Am. J. Respir. Crit. Care Med., Volume 158, Number 5, November 1998, 1493-1498

Prevalence of Asthma and Respiratory Symptoms in Dairy Farmers in the French Province of the Doubs

JEAN-CHARLES DALPHIN, ANDRÉ DUBIEZ, ELISABETH MONNET, DANIEL GORA, VIRGINIE WESTEEL, DIDIER PERNET, JEAN-CHARLES POLIO, ROGER GIBEY, JEAN-JACQUES LAPLANTE, and ALAIN DEPIERRE

Departments of Respiratory Disease, Public Health, and Biochemistry, University Hospital of Besançon; and the Medical Department of the Mutualité Sociale Agricole of the Doubs, Besançon, France

With the aim of determining whether dairy farming is associated with an excess of asthma and respiratory symptoms, we compared the respiratory status in a sample of dairy farmers (n = 265) and a control group of nonexposed subjects (n = 149). The study protocol comprised a questionnaire, spirometry, and a bronchodilatation test (400 µg salbutamol powder), and an allergological evaluation: serum total IgE level, Phadiatop test, and skin prick tests (SPT) for seven inhalant allergens. Cumulative prevalences of self-reported asthma and of current asthma were respectively 5.3% and 1.5% in farmers, and respectively 3.4% and 1.3% in control subjects (both NS). Prevalences of all the respiratory symptoms studied were higher in farmers, with statistically significant differences after adjusting for age, sex, and smoking, for wheezing ever (OR: 2.7, p < 0.05), wheezing within the last year (OR: 5.2, p < 0.025), usual morning cough (OR: 5, p < 10³), usual morning phlegm (OR: 11.3, p < 10⁴), and chronic bronchitis (OR: 11.8, p < 0.01). The effect of exposure on these symptoms was more pronounced than, or of the same magnitude as that of smoking. Smoking and exposure had an additive effect except for chronic cough for which a positive interaction was observed (p = 0.05). Mean FEV₁/VC (percentage of predicted) was statistically negatively correlated to dairy farming (p < 0.025) after adjusting for confounders. Bronchial obstruction was reversible in about 10% of subjects in both groups. In conclusion, this study mainly demonstrated an excess of respiratory symptoms in dairy farmers which is weak and nonsignificant for asthma, and high for cough, phlegm, and chronic bronchitis. It also suggested that the combined effect of farming and smoking was synergistic on chronic cough.

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