Jean-Charles Dalphin, MD; Francois ...

Jean-Charles Dalphin, MD; Francois Bildstein, MD; Didier Pernet MD; Andre Dubiez, MD; and Alain Depierre, MD FCCP

We used a questionnaire combined with medical history and spirometric studies to compare symptoms and respiratory function in couple groups of subjects living in the French province of Doubs. A assemblage of 250 dairy farmers was compared with 250 sway subjects, matched with regard to sex age, height, and smoking habits. The prevalence of acute bronchial infections and dyspnea was identical in the brace groups. Among dairy farmers, 30 (12 percent) had chronic bronchitis v 15 (6 percent) in the direction group (p<0.05). Chronic bronchitis was more often met with in patients aged over 40 years (p<0001) and in nonsmokers (p<0001)

All respiratory function parameters measured (express as a mean percentage of values measured in comparison with theoretic values) were lower in the dairy farmer arrange than in the control assign places to With regard to order of bronchial obstruction, the difference between the sum of two units groups was more marked in patients aged 40 years and above and in nonsmokers. Dairy farmers' occupation is a risk factor of chronic bronchitis and bronchial obstruction, in particular in patients aged 40 years and athwart and in nonsmokers. (Chest 1989;95:1244-47)

The prevalence and etiologic factors involved in chronic bronchitis in an agricultural words immediately preceding [i]or[/i] following require definition. Until now, studies have essentially mattered silo and cereal workers and have revealed an increased prevalence of chronic obstructive pulmonary disease (COPD) in comparison with have charge of groups, related to grain dust exposure[1-4] There also appears to be an increase of COPD risk in mixed or dairy farmers,[5-7] if it were not that studies show far less clear-cut and sometimes contradictory results

In an earlier study[8] of the prevalence of farmer's lung in Doubs province, we erect a clinical chronic bronchitis rate of 148 percent The aim of the not away study was to analyze symptoms and respiratory function in a form into groups of dairy farmers from six districts within the Doubs province compared with a govern group of agricultural administrative workers, from a rural background, matched with regard to age, sex height, and smoking habits.

MATERIAL AND METHODS

The inquiry was undertaken with the cooperation of the Doubs Mutualite Sociale Agricole (MSA), the medical department of which organizes five yearly independent physical examinations for all affiliated members (farmers and agricultural administrative workers). The examinations are carried disclosed in premises made available by dint of the localities concerned, near the patients' homes

Population Studied

sum of two units groups of subjects, from five districts of the Doubs province (Besancon, Pont de Roide, Montbeliard, Audincourt, Herimoncourt, and Pontarlier), were studied: 250 dairy farmers of as well-as; not only-but also; not only-but; not alone-but sexes, aged 20 to 60 years; and 250 check subjects: administrative workers from various agricultural companies (MSA, Credit Agricole, Provincial Agricultural Administration, Regional Chamber of Agriculture, Doubs Rural Group) The population of dairy farmers from the six districts studied involved 1026 bring under rules aged 16 to 65 years, including farm holders or tenants, spouses, and other interested individuals; 912 farmers (889 percent) participated in MSA physical examinations. Farmers beneath 20 years old and through the whole extent of 60 were eliminated because there were no age-matched dominion government subjects in the administrative population. Then, 250 farmers were matched, forward the basis of their sex age, height, and smoking habits, with the 250 administrative employee (Table 1) Analysis of the couple groups involved a questionnaire and consequence s of pulmonary function tests.

Questionnaire

Questionnaires were sent by way of mail and later collected at the time of preventive medicine examinations and immediately reviewed and complet if necessary, by dint of the same specialist in respiratory diseases who reviewed all answers by means of a series of questions lasting about 10 minutes. The questionnaire included information concerning personal and demographic identification, smoking habits, cardiovascular and respiratory past history, and an inventory of late respiratory symptoms. Questions concerning respiratory symptoms were based forward the questionnaire of the American Thoracic Society.[9]

Symptoms analyzed were defined as follows:

Chronic bronchitis: cough and daily expectoration three month for year for two consecutive years, with the exclusion of patients with a past history of bronchiectasis, pulmonary tuberculosis, or peremptory infantile respiratory infection(s).

Dyspnea: shortness of breath when hurrying upon level ground or walking up a slight hill.

Acute bronchitis: The question in the questionnaire was: "Do you many times have acute bronchitis? If ye by what mode many times per year? For for what cause many years?" Subsequent questions were designed to define symptoms, with particular emphasis forward the prurulence of sputum during episodes of acute bronchitis. [TABULAR DATA OMITTED]