Asthma in patients with farmer's lung during a five-year follow-up

Abstract

Objectives This study assessed the incidence of asthma in patients with farmer's lung. Methods The study population consisted of 103 1 patients who had occupational fanner's lung diagnosed from 1983 to 1988. The cases of farmer's lung were registered in the nationwide Register of Occupational Diseases by the Finnish Institute of Occupational Health, and all the patients in the study had received compensation from the insurance company for an occupational disease. The diagnosis of asthma was based on entitlement to a special refund for asthma medication costs from the national sickness insurance program. Results Seventy-four cases of asthma were found among farmers with farmer's lung up to the end of the 5 years following the year of the diagnosis for farmer's lung. The prevalence of asthma was 1 % in the year preceding the diagnosis. In the year of the diagnosis and during the 5 years of follow-up, asthma was diagnosed in an additional 6% of the patients. C O~C~U S~O~~S The results of this study confirm previous findings of a low prevalence of asthma before the onset of farmer's lung in small groups of patients. However, the results also indicate that the incidence of asthma increases during the first years after an episode of farmers lung. For example, in the present study, asthma was apparent in 7% of the patients 5 years after the diagnosis of farmer's lung.

Small airways diseases, excluding asthma and COPD: an overview

“…Nonspecific bronchial hyperresponsiveness [226,227] and wheezing may also be prevalent in subjects with recent hypersensitivity pneumonitis, especially in dairy farmers [228,229].…”

The risk of asthma among Finnish patients with farmer's lung

“…In our study, special reimbursement rights for the cost of asthma medication occurred in 8.6% of patients with farmer's lung during an average of 7.8 years of follow-up. Kokkarinen et al [10] found such reimbursement rights in 7.2% during a follow-up of 5 years, but did not include cases of occupational asthma. Erkinjuntti-Pekkanen found asthma diagnosed by physician in 16% of farmer's-lung patients during a mean follow-up of 14 years [5].…”

“…The incidence of asthma was increased especially during the first years after diagnosis of farmer's lung. In a previous Finnish register follow-up of patients diagnosed with farmer's lung in 1983-1988, most of the cases of asthma occurred during the first 3 years of the follow-up [10]. No comparison was made with farmers in general in that study, and cases of recognized occupational asthma were not included.…”

“…Follow-up studies have indicated that the prevalence of asthma [4,9,10,15], airway obstruction or bronchial hyperresponsiveness [1,3,6,11,13] may be increased among patients with farmer's lung. Very few of the studies have included a comparison group that would have allowed for adjustment for the overall risk of asthma among farmers.…”

Atteinte des petites voies aériennes dans la pneumopathie d’hypersensibilité

“…Les manifestations cliniques d'hyperréactivité bronchique (asthme, sibilances) ont été rapportées de façon accrue chez les sujets porteurs de pneumopathie d'hypersensibilité dans l'évolution de leur maladie, notamment en zone de production laitière [25,26]. En outre, plusieurs études suggèrent fortement un excès d'hyperréactivité bronchique chimique chez les patients atteints de pneumopathie d'hypersensibilité [27][28][29].…”