ABSTRACT

Purpose: Respiratory hazards of farming have been identified for centuries, with little focus on gender differences. We used data from the AGRICOH consortium, a collective of prospective cohorts of agricultural workers, to assess respiratory disease prevalence among adults in 18 cohorts representing over 200,000 farmers, farm workers, and their spouses from six continents.

Methods: Cohorts collected data between 1992 and 2016 and ranged in size from 200 to >128,000 individuals; 44% of participants were female. Farming practices varied from subsistence farming to large-scale industrial agriculture. All cohorts provided respiratory outcome information for their cohort based on their study definitions. The majority of outcomes were based on self-report using standard respiratory questionnaires; the greatest variability in assessment methods was associated with chronic obstructive pulmonary disease (COPD).

Results: For all three respiratory symptoms (cough, phlegm, and wheeze), the median prevalence in men was higher than in women, with the greatest difference for phlegm (17% vs. 10%). For asthma, women had a higher prevalence (7.8% vs 6.5%), with the difference associated with allergic asthma. The relative proportion of allergic asthma varied among cohorts. In two of eight cohorts for women and two of seven cohorts for men, allergic asthma was more common than non-allergic asthma.

Conclusions: These findings indicate that respiratory outcomes are common among farmers around the world despite differences in agricultural production. As women in the general population are at higher risk of asthma, exploring gender differences in occupational studies is critical for a deeper understanding of respiratory disease among agricultural workers.

摘要

目的：几个世纪以来，人们已经确定了农业的呼吸危害，很少关注性别差异。我们使用来自农业工人前瞻性队列的 AGRICOH 联盟的数据来评估代表来自六大洲超过 200,000 名农民、农场工人及其配偶的 18 个队列中成年人的呼吸道疾病患病率。

方法：队列收集了 1992 年至 2016 年间的数据，规模从 200 人到 >128,000 人不等；44% 的参与者是女性。农业实践从自给农业到大规模工业化农业不等。所有队列都根据他们的研究定义为其队列提供了呼吸结果信息。大多数结果是基于使用标准呼吸问卷的自我报告；评估方法的最大差异与慢性阻塞性肺病（COPD）有关。

结果：对于所有三种呼吸道症状（咳嗽、痰和喘息），男性的中位患病率高于女性，痰的差异最大（17% 对 10%）。对于哮喘，女性的患病率更高（7.8% vs 6.5%），差异与过敏性哮喘有关。过敏性哮喘的相对比例因队列而异。在八个女性队列中的两个和七个男性队列中的两个中，过敏性哮喘比非过敏性哮喘更常见。

结论：这些研究结果表明，尽管农业生产存在差异，但世界各地农民的呼吸系统结果很普遍。由于一般人群中的女性患哮喘的风险较高，因此探索职业研究中的性别差异对于更深入地了解农业工人的呼吸系统疾病至关重要。