Chronic Obstructive Pulmonary Disease (COPD) is a major health concern. The majority of COPD is caused by cigarette smoking. However, occupational exposures can also lead to the development of COPD in approximately 30% of patients. One industry where occupational exposures frequently lead to lung disease is agriculture. The Omaha Veteran’s Administration Hospital (OVAH) serves a largely rural area and many patients have worked in agriculture. However, there are no good estimates of the number of COPD patients with a history of agricultural exposure in our area.
We identified a cohort of patients with COPD by reviewing all pulmonary function tests done at the OVAH between November 2004 and March 2005. Obstructive lung disease was defined as a FEV1/FVC ratio of ≤ 70% and FEV1 ≤ 80% as per GOLD Criteria. A random sample of this cohort was administered a telephone survey based on NHANES III questionnaire. It detailed demographic data, smoking history, pulmonary symptoms and history of agricultural exposures.
Participants included 150 veterans with a mean age of 68.2 (standard deviation=10.8). A history of agricultural exposure was elicited in 68% (95% confidence interval: 61%-75%) of subjects. Of those that had worked in agriculture, the types of exposures varied, with 21% working in hog confinement barns, 30% on dairy farms, 12% on poultry farms.
In health systems that serve rural areas, patients with COPD commonly have a history of agricultural exposures. Exposures such as these can contribute to the development of COPD.
Health care workers in rural areas should include agricultural exposures as an important part of the social/occupational history in COPD patients.
Kristina Bailey, None.