Work Activities, Self-Reported Symptoms, and Diminished Lung Function in a Population of Predominantly Hispanic Industrial Hog Operation Workers in North Carolina, United States
Background/Aim: Although swine worker respiratory disease is established, evidence is mainly from predominantly Caucasian farm-owner-operator cohorts whose work exposures may differ from laborers hired to perform day-to-day intensive swine production jobs in confinement barns. The Rural Empowerment Association for Community Help (REACH) has initiated community-based participatory research (CBPR) with Hispanic laborers hired to work in industrial hog operations (IHOs) in eastern North Carolina. Together with REACH, we investigated whether such IHO workers’ occupational exposures were related to respiratory health outcomes. Methods: During 2013-14, we completed a 4-month CBPR panel study, involving baseline and 8 bi-weekly visits to collect demographic, personal, and work exposure data and spirometry measurements. We assessed the relation of IHO work activities with respiratory outcomes at baseline (linear regression) and longitudinally (fixed-effects ordinal logistic regression), adjusting for potential confounders. Results: One hundred and three IHO workers were enrolled (88% Hispanic; 46% male; age mean[±SD] 38±11 years) and completed 782 bi-weekly visits. Asthma prevalence was 8.7% and 92.6% were non-smokers. At baseline, total number of years of IHO work was negatively associated with forced expiratory volume (L) in the first second (FEV1) (ß=-0.031; 95% confidence interval [CI]: -0.060, -0.001). Longitudinally, positive associations were observed between pressure washing barns and coughing (odds ratio [OR]=3.8; 95%CI: 1.2, 12.3), herd changes and nasal congestion (OR=7.4; 95%CI: 1.2, 44.6) and confinement barn ventilation fans turned off and difficulty breathing (OR=11.2; 95% CI: 2.8, 44.4), eye irritation (OR=5.8; 95%CI: 1.1, 30.7), and chills (OR=5.1; 95%CI: 3.0, 8.9). Conclusions: In a predominantly Hispanic cohort of IHO workers, we observed relations between IHO work activities and adverse respiratory outcomes, particularly prolonged IHO employment and activities that aerosolize and keep waste in-barn. Challenges in exposure assessment from lack of on-IHO access and worker reluctance to enroll in cohorts can be mitigated using an empowering CBPR approach.