Gender differences in respiratory health outcomes among farming cohorts around the globe: findings from the AGRICOH consortium

Abstract

Purpose: Respiratory hazards of farming have been identified for centuries, with little focus on gender differences. We used data from the AGRICOH consortium, a collective of prospective cohorts of agricultural workers, to assess respiratory disease prevalence among adults in 18 cohorts representing over 200,000 farmers, farm workers, and their spouses from six continents.Methods: Cohorts collected data between 1992-2016 and ranged in size from 200 to >128,000 individuals; 44% of participants were female. Farming practices varied from subsistence farming to large scale industrial agriculture. All cohorts provided respiratory outcome information for their cohort based on their study definitions. The majority of outcomes were based on self-report using standard respiratory questionnaires; the greatest variability in assessment methods was associated with chronic obstructive pulmonary disease (COPD).Results: For all three respiratory symptoms (cough, phlegm, and wheeze), the median prevalence in men was higher than in women, with the greatest difference for phlegm (17% vs. 10%). For asthma, women had a higher prevalence (7.8% vs 6.5%), with the difference associated with allergic asthma. The relative proportion of allergic asthma varied among cohorts. In two of eight cohorts for women and two of seven cohorts for men, allergic asthma was more common than nonallergic asthma.Conclusions: These findings indicate that respiratory outcomes are common among farmers around the world despite differences in agricultural production. As women in the general population are at higher risk of asthma, exploring gender differences in occupational studies is critical for a deeper understanding of respiratory disease among agricultural workers.

Environmental exposures contribute to respiratory and allergic symptoms among women living in the banana growing regions of Costa Rica

“…For example, AGRICOH (A Consortium of Agricultural Cohort Studies) found an average asthma prevalence of 7.8% in women in the 18 cohorts studied, while 21% of women in our cohort reported an asthma diagnosis and 37% exhibited asthma symptoms, as measured by the asthma score. 32 Our cohort did have a similar prevalence of wheeze (16%) compared with AGRICOH, which found an average of 15% of participants had respiratory symptoms (cough and wheeze). 32 A study of mothers of young children living in an urban setting in Ethiopia found a lower prevalence of wheeze (6.2%) compared with our cohort; it also reported a statistically significant relationship between Workplace pesticide use in the household and respiratory symptoms.…”

“…32 Our cohort did have a similar prevalence of wheeze (16%) compared with AGRICOH, which found an average of 15% of participants had respiratory symptoms (cough and wheeze). 32 A study of mothers of young children living in an urban setting in Ethiopia found a lower prevalence of wheeze (6.2%) compared with our cohort; it also reported a statistically significant relationship between Workplace pesticide use in the household and respiratory symptoms. 33 We similarly found an association between pesticide use in the home and doctor-diagnosed asthma.…”

Environmental and Health Risks of Pesticide Use in Ethiopia

“… 54 However, another relatively larger study that focused both on male pesticide applicators as well as female re-entry workers in commercial farming systems in Ethiopia (i.e., small-scale irrigated farms, large-scale open farms and cut-flower greenhouses) indicated significant exposure-response associations of occupational pesticide exposure with respiratory symptoms and reductions in lung function. 56 – 57 Negatu et al compared the magnitude of the reduction in lung function due to pesticide exposure with a standardized estimate of lung function loss due to cigarette smoking per year and the observed effect due to pesticide exposure was 3- and 5-fold greater per year than cigarette smoking in males and females, respectively. 56 …”

Pesticide Research on Environmental and Human Exposure and Risks in Sub-Saharan Africa: A Systematic Literature Review

“…While other studies focused on water bodies in Kenya [ 41 ]. In Ethiopia, several research efforts were conducted around the flower and larger open-farming systems in proximity to the Rift Valley lakes [ 16 , 42 , 43 , 44 , 45 ]. Finally, in West Africa, several connected studies focused on different export-oriented farming systems (e.g., cotton and cocoa) and smallholder farming systems [ 46 ]).…”