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International Archives of Occupational and Environmental Health

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Open Access 01-11-2015 | Original Article

Healthy worker survivor analysis in an occupational cohort study of Dutch agricultural workers

Authors: E. A. J. Spierenburg, L. A. M. Smit, D. Heederik, P. Robbe, M. N. Hylkema, I. M. Wouters

Published in: International Archives of Occupational and Environmental Health | Issue 8/2015

Abstract

Objectives

High microbial exposures in farmers and agricultural workers are associated with less atopy. Although it has been speculated that healthy worker survival could be an explanation, this has not been studied so far. Therefore, we investigated the presence of healthy worker survival in a five-year follow-up study of an occupational cohort of Dutch farmers and agricultural industry (company) workers.

Methods

We compared baseline demographic characteristics, respiratory health, atopy and endotoxin exposure of 259 workers followed up with 124 workers lost to follow-up. Additionally, baseline health status of 31 participants who had changed to lower exposure jobs at follow-up was compared to those with similar or higher exposure jobs at follow-up.

Results

In general, no major healthy worker survival effect was found. Nonetheless, small differences were observed between subjects included in follow-up and those lost to follow-up. Those lost to follow-up were older, had a lower peak expiratory flow, and were less often raised on a farm. Company workers lost to follow-up with a farm childhood had more often self-reported allergy, but this was not observed for subjects with atopic sensitization or other respiratory symptoms. No differences were found for any of the studied characteristics in participants with lower exposure at follow-up compared to participants with similar or higher exposure at follow-up.

Conclusions

No major healthy worker survival is present in this organic dust exposed cohort. Differences between participants lost to follow-up and participants included in follow-up with regard to health characteristics are small and unlikely to explain the previously reported inverse associations between endotoxin exposure and atopy.

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Basinas I, Schlünssen V, Heederik D, Sigsgaard T, Smit LAM, Samadi S et al (2012) Sensitisation to common allergens and respiratory symptoms in endotoxin exposed workers: a pooled analysis. Occup Environ Med 69(2):99–106CrossRef

Bråbäck L, Hjern A, Rasmussen F, Van Schayck CP, Knottnerus JA (2006) Selective migration contributes to a healthy worker effect in the farming population [1] (multiple letters). J Clin Epidemiol 59(1):102–103CrossRef

Burney PGJ, Luczynska C, Chinn S, Jarvis D (1994) The European Community Respiratory Health survey. Eur Respir J 7(5):954–960CrossRef

Chénard L, Senthilselvan A, Grover VK, Kirychuk SP, Lawson JA, Hurst TS et al (2007) Lung function and farm size predict healthy worker effect in swine farmers. Chest 131(1):245–254CrossRef

Doekes G (1996) Enzyme immunoassays for total and allergen specific IgE in population studies. Occup Environ Med 53(1):63–70CrossRef

Dosman JA, Lawson JA, Kirychuk SP, Cormier Y, Biem J, Koehncke N (2004) Occupational asthma in newly employed workers in intensive swine confinement facilities. Eur Respir J 24(4):698–702CrossRef

Douwes J, Travier N, Huang K, Cheng S, McKenzie J, Le Gros G et al (2007) Lifelong farm exposure may strongly reduce the risk of asthma in adults. Allergy: European. J Allergy Clin Immunol 62(10):1158–1165CrossRef

Dumas O, Smit LAM, Pin I, Kromhout H, Siroux V, Nadif R et al (2011) Do young adults with childhood asthma avoid occupational exposures at first hire? Eur Respir J 37(5):1043–1049CrossRef

Ernst P, Cormier Y (2000) Relative scarcity of asthma and atopy among rural adolescents raised on a farm. Am J Respir Crit Care Med 161(5):1563–1566CrossRef

Fuchs O, Genuneit J, Latzin P, Büchele G, Horak E, Loss G et al (2012) Farming environments and childhood atopy, wheeze, lung function, and exhaled nitric oxide. J Allergy Clin Immunol 130(2):382.e6–388.e6CrossRef

Gainet M, Thaon I, Westeel V, Chaudemanche H, Venier AG, Dubiez A et al (2007) Twelve-year longitudinal study of respiratory status in dairy farmers. Eur Respir J 30(1):97–103CrossRef

Le Moual N, Kauffmann F, Eisen EA, Kennedy SM (2008) The healthy worker effect in asthma: work may cause asthma, but asthma may also influence work. Am J Respir Crit Care Med 177(1):4–10CrossRef

Mounchetrou IN, Monnet E, Laplante JJ, Dalphin JC, Thaon I (2012) Predictors of early cessation of dairy farming in the French Doubs province: 12-year follow-up. Am J Ind Med 55(2):136–142CrossRef

Portengen L, Sigsgaard T, Omland Ø, Hjort C, Heederik D, Doekes G (2002) Low prevalence of atopy in young danish farmers and farming students born and raised on a farm. Clin Exp Allergy 32(2):247–253CrossRef

Portengen L, Preller L, Tielen M, Doekes G, Heederik D (2005) Endotoxin exposure and atopic sensitization in adult pig farmers. J Allergy Clin Immunol 115(4):797–802CrossRef

Post W, Burdorf A, Bruggeling TG (1994) Relations between respiratory symptoms and sickness among workers in the animal feed industry. Occup Environ Med 51(7):440–446CrossRef

Post W, Heederik D, Houba R (1998) Decline in lung function related to exposure and selection processes among workers in the grain processing and animal feed industry. Occup Environ Med 55(5):349–355CrossRef

Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC (1993) Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl 16:5–40CrossRef

Shi J, Mehta AJ, Hang J, Zhang H, Dai H, Su L et al (2010) Chronic lung function decline in cotton textile workers: roles of historical and recent exposures to endotoxin. Environ Health Perspect 118(11):1620–1624CrossRef

Smit LAM, Wouters IM, Hobo MM, Eduard W, Doekes G, Heederik D (2006) Agricultural seed dust as a potential cause of organic dust toxic syndrome. Occup Environ Med 63(1):59–67CrossRef

Smit LAM, Heederik D, Doekes G, Blom C, Van Zweden I, Wouters IM (2008) Exposure–response analysis of allergy and respiratory symptoms in endotoxin-exposed adults. Eur Respir J 31(6):1241–1248CrossRef

Smit LAM, Heederik D, Doekes G, Wouters IM (2009) Exhaled nitric oxide in endotoxin-exposed adults: effect modification by smoking and atopy. Occup Environ Med 66(4):251–255CrossRef

Smit LAM, Heederik D, Doekes G, Lammers JWJ, Wouters IM (2010) Occupational endotoxin exposure reduces the risk of atopic sensitization but increases the risk of bronchial hyperresponsiveness. Int Arch Allergy Immunol 152(2):151–158CrossRef

Stayner L, Steenland K, Dosemeci M, Hertz-Picciotto I (2003) Attenuation of exposure–response curves in occupational cohort studies at high exposure levels. Scand J Work Environ Health 29(4):317–324CrossRef

Thaon I, Thiebaut A, Jochault L, Lefebvre A, Laplante JJ, Dalphin JC (2011) Influence of hay and animal feed exposure on respiratory status: a longitudinal study. Eur Respir J 37(4):767–774CrossRef

Thelin A, Hoglund S (1994) Change of occupation and retirement among Swedish farmers and farm workers in relation to those in other occupations: a study of ‘elimination’ from farming during the period 1970–1988. Soc Sci Med 38(1):147–151CrossRef

van Schayck CP, Knottnerus JA (2004) Can the ‘hygiene hypothesis’ be explained by confounding by behavior? J Clin Epidemiol 57(5):435–437CrossRef

Vogelzang RFJ, Van Der Gulden JWJ, Tielen MJM, Folgering H, Van Schayck CP (1999) Health-based selection for asthma, but not for chronic bronchitis, in pig farmers: an evidence-based hypothesis. Eur Respir J 13(1):187–189CrossRef

Zock JP, Heederik D, Doekes G (1998) Evaluation of chronic respiratory effects in the potato processing industry: indications of a healthy worker effect? Occup Environ Med 55(12):823–827CrossRef

Title: Healthy worker survivor analysis in an occupational cohort study of Dutch agricultural workers
Authors: E. A. J. Spierenburg
L. A. M. Smit
D. Heederik
P. Robbe
M. N. Hylkema
I. M. Wouters
Publication date: 01-11-2015
Publisher: Springer Berlin Heidelberg
Published in: International Archives of Occupational and Environmental Health / Issue 8/2015
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-015-1047-9

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Healthy worker survivor analysis in an occupational cohort study of Dutch agricultural workers

Abstract

Objectives

Methods

Results

Conclusions

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Abstract

Objectives

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Conclusions

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