Background

Although farming is often considered a risk factor for COPD, data regarding the burden and characteristics of COPD in dairy farmers are sparse and conflicting.

Objectives

To characterize COPD in dairy farmers.

Methods

4788 subjects entered two parallel COPD screening programs, one in agricultural workers and one in general practice from 2011 to 2015. Subjects with COPD were invited to participate in the characterization phase of the study. Those who accepted were included in two subgroups: dairy farmers with COPD (DF-COPD) (n = 101) and non-farmers with COPD (NF-COPD) (n = 85). Patients with COPD were frequency-matched with subjects with normal spirometry for age, sex and tobacco smoking (pack-years and status) (DF-controls n = 98, NF-controls n = 89). All subjects from these four groups underwent lung function and exercise testing, questionnaires and blood analysis.

Results

The frequency of COPD in dairy farmers was 8.0% using the GOLD criterion and 6.2% using the lower limit of normal criterion and was similar in non-farming subjects (7.3% and 5.2%, respectively) although dairy farmers had lower tobacco consumption (screening phase). DF-COPD had better pulmonary function, exercise capacity and quality of life, fewer symptoms and comorbidities than NF-COPD, and higher levels of some Th2 biomarkers (MCP-2, periostin) (characterization phase). In farmers, COPD was not related to occupational exposure factors, supporting the role of host factors.

Conclusion

COPD secondary to organic dust exposure (dairy farming) appears less severe and associated with fewer comorbidities than COPD secondary to tobacco smoking.

中文翻译：

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奶农慢性阻塞性肺疾病的特征。

背景

尽管通常认为耕种是COPD的危险因素，但有关奶农COPD负担和特征的数据稀少且相互矛盾。

目标

表征奶农的COPD。

方法

从2011年到2015年，有4788名受试者进入了两个平行的COPD筛查计划，一个是农业工人，另一个是一般实践。邀请患有COPD的受试者参加研究的特征化阶段。接受者包括两个子组：患有COPD的奶农（DF-COPD）（n = 101）和患有COPD的非农民（NF-COPD）（n = 85）。患有COPD的患者与年龄，性别和吸烟情况正常的肺活量测定的患者频率匹配（包装年限和状态）（DF对照组n = 98，NF对照组n = 89）。这四个组的所有受试者均接受了肺功能和运动测试，问卷调查以及血液分析。

结果

尽管奶农的烟草消费量较低（筛查），但按照GOLD标准，奶农的COPD频率为8.0％，按正常标准下限为6.2％，在非农业人群中相似（分别为7.3％和5.2％）。相）。DF-COPD具有比NF-COPD更好的肺功能，运动能力和生活质量，更少的症状和合并症，并且某些Th2生物标记物（MCP-2，骨膜素）水平更高（表征阶段）。在农民中，COPD与职业接触因素无关，支持宿主因素的作用。

结论

与吸烟引起的慢性阻塞性肺病相比，继发于有机粉尘暴露（奶牛场）的慢性阻塞性肺病的严重性较轻，合并症的发生率也较低。