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Clinical Trial
. 2019 Jun 17;20(1):124.
doi: 10.1186/s12931-019-1082-2.

Is atopy a risk indicator of chronic obstructive pulmonary disease in dairy farmers?

Matthieu Veil-Picard  1 , Thibaud Soumagne  1 , Rechana Vongthilath  1 , Isabella Annesi-Maesano  2 , Alicia Guillien  3 , Lucie Laurent  1 , Pascal Andujar  4   5 , Nicolas Roche  6 , Stephane Jouneau  7   8 , Benoit Cypriani  9 , Jean-Jacques Laplante  10 , Bruno Degano  11   12 , Jean-Charles Dalphin  13   14
Affiliations
Clinical Trial

Is atopy a risk indicator of chronic obstructive pulmonary disease in dairy farmers?

Matthieu Veil-Picard et al. Respir Res. .

Abstract

Allergic mechanisms related to environmental and occupational exposure have been suggested to contribute to the development of chronic obstructive pulmonary disease (COPD).

Objectives: To investigate the relationships between atopy markers, persistent airflow limitation (PAL) and occupational exposure in dairy farmers.

Methods: Clinical and biological (total IgE and 21 allergen specific IgE) markers of atopy were assessed in 101 dairy farmers with PAL (DF-PAL), 85 non-farmers with PAL (NF-PAL) (both groups were prospectively included from a screening program performed between 2011 and 2015), and matched controls, i.e. 98 farmers without PAL (DF-controls) and 89 non-farming subjects without PAL (NF-controls). Occupational exposure in farmers was estimated using a validated questionnaire.

Results: Prevalence of allergy history was significantly higher in DF-PAL and in NF-PAL than in controls. Polysensitization, and sensitization to seasonal and food allergens were more frequent in DF-PAL than in DF-controls, respectively: 13.8% vs 1% (adjusted odds ratio (aOR): 17.5 (2.2-134), 11.9% vs 3.1% (aOR: 4.4 (1.2-7.2) and 16.8% vs 4.1% (aOR: 5.2 (1.7-7.2)). The prevalence of atopy markers was similar between NF-PAL patients and NF-controls.

Conclusions: PAL in farmers is associated with a high rate of markers of atopy, supporting atopy as a risk indicator. Clinical trial registered with ClinicalTrials.gov (NCT02540408).

Keywords: Atopy; Chronic obstructive pulmonary disease; Farmers; Matthieu Veil-Picard and Thibaud Soumagne contributed equally to the work.; Occupational exposure; Specific IgE.

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Conflict of interest statement

Dr. Roche reports grants and personal fees from Boehringer Ingelheim, Pfizer and Novartis, personal fees from Teva, GSK, AstraZeneca, Chiesi, Mundipharma, Cipla, Sano, Sandoz, 3 M, Zambon, outside the submitted work. Dr. Dalphin reports grants, personal fees and non-financial support from Novartis Pharma, GSK, Chiesi, Intermune, AstraZeneca, Boehringer ingelheim and non-financial support from Stallergenes, outside the submitted work.

Dr. Dalphin reports grants, personal fees and non-financial support from Novartis Pharma, personal fees and non-financial support from GSK, personal fees and non-financial support from Chiesi, personal fees and non-financial support from Intermune, personal fees and non-financial support from AstraZeneca, personal fees and non-financial support from Boehringer ingelheim, non-financial support from Stallergenes, outside the submitted work.

The other authors declare that they have no conflict of interest for the submitted work.

Figures

Fig. 1
Fig. 1
Flow chart of participants included in the study. Subjects were recruited through a screening program set up by two national health insurance organizations. Inclusion criteria in the screening programs were: men or women aged 40 to 74 years, with no history of chronic respiratory disease including asthma and hypersensitivity pneumonitis. Abbreviations: COPD: chronic obstructive lung disease; DF: dairy farmer; NF: non farmer
Fig. 2
Fig. 2
Frequency histogram of specific IgE among dairy-farmers and non-dairy-farmers’ patients COPD: chronic obstructive pulmonary disease; DF-COPD: dairy farmers with COPD; DF-control: dairy farmers in control group; NF- COPD: COPD in non-dairy farmers; NF-control: non-dairy farmers in control group.
Fig. 3
Fig. 3
Comparison of odds ratios for markers of atopy among dairy-farmers and non-dairy-farmers (reference groups are patients without chronic obstructive pulmonary disease (COPD). All ORs were adjusted for age (continuous), gender (reference: female) and pack-years (< 1, 1–15, > 15)
See this image and copyright information in PMC

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