A Primer for Wisconsin Practitioners and Health/safety Professionals

The agriculture workplace has long been known to be associated with respiratory disease. Respiratory disease is among the main chronic health conditions affecting farmers (Brackbill et al, 1994). Those who are at potential risk include farmers and farm families, agricultural workers, abattoir workers, greenhouse and nursery workers, veterinarians, and grain elevator workers. While the massive exposures leading to severe acute disease have decreased, it is postulated that there has been a significant increase in subacute and chronic respiratory disease resulting from increased indoor air exposure (Donham 2000; Von Essen and Donham, 1999). Animal confinement workers or dairy technicians may spend as much time as 40-50 hours or more a week indoors in larger operations, resulting in longer exposures to higher levels of gases and dusts. This is a result from changing animal production techniques with higher animal densities and shift work in animal feeding units (AFOs) and high density concentrated animal feeding operations (CAFOs). Many of these conditions are found in Wisconsin. In fact, some of the early work in establishing the methods in the diagnosis of Farmer’s Hypersensitivity Pneumonitis (FHP), formerly known as Farmer’s Lung Disease, and Organic Dust Toxic Syndrome (ODTS) was performed in Wisconsin at the Marshfield Clinic. There are a number of common exposures that will lead to respiratory illnesses, often with overlapping clinical signs and symptoms (See Table 1). These include organic dusts, molds, bacteria, and gases from fermentation of silage and manure. Other respiratory hazards include inorganic dusts, pesticides, and other agricultural chemicals. There are also infectious respiratory conditions that are not unique to agriculture but may be encountered in the work and living environments associated with farm families See Table 1 for a compendium of agricultural respiratory diseases.