Respirační alergická onemocnění u pracovníků v zemědělství

Respiratory Allergic Diseases in Workers in Agriculture

Agriculture is the field with the frequent occurrence of occupational diseases including professional respiratory allergic diseases,

especially asthma bronchial and allergic rhinitis, rarely exogenous allergic alveolitis.

Noxae of an animal and vegetable origin are allergenic. As concerns animal allergens, there is especially the cow epithelium,

which is the second most common cause of professional asthma following the flour powder in the Czech Republic and other European countries. As concerns vegetable allergens, especially hay, straw and so-called dust from barns is important.

The paper presents the information on the sample of 40 agriculture workers with professional athma and/or allergic rhinitis

reported by the Clinic of Occupational Diseases of the Faculty Hospital in Hradec Králové in the course of 1994–2003.

The most frequent profession was the breeder of the farm animals, the male/female nurse of cattle and poultry. The simultaneous sensitivity to several agricultural allergens was found in the most of patients. The average length of a latent period between the beginning of exposure and reporting occupational disease was 16,5 years. The working environment of poultry farms was found to be the most at risk with the shorter latent period. The author attached the case reports of agriculture workers with allergic diseases from her own practice.

The shortcomings of diagnostics are related to a complex action of allergens of different origins and the presence of a mixture of allergens, which contribute to the problems related to identification of particular noxae. In the diagnostic process, it is always necessary to consider chronic bronchitis or a common occurrence of asthma and bronchitis, which is present in about 10 % patients with asthma. The paper includes the review of more rare respiratory diseases, which have to be considered in the differential diagnostic process (organic dust toxic syndrome, hypersensitivity pneumonitis, silo-filler’s disease, asthma like syndrome, etc.).

Key words:
occupational diseases in agriculture workers, professional asthma bronchiale, agricultural allergens, lung syndromes in workers in agriculture