Occupational Asthma Reference

van Kampen V, Hoffmeyer F, Deckert A, Kendzia B, Casjens S, Neumann HD, Buxtrup M, Willer E, Felten C, Schöneich R, Brüning T, Raulf M, Bünger J, Effects of bioaerosol exposure on respiratory health in compost workers: a 13-year follow-up study, Occup Environ Med, 2016;73:829-837,10.1136/oemed-2016-103692
(Plain text: van Kampen V, Hoffmeyer F, Deckert A, Kendzia B, Casjens S, Neumann HD, Buxtrup M, Willer E, Felten C, Schoneich R, Bruning T, Raulf M, Bunger J, Effects of bioaerosol exposure on respiratory health in compost workers: a 13-year follow-up study, Occup Environ Med)

Keywords: Germany, compost, bronchitis, bioaerosol, FEV1, longitudinal decline, IgE, IgG

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Abstract

Objectives
To determine the risk of German compost workers developing chronic respiratory effects from long-term exposure to bioaerosols.

Methods
Respiratory health was determined in 74 currently exposed compost workers and 37 non-exposed controls after 13 years of follow-up. In addition, 42 former compost workers (drop-outs) who left their work during the follow-up period were also examined. Respiratory symptoms and working conditions were assessed using identical questionnaires as at baseline. In addition, lung function was measured using the same spirometer as in the initial study. Sera from both surveys were tested for specific IgE and IgG antibodies to moulds and the risk of work-related symptoms was evaluated using regression approaches for prospective studies with binary data.

Results
In the follow-up period, the number of participants reporting cough significantly increased in compost workers and drop-outs compared to the controls. Working as a compost worker for at least 5 years increased the relative risk for cough (RR 1.28; 95% CI 1.2 to 1.4) and for cough with phlegm (RR 1.32; 95% CI 1.2 to 1.5). Current and former compost workers had slightly lower predicted percentage of forced expiratory volume in 1 s and predicted percentage of forced vital capacity than controls, but decrease in lung function during follow-up was not different among the 3 groups. In addition, no significant changes could be detected in antibody concentrations.

Conclusions
Our results suggest that chronic exposure to bioaerosols in composting plants is related to a significantly higher risk for cough with phlegm, indicating chronic bronchitis. However, compost workers showed no higher incidence of deterioration of pulmonary function over the study.

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Comments

This is an important paper reporting long-term surveillance of compost workers in Germany, and is generally reassuring except for an increase in cough and sputum. There seems to be no increase in asthma or alveolitis in this cohort. We are not told anything about the composting process, whether in or out doors, whether workers used RPE or where protected in vehicles etc. It does suggest that this process can be done with relatively little risk to exposed workers
12/21/2016

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