“…This is in line with what has been found for pig and poultry farmers, where endotoxin exposure is regarded the key exposure of relevance for the health effects (Omland, 2002;Doekes et al, 1997). A couple of studies, including the SUS study, have suggested a protective effect of farming exposure on sensitization, also among dairy farmers (Portengen et al, 2002;Elholm et al, 2013;Basinas et al, 2012b;Smit et al, 2010) From studies among farmers with bovine sensitization and allergic disease the need for action (secondary and tertiary prevention) is obvious; the study by Hinze et al (1997) suggest avoidance of farming to decrease both symptoms severity and sIgE level for Bos d2 compared to farmers who continue to work as a farmer.…”