Electronic Thesis and Dissertation Repository

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Johnson, Andrew M.

Abstract

Chronic obstructive lung disease (COPD), develops gradually, and tends to be noticed by farmers only after there has been a significant loss of lung function. People with symptoms of COPD often present for health care in later stages of disease, because they accept cough or breathlessness as “normal”.

Measurement of lung health for those at risk of developing COPD provides an opportunity for early detection of lung disease, and deter the progression toward irreversible damage to the lungs. COPD is, however, under-diagnosed.

The importance of bringing primary care providers and farmers together, and acknowledging the high-risk nature of occupational exposures, is essential in being able to influence change in early detection and protection of lung health. Standardized methods and measurement of lung health are needed to ensure the earliest diagnosis of COPD.

The purpose of this dissertation is to determine if early signs of lung disease are present in poultry farmers of Huron county in southwestern Ontario, and determine how often farmers use respiratory protection during poultry farming operations. A cross-Canada survey of lung health symptoms and respirator use will be reported, in comparison to the Huron county findings.

A cross-sectional observational study, with a convenience sample, based on the available 2-day lung health clinic appointments, provided fourteen (n=14) interpretable pre/post spirometry results. All FEV1/FVC ratios were above the cutoff of < 0.70%, however four of the results were between 70 and 75%, with three approaching COPD diagnostic criteria. The independent collection of symptoms from the standardized lung health questionnaire of MD-confirmed chronic bronchitis matched spirometry results and reduction in post FEF 25-75%.

Respirator use within Huron county, and across Canada, demonstrated low use of respirators all of the time, in both samples, 6.25% and 2% respectively. All poultry producers in the Huron county and cross-Canada lung health survey reported having a family physician. MD-confirmed bronchitis was reported as 18.75% in Huron county and 28.0% in the cross-Canada survey reported results.

The dissertation is the result of concerns raised by poultry farmers about their lung health. These findings point to the urgent need for lung health clinics for poultry farmers, to provide early detection and prevention of COPD.

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