The relation between the health of workers and the environment in swine confinement buildings was investigated in a study of 57 workers on 30 swine farms in southern Sweden and 55 matched controls. Swine workers reported significantly higher frequencies of respiratory symptoms, more frequent colds and absence due to chest illness, and a history of pneumonia. The increased frequency of symptoms of respiratory disease was related to the number of years and per cent of the day spent working with swine. Symptoms were also associated with respirable dust, total dust, endotoxin in total dust, and number of microbes in the air of the work environment.

QUESTIONNAIRESStandardized questionnaires are commonly used to determine the extent of symptoms among workers exposed to organic dusts. Most of the questionnaires are based upon the original British Medical Research Council questionnaire or the American Thoracic Society questionnaire. These questionnaires were mainly designed for long-term exposure to inorganic dust (e.g., coal mining) or to air pollution.A recent workgroup meeting about the health effects caused by exposure to dust in swine confinement buildings reviewed the symptoms that have been reported in different studies [Rylander et al., 1989]. It was found that airway, as well as generalized symptoms, were frequent. Major symptoms included cough with and without sputum, chest tightness, wheezing, and dyspnea. Generalized symptoms were influenza-like (fever, chills, and joint pains), but eye irritation, repeated upper respiratory infections, and pneumonia also occurred. Some of the symptoms were related to work with unusually dusty tasks, and others were more common after the return to work following a holiday.In view of the information accumulated by the workgroup, the questionnaires used previously were found to be incomplete. A new questionnaire has since been designed to study environments in which persons are exposed to organic dusts.The following questionnaire was presented during the workshop and subsequently modified, taking the points raised during discussion as well as experience from a field study using the questionnaire into consideration. In its present form, it represents a proposal for a standard questionnaire suggested by the above authors, but has not been formally endorsed by all participants of the workshop.

A study was performed to assess medical symptoms and pulmonary function among persons working in 30 swine confinement buildings on 28 farms. Data were taken from 57 persons working on these farms and on 55 matched controls.Health data collected included an interview for occupational history, health history, and disease symptoms. Pulmonary function testing was done before and after a daily work period [Ferris, 1978; Gardner, 19791, and a blood sample was collected to test for antibodies to agents in the work environment pelin et al, 19851. The questionnaire used for the interview consisted of two parts. The first part asked for specific symptoms (primarily respiratory symptoms) that the workers attributed directly to their work in swine stables. These questions were asked both before and after the work shift. The first part of the questionnaire was compiled from two separate questionnaires that had been used extensively in previous farm health studies [Donham and Gustafsson, 1982; Donham et al, 1984 a,b, Donham et al, 1986; Kolmodin-Hedman et al, manuscript in preparation]. The second part consisted of the complete American Thoracic Society (ATS) Epidemiology Standardization Project questionnaire [Ferris, 19781, which had been translated into Swedish.The questionnaire had also been used extensively in a similar study in Iowa. The second part of the questionnaire was also used to interview controls, who were farmers or farm workers from the same geographical area, who worked in any type of farming except swine or poultry buildings. These controls were matched to the swine farm workers by age (+5 years), sex, and smoking history (f5 cigarette pack years). Figure 1 summarizes some of the significant findings from the first part of the questionnaire interview. Bronchitis symptoms were very commonly reported, with 60% reporting cough and 40% reporting cough with phlegm. Symptoms of bronchoconstriction were reported by 28% of the workers. Eye, nose, and throat irritation

Work-related respiratory symptoms and bronchial reactivity were studied in 76 never-smoking farmers and in a control group not exposed to organic dusts. The farmers were divided into those working with vegetables/grain crops, animals but not swine, and with swine. The extent of symptoms was evaluated using a specific organic dust questionnaire. Bronchial reactivity was assessed with the methacholine challenge test. An increased incidence of organic dust toxic syndrome (ODTS), mucous membrane irritation (MMI), and chronic bronchitis (CB) was found among farmers working with swine or other animals. Pulmonary function baseline values were normal. Bronchial reactivity was increased and related to subjective symptoms of MMI and CB. There was also a relation between fatigue at work and bronchial reactivity.

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