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Impact of aerosols on respiratory health of dairy workers and residents living near dairies discussion and implications of recent research


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Impact of aerosols on respiratory health of dairy workers and residents living near dairies discussion and implications of recent research

  1. 1. Impact of Aerosols on Respiratory Health of Dairy Workers and Residents Living Near Dairies: Discussion and Implications of Recent Research Stephen J Reynolds, PhD, CIH, FAIHA Director High Plains Intermountain Center for Agricultural Health and Safety, Colorado State University, Ft. Collins, CO Robert Hagevoort, PhD Dairy Extension Specialist, New Mexico State University, Clovis, NM 2015 Waste to Worth Confernce Seattle, Washington March 31, 2015
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  3. 3. Occupational Exposures and Lung Disease
  4. 4. Overview Health or disease endpoints? Populations? Exposures? Genetics? Other risk factors?
  5. 5. Association and Causation Epidemiology • Most convincing evidence for a causal relation comes from reproducible experimental demonstration of association. • Observational studies on human populations (ethics of experimentation) o Retrospective (Case History), Prospective (Cohort) o Mathematical (statistical) models and agreement on acceptable error
  6. 6. Community Studies: Evidence for Hygiene Hypothesis Braun-Fahrlander et al. Enviromental Exposure to Endotoxin and its relation to asthma in school age children. N Eng J Medicine 2002 Illi et al. Protection from childhood asthma and allergy in Alpine farm environments – the GABRIEL Advanced Studies. J Allergy Clin Immunol 2012
  7. 7. Community Studies: Evidence for Hygiene Hypothesis Ege et al. Gene-environment interaction for childhood asthma and exposure to farming in Central Europe. J Allergy Clin Immunol 2011 Smit et al. Air pollution from livestock farms, and asthma, allergic rhinitis, and COPD among neighboring residents. Occup Environ Med 2014
  8. 8. Williams et al. Cow allergen (Bos d2) and endotoxin concentrations are higher in settled dust of homes proximate to industrial-scale dairy operations. Nature 2014.
  9. 9. Endotoxin & Innate Immunity Source: Cook et al. 2004
  10. 10. Lundell et al. High Proportion of CD5 B Cells in Infants Predicts Development of Allergic Disease. J Immunology 2014.
  11. 11. Occupational Studies • Reynolds. Systematic Review of Respiratory Health Among Dairy Workers J Agromedicine 2013 • Basinas. Sensitization to Common Allergens and Respiratory Symptoms in Endotoxin Exposed Workers: a Pooled Analysis JOEM 2012 • Senthilselvan Association of polymorphisms of toll-like receptor 4 with a reduced prevalence of hay fever and atopy. Ann Allergy Asthma Immunol 2008
  12. 12. Occupational Studies • Smit. CD14 and Toll-like receptor Gene Polymorphisms, Country Living, and Asthma in Adults . Am J Respir Crit Med 2009 • Gao. Association of Toll-like receptor 2 gene polymorphisms with lung function in workers in swine operations . Ann Allergy Asthma Immunol 2013
  13. 13. Reynolds. Pulmonary Function Reductions Among Potentially Susceptible Subgroups of Agricultural Workers in Colorado and Nebraska JOEM 2012
  14. 14. Asthma
  15. 15. But ….
  16. 16. Risk Management in face of Uncertainty? Liabilities – Community/consumers vs. workplace Information needed Communication and scientific literacy Cost effective best practices that promote cow health, productivity, worker health and community health
  17. 17. Recommendations Identify locations and tasks that contribute to respiratory exposures Provide baseline and annual medical exams Engineering controls – ventilation, enclosed/ventilated cabs, feed additives, bedding materials, washing frequency Protective equipment – N95 dust masks and respirators (when engineering is not available Training
  18. 18. Questions? Comments?