Etiology

Exposure to organic dusts in agricultural work areas appears to be a major risk factor for developing acute and chronic bronchitis. Organic dusts are mixtures of several entities including endotoxin, microbial products, and plant and soil particles, and may also include inorganic dusts. It is unclear which of these components is most correlated with respiratory illness, but endotoxin levels are more clearly associated with bronchitis than total dust levels (92).

Concentration and length of exposure to dusts may also be important factors. For instance, acute, high-level exposures to organic dusts may lead to ODTS; chronic, intermittent, lower level exposures may lead to bronchitis. Prior sensitization is not required for acute responses to organic dust exposure. For example, acute cough and signs of lower respiratory inflammation may develop with exposure to hog confinement areas by persons not previously exposed. Compared to previously unexposed nonfarmers, persons chronically exposed to swine confinement areas appear to have a reduced airway response, suggesting possible adaptive mechanisms. Having a history of HP or ODTS from work in animal confinement or greenhouses is a risk factor for chronic bronchitis (93-95).

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