Published ahead of print on April 7, 2004, doi:10.1164/rccm.200309-1228OC Am. J. Respir. Crit. Care Med., Volume 169, Number 12, June 2004, 1308-1313 A more recent version of this article appeared on June 15, 2004
Submitted on September 8, 2003 Diesel Exhaust, Solvents, and Other Occupational Exposures as Risk Factors for Wheeze Among FarmersJane A Hoppin1*,1 Department of Health and Human Services, National Institute of Environmental Health Sciences, NIH, Epidemiology Branch, Research Triangle Park, NC, USA, 2 Department of Health and Human Services, National Institute of Environmental Health Sciences, NIH, Biostatistics Branch, Research Triangle Park, NC, USA, 3 Biostatistics Branch, National Cancer Institute, NIH, Occupational Epidemiology Branch, Rockville, MD, USA * To whom correspondence should be addressed. E-mail: hoppin1{at}niehs.nih.gov.
Farmers engage in activities which result in exposure to diesel exhaust, solvents, welding fumes, and other respiratory irritants. Using the Agricultural Health Study, a cohort of pesticide applicators in Iowa and North Carolina, we evaluated the odds of wheeze associated with non-pesticide occupational exposures. We used logistic regression models controlling for age, state, smoking, and history of asthma or atopy to evaluate odds of wheeze in the past year among the 20,898 farmers who provided complete information on all covariates. Driving diesel tractors was associated with an elevated odds of wheeze (Odds Ratio(OR)=1.31, 95% Confidence Interval(CI)=1.13, 1.52); the OR for driving gasoline tractors was 1.11(95%CI=1.02,1.21). A duration-response relationship was observed for driving diesel tractors but not for driving gasoline tractors. Activities involving solvent exposure, including painting and use of solvents for cleaning, were associated with an increased odds of wheeze in a duration dependent fashion. The highest odds of wheeze for farm activities was for daily painting (OR=1.82,95%CI=0.89,3.73), an indication of daily solvent exposure. These results add to the growing body of evidence of adverse respiratory effects of diesel exposure on the lung and suggest exposure to solvents may contribute as well. Key words: Diesel exhaust, agriculture, occupational cohort, respiratory symptoms, solvents
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