THE ROLE OF OCCUPATIONAL EXPOSURE TO ANIMAL PRODUCTION IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE AMONG FARMERS IN IOWA AND NORTH CAROLINA

Rinsky, Jessica

THE ROLE OF OCCUPATIONAL EXPOSURE TO ANIMAL PRODUCTION IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE AMONG FARMERS IN IOWA AND NORTH CAROLINA

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March 19, 2019

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Rinsky, Jessica
- Affiliation: Gillings School of Global Public Health, Department of Epidemiology

Abstract

Individuals who work in animal production may be exposed to respiratory hazards including high concentrations of organic dust, gases, and chemicals. Long-term, chronic inhalation of these agents may contribute to risk of chronic obstructive pulmonary disease (COPD). I examined the association between work in animal production, including the use of insecticides, and the prevalence of COPD diagnosis and chronic bronchitis symptoms among 22,721 farmers who enrolled in the Agricultural Health Study (AHS) (1993-1997) and participated in the 2005-2010 interview. I also assessed the impact of restricting analysis to participants of the 2005-2010 interview. To assess the impact of restriction, predictors of participation in the 2005-2010 interview were identified, example exposure-outcome associations estimated in the enrollment and 2005-2010 cohorts were compared, and the utility of inverse probability of selection weights (IPSW) to correct for selection bias was considered. Participation was related to age, state, race/ethnicity, education, marital status, smoking, and alcohol consumption. In example analyses, when case participation was differential with respect to exposure, estimates were biased; IPSW conditional on exposure and covariates failed to fully correct estimates. When participation was non-differential, estimates from 2005-2010 participants and the enrollment cohort were similar rendering IPSW unnecessary. Using log binomial regression and inverse probability of exposure weights to address confounding, I estimated the association between animal production, insecticide use and COPD diagnosis and symptoms. Raising beef cattle, hogs, or poultry was associated with greater prevalence of chronic bronchitis symptoms. Farmers with medium/large animal operations had 1.51 (95% CI: 1.21, 1.89) times the prevalence of chronic bronchitis symptoms than those raising no animals. Applying insecticides to livestock and use of coumaphos, diazinon, dichlorvos, malathion, parathion, carbaryl, and permethrin were also associated with greater prevalence of chronic bronchitis. Personal use of diazinon and trichlorfon were associated with a greater prevalence of COPD diagnosis. These results support an association between animal production, including use of insecticides, and chronic bronchitis, a component condition of COPD. Further investigation of animal production- and insecticide-related risk factors for COPD is necessary. There is also a need for continued monitoring of the respiratory health of farmers and workers involved in animal production

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