Do farming exposures cause or prevent asthma? Results from a study of adult Norwegian farmers
Do farming exposures cause or prevent asthma? Results from a study of adult Norwegian farmers
复制标题
DOI：
10.1136/thx.2004.013326
复制
发表时间：
2004-05-01
期刊：
影响因子：
10
通讯作者：
Heederik, D
中科院分区：
文献类型：
--
作者：
Eduard, W;Douwes, J;Heederik, D
背景：内毒素暴露对农民儿童的特应性和哮喘具有保护作用。对成年农民的研究显示了相互矛盾的结果，但往往缺乏接触数据。比较了不同微生物制剂和刺激性气体暴露水平的农民的哮喘患病率。方法：特应性定义为对10种常见呼吸道变应原的多项放射过敏抗体试验(RAST)呈阳性反应，哮喘通过对挪威东南部农业人口的分层样本(n=2169)进行问卷调查来确定。通过暴露测量评估农民对总粉尘、真菌孢子、细菌、内毒素和氨的暴露。结果：内科医生诊断的哮喘患病率为3.7%，当前哮喘的患病率为2.7%。特应性的患病率为14%，但大多数哮喘患者都是非特应性的(80%)。与不饲养牲畜的农民相比，(1)养牛农民(ORADJ 1.8，95%CI 1.1~2.8)和养猪农民(ORADJ 1.6，95%CI 1.0~2.5)的哮喘发病率显著升高；(2)养猪户(ORADJ 2.0，95%CI 1.2~3.3)和有两种或两种以上牲畜的农民(ORADJ 1.9，95%CI 1.1~3.3)的非过敏性哮喘显著增高。(3)特应性哮喘在有两种或两种以上牲畜的农民中较少见(ORADJ 0.32，95%CI 0.11~0.97)。暴露于内毒素、真菌孢子和氨气与非特应性哮喘呈正相关，与特应性哮喘呈负相关。结论：暴露于内毒素和真菌孢子似乎对特应性哮喘有保护作用，但可能会诱发农民的非特应性哮喘。
Background: A protective effect of endotoxin exposure on atopy and asthma in farmers' children has been postulated. Studies of adult farmers have shown conflicting results but often lack exposure data. The prevalence of asthma in farmers with different exposure levels to microbial agents and irritant gases was compared.Methods: Atopy was defined as a positive response to multiple radioallergosorbent tests (RAST) with a panel of 10 common respiratory allergens, and asthma was ascertained by a questionnaire using a stratified sample (n = 2169) of a farming population from south-eastern Norway. Exposure of farmers to total dust, fungal spores, bacteria, endotoxins, and ammonia was assessed by exposure measurements.Results: The prevalence of asthma was 3.7% for physician diagnosed asthma and 2.7% for current asthma. The prevalence of atopy was 14%, but most asthmatic subjects were non-atopic (80%). Compared with farmers without livestock, ( 1) asthma was significantly higher in cattle farmers (ORadj 1.8, 95% CI 1.1 to 2.8) and pig farmers (ORadj 1.6, 95% CI 1.0 to 2.5), (2) non-atopic asthma was significantly higher in pig farmers (ORadj 2.0, 95% CI 1.2 to 3.3) and in farmers with two or more types of livestock (ORadj 1.9, 95% CI 1.1 to 3.3), and ( 3) atopic asthma was less common in farmers with two or more types of livestock (ORadj 0.32, 95% CI 0.11 to 0.97). Exposure to endotoxins, fungal spores, and ammonia was positively associated with non-atopic asthma and negatively associated with atopic asthma. No associations were found with atopy.Conclusions: Exposure to endotoxins and fungal spores appears to have a protective effect on atopic asthma but may induce non-atopic asthma in farmers.