.org/10.1201/b15116

Karjalainen A, Kurpa K, Martikanen R. Work is related to a substantial portion of adult-onset asthma: Incidence in Finnish population. Am J Respir Crit Care Med. 2001;164:565-8. https:// doi.org/10.1164/ajrccm.164.4.2012146 DOI: https://doi.org/10.1164/ajrccm.164.4.2012146

Johnson AR, Dimich-Ward HD, Mantreda J, Klaukka T, Karjalainen J. Occupational asthma in adults in six Canadian communities. Am J Respir Crit Care Med. 2000;162(4):2058-62. https://doi.org/10.1164/ajrccm.162.6.9805079 PMid:11520716 DOI: https://doi.org/10.1164/ajrccm.162.6.9805079

Blanc PD, Toren K. How much adult asthma can be attributed to occupational factors? Am J Med. 1999;107(6):580-7. https://doi. org/10.1016/s0002-9343(99)00307-1 PMid:10625027 DOI: https://doi.org/10.1016/S0002-9343(99)00307-1

Blanc PD, Ellbjar S, Janson C, Norbäck D, Norrman E, Plaschke P, et al. Asthma-related disability in Sweden. Am J Respir Crit Care Med. 1999;160(6):2028-33. https://doi. org/10.1164/ajrccm.160.6.9901033 PMid:10588624 DOI: https://doi.org/10.1164/ajrccm.160.6.9901033

Leuenberger P, Schindler C, Schwartz J, Ackermann-Liebrich U, Tara D, Perruchoud AP, et al. Occupational exposure to inhalative irritants and metacholine responsiveness. Scand J Work Environ Health. 2000;26(2):146-52. https://doi.org/10.5271/sjweh.524 PMid:10817380 DOI: https://doi.org/10.5271/sjweh.524

Nemery B. Occupational asthma for the clinician. Breath. 2004;1(1):25-33. DOI: https://doi.org/10.1183/18106838.0101.25

Chen-Yeung M. Assessment of asthma in the workplace. ACCP consensus statement. American college of chest physicians. Chest. 1995;108(4):1084-117. https://doi.org/10.1378/chest.108.4.1084 PMid:7555124 DOI: https://doi.org/10.1378/chest.108.4.1084

Stoleski S, Minov J, Karadzinska-Bislimovska J, Mijakoski D, Atanasovska A, Bislimovska D. Asthma and chronic obstructive pulmonary disease associated with occupational exposure in dairy farmers-importance of job exposure matrices. Open Access Maced J Med Sci. 2019;7(14):2350-9. https://doi. org/10.3889/oamjms.2019.630 PMid:31592062 DOI: https://doi.org/10.3889/oamjms.2019.630

Stoleski S, Minov J, Karadzinska-Bislimovska J, Mijakoski D. Respiratory symptoms, lung function impairment, and chronic respiratory diseases among crop farmers: Assessment by job exposure matrices. EMJ Respir. 2016;4(1):72-80. https://doi. org/10.1183/13993003.congress-2015.pa1180

Larbanois A, Jamari J, Delwiche JP, Vandenplas O. Socioeconomic outcome of subjects experiencing asthma symptoms at work. Eur Respir J. 2002;19(6):1107-13. https:// doi.org/10.1183/09031936.02.00272202a PMid:12108864 DOI: https://doi.org/10.1183/09031936.02.00272202a

Tarlo SM, Leung K, Broder I, Silverman F, Holness DL. Asthmatic subjects symptomatically worse at work: Prevalence and characterization among a general asthma clinic population. Chest. 2000;118(5):1309-14. https://doi.org/10.1378/ chest.118.5.1309 PMid:11083679 DOI: https://doi.org/10.1378/chest.118.5.1309

Saarinen K, Uitti J, Tammilehto L. Work-related exacerbation of symptoms of established asthma: A population-based survey. Eur Respir J. 2001;18(33):277-8.

Plaschke PP, Janson C, Norrman E. Onset and remission of allergic rhinitis and asthma and the relationship with atopic sensitization and smoking. Am J Respir Crit Care Med. 2000;162(3):920-4. https://doi.org/10.1164/ ajrccm.162.3.9912030 PMid:10988106 DOI: https://doi.org/10.1164/ajrccm.162.3.9912030

Vandenplas O, Toren K, Blanc PD. Health and socioeconomic impact of work-related asthma. Eur Respir J. 2003;22(4):853- 60. https://doi.org/10.1183/09031936.03.00053203 PMid:14582924 DOI: https://doi.org/10.1183/09031936.03.00053203

Vandenplas O, Malo JL. Definitions and types of work-related asthma: A nosological approach. Eur Respir J. 2003;21(4):706- 12. https://doi.org/10.1183/09031936.03.00113303 PMid:12762361 DOI: https://doi.org/10.1183/09031936.03.00113303