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Abstract
Long-term exposure to greenhouse environments exposes greenhouse workers to inhalation of antigens that can cause respiratory diseases. This study was conducted to investigate the prevalence and potential risk factors for bronchial asthma among the Chinese greenhouse workers based on questionnaire and spirometry data. This was an observational cross-sectional study, performed via stratified-cluster-random sampling. It was conducted in Liaoning Province from the northeast of People’s Republic of China, using a population-based sample of 5,880 workers at 835 plastic film greenhouses. All subjects were interviewed using a standardized questionnaire and underwent pulmonary function tests. Multiple logistic regression analysis was conducted to assess associations between self-reported factors of greenhouse worker exposure and bronchial asthma and to identify potential risk factors for this disease. A total of 5,420 questionnaires were completed. The overall prevalence of asthma in greenhouse workers was 19.2% (1040/5420). Multiple logistic regression analysis revealed that the use of multiple pesticides (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.03–1.49), bad odors in the greenhouse (OR = 1.26, 95% CI = 1.07–1.49), and report of the onset of cough when entering the greenhouse (OR = 1.25, 95% CI = 1.09–1.44) were associated with the development of asthma. In contrast, a higher body mass index (BMI >18.5 kg/m2, OR = 0.93, 95% CI = 0.90–0.95), planting flowers (OR = 0.92, 95% CI = 0.87–0.98), open sidewall to outside (natural ventilation) for at least 30 min per event (OR = 0.82, 95% CI = 0.69–0.96), living in greenhouse (OR = 0.85, 95% CI = 0.73–0.99), and experiencing cough before 14 years old (OR = 0.61, 95% CI = 0.43–0.84) were protective factors to the presentation of asthma among greenhouse workers. Our results suggest that asthma is a major public health problem among Chinese greenhouse workers and more attention should be devoted to preventive measures and management of this disease.
Acknowledgments
The authors would like to thank Professor Nanshan Zhong (Guangzhou Institute of Respiratory Disease, Guangzhou Medical College, People’s Republic of China), Quanying He (Beijing Chaoyang Hospital, Capital University of Medical Sciences, People’s Republic of China), Jian Kang (The First Affiliated Hospital, China Medical University, People’s Republic of China), and Yiming Zhao (The Third Hospital, Peking University, People’s Republic of China) for their responsiveness and helpful support. The authors thank the following investigators and local administrations for their technical assistance with this study: Shuang Fu (The General Hospital of Fushun Mining Bureau, People’s Republic of China), Yangang Ren, Deliang Wen (both of whom from China Medical University, People’s Republic of China), Liyun Li, Zhenhua Li (both of whom from The First affiliated hospital, China Medical University, People’s Republic of China), Lei Xu, Qun Wang, Yuan Ling, Xuhua Zhang, Lihua Wu, Jing Li, Xiaoling Yu, Donghong Chen, Fangzhi Li, Bo Zou, Yanqing Liu, Baoguo Jiang, Xiaoyu He, Lie Ma, Jiaying Sun, Hongguang Dong, Lijiao Zhang, Jie Zou, Hao Zhang, Xuewen Wang, Dan Ma, Fang Nie (all of whom are from The Fourth Affiliated Hospital, China Medical University, People’s Republic of China), Shuyue Xia (Fengtian hospital, shenyang Medical College, People’s Republic of China), Dongliang Wang (202nd hospital of People’s Liberation Army, People’s Republic of China), Hong Chen (The First People’s hospital of Kazuo, People’s Republic of China), Jian Zhao (205th hospital of People’s Liberation Army, People’s republic of China), Jun Tian (The Fourth People’s Hospital of Shenyang, People’s Republic of China), Yuhong Zhou (General Hospital of Liaoning, Anshan Iron and Steel Group, People’s Republic of China), and Wenliang Ren (People’s Hospital of Shenyang Metro sub-district, People’s Republic of China).