Chronic obstructive pulmonary disease in never-smoking animal farmers working inside confinement buildings

Background In animal farming, respiratory disease has been associated with indoor air contaminants and an excess in FEV1 decline. Our aim was to determine the characteristics and risk factors for chronic obstructive pulmonary disease (COPD) in never-smoking European farmers working inside animal confinement buildings. Methods A sample of participants in the European Farmers' Study was selected for a cross-sectional study assessing lung function and air contaminants. Dose-response relationships were assessed using logistic regression models. Results COPD was found in 18 of 105 farmers (45.1 SD 11.7 years) (17.1%); 8 cases (7.6%) with moderate and 3 cases (2.9%) with severe disease. Dust and endotoxin showed a dose-response relationship with COPD, with the highest prevalence of COPD in subjects with high dust (low = 7.9%/high = 31.6%) and endotoxin exposure (low = 10.5%/ high = 20.0%). This association was statistically significant for dust in the multivariate analysis (OR 6.60, 95% CI 1.10-39.54). Conclusion COPD in never-smoking animal farmers working inside confinement buildings is related to indoor dust exposure and may become severe. (C) 2004 Wiley-Liss, Inc.