Investigation on the Protective Value of Breathing Masks in Farmer's Lung Using an Inhalation Provocation Test

Müller-Wening, D.; Repp, H

doi:10.1378/chest.95.1.100

Cited by 46 publications

(16 citation statements)

References 15 publications

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“…In persons exposed to grain dust, the utilization of RDs did not cause a decrease in symptoms or changes in lung function [16,19]. It has been demonstrated among patients suffering from farmer's lung that the use of an RD cannot avoid the allergic reaction completely when the farmers are exposed to appropriate allergens [13] and acute febrile reactions may even occur [14]. It has also been shown that, among persons suffering from flour-dust asthma, RDs could not protect all patients who were exposed [15].…”

Section: Discussionmentioning

confidence: 99%

“…Farmers suffering from respiratory symptoms tend to wear RDs more frequently than farmers without these symptoms [12]. However, it has been shown that even the use of RDs with P2 and P3 filters did not protect patients with farmer's lung; they developed systemic and pulmonary reactions after a challenge [13,14]. It has also been demonstrated that flour-dust asthmatics [15], pig farmers [16,17], grain workers [18,19], subjects suffering from laboratory animal allergy [20], and patients with a cedar allergy [21] cannot receive complete protection using RDs.…”

mentioning

confidence: 99%

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Protective effect of respiratory devices in farmers with occupational asthma

Müller-Wening¹,

Neuhauss²

1998

Eur Respir J

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Among farmers, the prevalence of chronic bronchitis and asthma is higher than in the general population [1][2][3]. This phenomenon is due to the influence of immunological and nonimmunological components of organic dusts [4,5]. Particular importance is attached to the endotoxins [6][7][8]. Reduced exposure to organic dusts is an important preventive measure [9,10]. The utilization of a personal respiratory device (RD) is a common method of cleaning contaminated air [11]. Farmers suffering from respiratory symptoms tend to wear RDs more frequently than farmers without these symptoms [12]. However, it has been shown that even the use of RDs with P2 and P3 filters did not protect patients with farmer's lung; they developed systemic and pulmonary reactions after a challenge [13,14]. It has also been demonstrated that flour-dust asthmatics [15], pig farmers [16,17], grain workers [18,19], subjects suffering from laboratory animal allergy [20], and patients with a cedar allergy [21] cannot receive complete protection using RDs. This failure has been blamed on filter-and face-seal leaks. LACEY et al. [22] demonstrated that filters allow penetration of 0.1-3.1% of actinomycete spores, depending on design. MANNINEN et al. [23] demonstrated face-seal leakages of 2.4-3.4% in RDs.The present study examined whether RDs have a protective effect on farmers with occupational asthma. MethodsTwenty-six farmers from southern Bavaria with suspected occupational asthma were examined. The sample comprised eight females and 18 males with an age of 38.6± 11.8 yrs (mean±SD). Four of the females and six of the males were smokers. All 26 subjects were involved in dairy farming and/or bull breeding either using conventional straw bedding and mucking out by hand or working with manure. They all came in contact with grain dust, hay and straw daily and had been exposed to these conditions for a mean duration of 34±14.9 yrs. Health problems had been present for a mean of 9.1±6.8 yrs. The average daily duration of exposure to agricultural dust lasted up to 4 h. After the farmers had been exposed to hay, straw or grain dust, all of them suffered from coughing, dyspnoea and wheezing breath. Six of them had a history of atopy. A physical examination revealed no deviation from what is considered to be normal. The mean total serum immunoglobulin (Ig)E level was 325±403 IU·mL -1 . The mean serum levels of IgG, IgM, IgA and α 1 -antitrypsin were within normal limits. Table 1 shows the results of the lung-function tests of the 26 farmers at the time of their admission as inpatients. The patients were taking no antiinflammatory or bronchodilatory medicine at the time of the investigations.In all patients, nonspecific bronchial reactivity was tested. A test was rated positive if the specific airway resistance (sRaw) rose to at least twice the baseline value and the absolute value became Š2.0 kPa·s -1 . None of the patients showed a significant rise in sRaw following the inhalation of physiological saline and lactose powder. Eleven of the farmers experi...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Protective effect of respiratory devices in farmers with occupational asthma

Müller-Wening¹,

Neuhauss²

1998

Eur Respir J

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“…In the laboratory a standardized hay exposure or an inhalation challenge with the offending antigen can be performed (4,5). In a study of inhalation provocation tests in the case of bird fancier's lung, mushroom worker's lung, and farmer's lung, the two strongest reactions occurred in two patients tested in the laboratory with the method of natural hay exposure (6).…”

Section: Discussionmentioning

confidence: 99%

Severe farmer's lung following a workplace challenge.

Kokkarinen¹,

Tukiainen²,

Terho³

1992

Scand J Work Environ Health

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“…Antigen exposure cannot be totally removed in dry sausage factories, for technical and economical reasons. Carrying dust mask is ecient in farmer studies [16]. The use of dust masks that ®lter particles from 0.5 to 10 lm signi®cantly decreases clinical symptoms during provocation tests [16].…”

Section: Extractmentioning

confidence: 99%

“…Carrying dust mask is ecient in farmer studies [16]. The use of dust masks that ®lter particles from 0.5 to 10 lm signi®cantly decreases clinical symptoms during provocation tests [16]. However, if the mask is not fully ecient, workers may still inhale spores from very dense aerosols.…”

Section: Extractmentioning

confidence: 99%