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Table 1 Risk of asthma, rhinitis and respiratory symptoms and sensitization in farmers working with large animals: studies from 2000

From: Respiratory diseases and allergy in farmers working with livestock: a EAACI position paper

References/country Study design Subjects (n) Participation rate (%) Age (years) Animal exposures Methods for defining rhinitis Methods for defining asthma Atopy assessment Risk factors WR asthma/rhinitis/respiratory symptoms: OR in farmers exposed to large animals (95% CI)
[8]/Denmark 2011 (SUS study) Nested case–control study
4 years of FU
107 cases
102 controls
  20¤ Swine dairy and chickens Not done SUS algorithm SPT Swine
Dairy
New-onset asthma
Exposure during FU: swine 3.4 (1.6–7.0)
Dairy 2.5 (1.1–5.3)
Corrected for Childhood exposure
[42]/Denmark 2018 (SUS study) Follow up at age 35 for new onset sensiti-sation to common allergens; 15 years 1113 (of 1166) 50 20¤ Swine dairy and chickens Not done   SPT and IgE Endotoxin and dust
Animal exposure
Endotoxin exp in quartiles associated to
SPT: less sensitisation to cat allergens OR 0.1 → 0.6 and a tendency to increased loss of sen. to grass OR 3 → 4.2
IgE: less sensitisation to common allergens OR 0.4 → 0.8 and a tendency to increased loss of sense. Corrected for childhood exposure
[41]/Denmark 2018 (SUS study) Follow up age 35 for new onset Lep D sensitisation 15 years FU 1116 (of 1166) 50 20¤ Swine dairy and chickens Not done   SPT and IgE Endotoxin and dust
Animal exposure
Endotoxin exp in quartiles associated to
SPT: more sensitisation
OR 1.9 → 2.3 and decreased loss of sensitisation OR 0.1 → 0.2
IgE: more sensitisation OR 5 → 7 and decreased loss of sensitisation OR 0.1 → 0.7 Corrected for childhood exp
[56]/Germany, Denmark, Switzerland, Spain 2001 Cross-sectional 6156 61–80 48 Pig farmers Q for nasal irritation Q for wheezing Not stated Pig farmers only Wheezing: pig farmers only 1.5 (1.2–2.0)
Nasal irritation: pig farmers only 1.5 (1.2–1.9)
[15]/Turkey 2002 Cross-sectional 125 62 37 Grooms Q Q, Not stated Asthma: sensitization to horse hair
Allergic rhinitis and conjunctivitis: being in the grooms group
Asthma: sensitization to horse hair 4.5 (1.5–13.3)
Allergic rhinitis: groom 1.8 (1.0–3.1)
Allergic conjunctivitis: groom 3.9 (1.6–6.6)
[141]/USA 2003 Cross-sectional 22,756 44 16–88 Beef cattle
Dairy cattle
Pig
Not reported Q Q Wheeze: n. of animals on the farm, frequency of veterinary procedures, age, atopy
Asthma: atopy
Wheeze: beef cattle 1.1 (0.98–1.1)
Dairy cattle 1.3 (1.1–1.5) pig 1.1 (1.03–1.2)
Any animal 1.1 (1.04–1.2)
[17]/Germany 2003 Cross-sectional 325 82 50 Sheep and other animals 37%
Sheep shearing 24%
Sheep dip 27%
Chemical footbaths 66%
Q Q Q Asthma-related sx: full time farming Nasal allergy: 3.2 (2.1–4.6)
Asthma-related sx 2.3 (1.2–4.3)
[16] USA 2009 Cross-sectional 82
72
80
34
41
38
Horse barns Not done Not Stated   Equine barn exposure 0; 1–10 and > 10 h/week
Respiratory sx and nasal irritation: family history of respiratory problems and history of allergies
Respiratory sx: 2.3 (0.6–9.8) and 8.9 (3.3–32.3) in low and high exp
Nasal irritation: 0.4 (0.6–1.5) & 3.5 (1.1–10.6) in low and high exposure
In both analyses, family history of respiratory problems and history of allergies showed a significant association to increased symptoms OR of 5.3 and 8 for respiratory problems and 2.7 and 3.6 for Nasal irritation
[142]/USA 2017 Cross-sectional 11,210 71* 59.8 Crop 54%
Livestock 46%
Not done Rhinitis and Asthma D.D. Not reported Bale hay, Manure storage, grain, animals pesticides Asthma and Rhinitis ass. to Pesticide spraying OR 1.9 (1.4–2.5)
Rhinitis alone 1.3 (1.2–1.5)
Ass to manure storage OR 0.71 (0.1–0.96)
  1. Q Questionnaire, WR work-related, sx symptoms, SPT skin prick tests, IgE immunoglobulin E tests, OR odd ratios, exp exposure
  2. * After exclusion of non-active farmers
  3. ¤At baseline