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Occupational and Environmental Lung Disease |

Longitudinal Changes in Bronchial Responsiveness Associated With Swine Confinement Dust Exposure*

Peter F. J. Vogelzang, MD, PhD; Joost W. J. van der Gulden, MD, PhD; Hans Folgering, MD, PhD; Dick Heederik, PhD; Martin J. M. Tielen, PhD; Constant P. van Schayck, PhD
Author and Funding Information

*From the Department of General Practice and Social Medicine (Drs. Vogelzang, van der Gulden, and van Schayck), and the Department of Pulmonology Dekkerswald (Dr. Folgering), University of Nijmegen; the Department of Environmental and Occupational Health (Dr. Heederik), University of Wageningen; and the Department of Herd Health and Reproduction (Dr. Tielen), University of Utrecht, The Netherlands.

Correspondence to: Peter F. J. Vogelzang, MD, PhD, Department of General Practice and Social Medicine, HSV 229, University of Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands; e-mail P.Vogelzang@hsv.kun.nl



Chest. 2000;117(5):1488-1495. doi:10.1378/chest.117.5.1488
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Study objectives: Acute exposure to the air in swine confinement units causes bronchial hyperresponsiveness and inflammation of the airways. This study was performed to assess the longitudinal development of bronchial responsiveness in pig farmers and to establish exposure-response relationships.

Methods: A cohort of 171 pig farmers was followed over a 3-year period. Bronchial responsiveness was assessed by a histamine provocation test. Long-term average exposure to inhalable dust and endotoxin was determined by personal monitoring in summer and winter, using data on farm characteristics and activities. Time-weighted average (TWA) personal exposure to ammonia was measured. Data on farm characteristics were gathered in the same period.

Results: Mean increase in responsiveness was 2.52 doubling concentrations of histamine for a 10% decrease in FEV1 and 1.36 doubling concentrations for a 20% decrease in FEV1. Long-term average exposure to dust was 2.63 mg/m3 and to endotoxin was 105 ng/m3. TWA exposure to ammonia was 1.60 mg/m3. After adjusting for age and smoking behavior, long-term average exposure to inhalable dust was associated with increases in bronchial responsiveness expressed as steps for provocative concentration causing 10% fall in FEV1. TWA exposure to ammonia, use of wood shavings as bedding, and automated dry feeding were associated with increases in responsiveness expressed as steps for provocative concentration causing a 20% fall in FEV1.

Conclusions: Exposure to dust and ammonia in pig farms contributes to chronic inflammation of the airways and should be reduced.

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