Agricultural Exposures in Patients with COPD in Health Systems Serving Rural Areas

ABSTRACT

Background: Agricultural exposure is a risk factor for the development of chronic obstructive pulmonary disease (COPD). However, there are no good estimates of the number of COPD patients with a history of agricultural exposure. Methods: We conducted a telephone interview of subjects with COPD identified by reviewing all pulmonary function tests at the Omaha Veterans Administration Hospital between November 2004 and March 2005. Obstructive lung disease was defined as a FEV₁/FVC ratio of less than 70%. The survey detailed demographic data, smoking history, pulmonary symptoms, and history of agricultural exposures. Results: Participants included 150 veterans (mean age 68.2 years ±10.8). A history of agricultural exposure was elicited in 68% of subjects. Of those who had worked in agriculture, the types of exposures varied, with 14% in hog confinement barns, 20% on dairy farms, 8% on poultry farms, and 87% exposed to grain dust. There was a trend of diminishing FEV₁ with increasing years of agricultural exposure. Conclusions: In health systems that serve rural areas, patients with COPD commonly have a history of agricultural exposures that may contribute to the development of COPD. Health care workers in these areas should include agricultural exposures as an important part of the social/occupational history in these patients.

KEYWORDS:

• Agriculture
• COPD
• lung disease
• pulmonary function tests
• farming

Work was performed at the University of Nebraska Medical Center and the VA Nebraska Western Iowa Health Care System—Omaha Division. Special thanks to Holly DeSpiegelaere for conducting several of the telephone interviews.

Dr Kristina L. Bailey, Dr Jane L. Meza, Lynette M. Smith, Dr Susanna G. Von Essen, and Dr Debra J. Romberger do not have conflicts of interest, either personal or financial, regarding the subject matter presented in this article.