Shelley Kirychuk

Total dust and endotoxin in poultry operations: comparison between cage and floor housing and respiratory effects in workers.

Objective: The objective of this study was to assess respiratory outcomes and environmental exposure levels of workers in cage-housed and floor-housed poultry operations. Methods: Poultry operations were evaluated for total dust, endotoxin, and ammonia, and respiratory symptoms and lung function tests of workers were conducted. Results: Workers in floor-housed poultry operations had significantly greater exposures to total dust and ammonia, whereas workers from cage-housed poultry operations reported greater frequency of current and chronic symptoms overall and significantly greater current and chronic phlegm (39% vs 18% and 40% vs 11%, respectively). Endotoxin concentration (EU/mg) was a significant predictor (P = 0.05) of chronic phlegm for all poultry workers. Conclusions: Greater endotoxin concentration in the presence of significantly lower total dust, in conjunction with greater respiratory symptoms in workers from cage-housed poultry operations, as compared with workers from floor-housed poultry operations, appears to indicate that differences in environmental exposures may impact respiratory outcomes of workers.

Assessment of endotoxin levels in the home and current asthma and wheeze in school-age children

UNLABELLED The relationship between household endotoxin and asthma in children is not clear. To further investigate the relationship between sources of endotoxin and childhood asthma, we conducted a case-control study of children with and without asthma and examined their more frequent household exposures in the home. Children ages 6-13 years with current asthma (n = 70) or wheeze only (n = 19) were sex and age matched (+/-1 year) to 107 controls. Play area and mattress dust were collected for endotoxin analysis. Atopic status was determined by skin prick testing for allergies. A family size of >4 per household was associated with higher endotoxin levels (EU/mg) in the bed dust (P < 0.05). Passive smoking (P < 0.05) and the presence of a cat were associated with higher levels of endotoxin in mattress dust. Endotoxin levels in either the play dust or the bed dust did not differ between cases and controls. Within atopic cases, those with higher endotoxin loads (EU/m2) in bed or play areas were more likely to miss school for chest illness (P < 0.05). In this study, household endotoxin is not a risk factor for current asthma overall but may be associated with increased severity in children with atopic asthma. PRACTICAL IMPLICATIONS This study did not find that household sources of endotoxin were associated with asthma. However, within atopic asthmatics, asthma severity (as measured by a history of being kept home from school because of a chest illness in the past year) was associated with higher levels of endotoxin in dust from the childs bed. There is a need to further investigate the nature of the relationship between household endotoxin and asthma severity in children which could lead to better management of childhood asthma.

Predictors of longitudinal changes in pulmonary function among swine confinement workers.

OBJECTIVE To determine predictors of longitudinal changes in pulmonary function in swine confinement workers. DESIGN Longitudinal study conducted from November 1989 to June 1991 and January 1994 to May 1995. SETTING Swine confinement workers in Saskatchewan. PARTICIPANTS Forty-two swine confinement workers who were studied in 1989/90 and studied again in 1994/95. RESULTS Of 98 male swine confinement workers (mean age SD 36.3 11.1 years) studied at baseline, 42 were studied again five years following. Complete information on baseline across-shift pulmonary function (preshift forced expiratory volume in 1 s [FEV1], forced vital capacity [FVC], and every 2 h FEV1 and FVC during the shift), and five-year follow-up pulmonary function (with FEV1 and FVC) were available on all 42 subjects. Mean across-shift changes (preshift measurement to last measurement of the day) at baseline were -159. 8 61.7 mL in FEV1 and -35.3 65.6 mL in FVC. Mean annual rate change between baseline and follow-up for FEV1 was -53.9 61.7 mL/year and for FVC -48.9 71.6 mL/year. After adjusting for age, height, smoking and hours spent in the barn, the baseline across-shift change in FEV1 and FVC was a significant predictor of annual rate change in FEV1 (P=0.01) and FVC (P=0.02), respectively. To determine the effects of indoor air quality on longitudinal lung function decline, indoor air environmental measurements were analysed. Complete information on respiratory health and indoor air quality was available on 34 of the 42 subjects. Assessment of indoor environment of swine barns included a summer and winter measurement for airborne dust, gases and endotoxin levels. After adjusting for age, height, smoking, ammonia and hours spent in the barn, the endotoxin level (Eu/mg)was a significant predictor of annual rate change for FEV1 but not FVC. CONCLUSIONS These results suggest that shift change is an important predictor of longitudinal changes in lung function in swine confinement workers and that endotoxin exposures may mediate annual decline in FEV1 in these workers.

Respiratory symptoms and lung function in poultry confinement workers in Western Canada.

OBJECTIVE To determine whether poultry production methods impact respiratory health, and whether poultry farmers have more respiratory symptoms and lower lung function than comparison control groups. DESIGN Cross-sectional study. SETTING Provinces of Saskatchewan, Alberta and Manitoba during the winters of 1997 to 1999. POPULATION Three hundred three poultry workers, 241 grain farmers and 206 nonfarming control subjects were studied. Poultry workers were further classified according to the poultry housing type in which they worked, ie, workers who worked with poultry raised on the floor (floor-based operations), which included broiler/roaster, broiler/breeder and turkey operations (n=181), and workers who worked with poultry raised in a caged setting (cage-based operations), which included egg operations (n=122). INTERVENTIONS Subjects completed a respiratory health questionnaire, which included questions on the poultry operation and work habits, and participated in lung function testing. MAIN RESULTS Overall, this study indicated that poultry workers report greater prevalences of current and chronic respiratory symptoms than control populations, and that the type of production method (cage-based versus floor-based) appears to influence the prevalence of respiratory symptoms and lung function values. Workers from cage-based operations report greater prevalences of current cough and wheeze, as well as lower mean values for forced expiratory volume in the first second (FEV1), forced expiratory flow at 25% to 75% of vital capacity (FEF25-75) and FEV1/FVC than workers from floor-based facilities. Workers from cage-based facilities also reported greater prevalences of current and chronic cough and phlegm, as well as significantly lower FEF25-75 and FEV1/FVC values than nonfarming control subjects. Furthermore, grain farmers had lower FVC and FEV1 values than nonfarmers. CONCLUSIONS The results suggest that the type of poultry production system (ie, floor- versus cage-based) appears to have an effect on the respiratory response of workers from these facilities. Further studies are required to understand the physiological mechanisms of respiratory dysfunction and the relationships concerning workplace exposure among poultry workers.

Bacterial diversity characterization of bioaerosols from cage-housed and floor-housed poultry operations.

BACKGROUND Although bioaerosols from both cage-housed (CH) and floor-housed (FH) poultry operations are highly concentrated, workers from CH operations have reported a greater prevalence of respiratory symptoms. OBJECTIVE The objective of this study was to directly compare bacteria, both quantitatively and qualitatively, in bioaerosols from CH and FH poultry facilities. METHODS Bioaerosols were collected from fifteen CH and fifteen FH poultry operations, using stationary area samplers as well as personal sampling devices. Dust, endotoxin and bacteria were quantified and bacterial diversity was investigated using PCR followed by denaturing gradient gel electrophoresis (DGGE). RESULTS Dust (p<0.001), endotoxin (p<0.05) and bacteria (p<0.05) were significantly higher in personal bioaerosols of FH poultry operations than CH bioaerosols. Although dust and endotoxin did not differ significantly between area and personal samples within each barn type, clustering analysis of DGGE profiles of bacteria revealed that area and personal samples shared less than 10% similarity. These data suggest that area samples are not representative of personal bacteria exposures, which may be affected by worker movement, bacteria carried on the worker and worker location. Personal DGGE profiles from CH and FH operations shared less than 20% similarity and composite analysis showed that bacteria were more prevalent in personal samples from CH bioaerosols than FH bioaerosols. CONCLUSIONS Bacteria concentration and diversity are significantly different between bioaerosols from CH and FH poultry operations.

The Saskatchewan rural health study: an application of a population health framework to understand respiratory health outcomes

BackgroundRespiratory disease can impose a significant burden on the health of rural populations. The Saskatchewan Rural Health Study (SRHS) is a new large prospective cohort study of ages 6 and over currently being conducted in farming and non-farming communities to evaluate potential health determinants associated with respiratory outcomes in rural populations. In this article, we describe the rationale and methodology for the adult component.The study is being conducted over 5 years (2009–15) in two phases, baseline and longitudinal. The baseline survey consists of two components, adults and children. The adult component consists of a questionnaire-based evaluation of individual and contextual factors of importance to respiratory health in two sub populations (a Farm Cohort and a Small Town Cohort) of rural families in Saskatchewan Rural Municipalities (RMs). Clinical studies of lung function and allergy tests are being conducted on selected sub-samples of the two cohorts based on the positive response to the last question on the baseline questionnaire: “Would you be willing to be contacted about having breathing and/or allergy tests at a nearby location?”. We adopted existing population health theory to evaluate individual factors, contextual factors, and principal covariates on the outcomes of chronic bronchitis, chronic obstructive pulmonary disease, asthma and obstructive sleep apnea.FindingsOf the RMs selected to participate, 32 (89%) out of 36 RMs and 15 (94%) out of 16 small towns within the RMs agreed to participate. Using the mail out survey method developed by Dillman, we obtained completed questionnaires from 4264 households (8261 individuals). We obtained lung function measurements on 1609 adults, allergy skin test information on 1615 adults; both measurements were available on 1549 adults. We observed differences between farm and non-farm rural residents with respect to individual, contextual factors and covariates.DiscussionThere are differences between farm and non-farm rural residents with respect to individual and contextual factors and other variables of importance. The findings of the SRHS will improve knowledge of respiratory disease etiology, assist in the development and targeting of prevention programs, and in planning health services with farm and small town populations.

Endotoxin and Dust at Respirable and Nonrespirable Particle Sizes are not Consistent Between Cage- and Floor-Housed Poultry Operations

BACKGROUND Individuals engaged in work in intensive animal houses experience some of the highest rates of occupationally related respiratory symptoms. Organic dust and in particular endotoxin has been most closely associated with respiratory symptoms and lung function changes in workers. It has previously been shown that for intensive poultry operations, type of poultry housing [cage-housed (CH) versus floor-housed (FH)] can influence the levels of environmental contaminants. The goal of the study was to determine the differences in endotoxin and dust levels at different size fractions between CH and FH poultry operations. METHODS Fifteen CH and 15 FH poultry operations were sampled for stationary measurements (area) of dust and associated endotoxin. Fractioned samples were collected utilizing Marple cascade impactors. Gravimetric and endotoxin analysis were conducted on each of the filters. RESULTS When assessed by individual Marple stage, there was significantly greater airborne endotoxin concentration (endotoxin units per cubic meter) in the size fraction >9.8 μm for the FH operations whereas at the size fraction 1.6-3.5 μm, the CH operations had significantly greater airborne endotoxin concentration than the FH operations. Endotoxin concentration in the dust mass (endotoxin units per milligram) was significantly greater in the CH operations as compared to the FH operations for all size fractions >1.6 μm. As such, endotoxin in the respirable fraction accounted for 24% of the total endotoxin in the CH operations whereas it accounted for only 11% in the FH operations. There was significantly more dust in all size fractions in the FH operations as compared to the CH poultry operations. CONCLUSIONS There is more endotoxin in the presence of significantly lower dust levels in the respirable particle size fractions in CH poultry operations as compared to the FH poultry operations. This difference in respirable endotoxin may be important in relation to the differential respiratory response experienced by CH and FH poultry operation workers.

A community-based participatory research methodology to address, redress, and reassess disparities in respiratory health among First Nations

BackgroundTo date, determinants of respiratory health in First Nations people living on reserves and means of addressing and redressing those determinants have not been well established. Hence the Saskatchewan First Nations Lung Health Project (FNLHP) is a new prospective cohort study of aboriginal people being conducted in two First Nations reserves to evaluate potential health determinants associated with respiratory outcomes. Using the population health framework (PHF) of Health Canada, instruments designed with the communities, joint ownership of data, and based on the 4-phase concept of the First Nations Regional Longitudinal Health Survey, the project aims to evaluate individual factors, contextual factors, and principal covariates on respiratory outcomes. The objective of this report is to clearly describe the methodology of (i) the baseline survey that consists of two components, an interviewer-administered questionnaire and clinical assessment; and (ii) potential intervention programs; and present descriptive results of the baseline data of longitudinal FNLHP.MethodsThe study is being conducted over 5 years (2012–2017) in two phases, baseline and longitudinal. Baseline survey has been completed and consisted of (i) an interviewer-administered questionnaire-based evaluation of individual and contextual factors of importance to respiratory health (with special focus on chronic bronchitis, chronic obstructive pulmonary disease, asthma and obstructive sleep apnea), and (ii) clinical lung function and allergy tests with the consent of study participants. The address-redress phase consists of potential intervention programs and is currently being rolled out to address-at community level (via green light program and environmental study), and redress-at policy level (via obesity reduction and improved diagnosis and treatment of obstructive sleep apnea) the issues that have been identified by the baseline data.ResultsInterviewer-administered surveys were conducted in 2012–2013 and collected data on 874 individuals living in 406 households from two reserve communities located in Saskatchewan, Canada. Four hundred and forty six (51%) females and 428 (49%) males participated in the FNLHP.ConclusionsThe information from this project will assist in addressing and redressing many of the issues involved including the provision of adequate housing, health lifestyle practices, and in planning for health service delivery.

Potentially Pathogenic Bacteria and Antimicrobial Resistance in Bioaerosols from Cage-Housed and Floor-Housed Poultry Operations

BACKGROUND Antibiotics are used in animal confinement buildings, such as cage-housed (CH) and floor-housed (FH) poultry operations, to lower the likeliness of disease transmission. In FH facilities, antibiotics may also be used at sub-therapeutic levels for growth promotion. Low levels of antibiotic create a selective pressure toward antimicrobial resistance (AMR) in chicken fecal bacteria. OBJECTIVE The objective of this study was to compare bacteria and AMR genes in bioaerosols from CH and FH poultry facilities. METHODS Bioaerosols were collected from 15 CH and 15 FH poultry operations, using stationary area samplers as well as personal sampling devices. Bacteria concentrations were determined by genus- or species-specific quantitative polymerase chain reaction (PCR) and AMR genes were detected using endpoint PCR. RESULTS Enterococcus spp., Escherichia coli, and Staphylococcus spp. were significantly higher in bioaerosols of FH poultry operations than CH bioaerosols (P < 0.001) while Clostridium perfringens was significantly higher in area bioaerosols of CH operations than FH area bioaerosols (P < 0.05). Campylobacter spp. were detected only in bioaerosols of FH facilities. Zinc bacitracin resistance gene, bcrR, erythromycin resistance gene, ermA, and tetracycline resistance gene, tetA/C, were more prevalent in bioaerosols of FH facilities than CH bioaerosols (P < 0.01, P < 0.01, and P < 0.05, respectively). CONCLUSIONS Most bacteria are more concentrated and most AMR genes are more prevalent in bioaerosols of FH poultry operations, where growth-promoting antibiotics may be used.

Three new cases of apparent occupational asthma in swine confinement facility employees

To the Editors: In a previous issue of the European Respiratory Journal , Dosman et al. 1 reported on four cases of occupational asthma in newly employed workers in the large, recently developed, swine production facilities in Saskatchewan (Canada). All were full-time employees and all developed symptoms suggestive of asthma within a short time of commencing employment. None of the cases had a history of asthma, allergy symptoms or previous exposure to indoor air contaminants of swine confinement facilities. Work in swine buildings has been associated with respiratory symptoms, reductions in mean and across-shift lung function values 2, and increased bronchial responsiveness 3, 4. Asthma has been reported in swine workers, but this has typically occurred in workers with lengthy employment 5, 6. Cases 1–3 in our initial report showed some reaction to …