Agricultural workers are a large and understudied population (7) Respiratory disease appears to be a major problem in agriculture (11); specific respiratory illnesses recognized, include silo filler's disease, farmers lung, atypical farmer's lung, and grain handler's illness (12). We have described a new respiratory hazard among swine confinement workers (1-6). As a result of this work, we have become concerned about possible health hazards among workers in poultry confinement systems. Our pilot studies suggested they experience exposures and respiratory symptoms similar to swine confinement workers. A very limited amount of data by other researchers support this supposition. We propose the first in-depth medical and environmental study to investigate possible occupational hazards of poultry workers. The proposed investigation is a three-phase four-year study. Phase I is a 12-month effort to develop an industry-wide worker exposure profile by performing a series of walkthrough evaluations of typical turkey growing, chicken growing, hatchery, egg production and poultry processing operations. We intend to identify and quantify the subgroups of poultry workers with the greatest potential for occupational health risks for comprehensive medical and environmental studies in phase II. In phase II (years 2 and 3) we will recruit 400 workers for medical studies, (100 workers from each of the 4 subgroups of poultry workers at greatest risk). Medical assessment of these subjects will include ATS questionnaire (modified for occupational history) spirometry before and after 6 hours of work, serum precipitins, and skin testing. These data will be compared to two reference populations: 1) regionally proportioned unexposed blue collar workers, and 2) a blue collar reference population previously studied by NIOSH. Environmental assessment of the estimated 116 work-sites and 20 control work-sites will include measurements for ammonia, carbon dioxide, carbon monoxide, total and respirable dust, and endotoxin. Phase III, data analysis, will occur during year 4 of the study. We will examine the relationships of environmental exposures to respiratory symptoms and pulmonary function. We will also examine relationships of environmental control systems and levels of environmental contaminants. We will determine what recommendations are needed, if any, to improve the work environment, to protect workers from potential health hazards, and for possible future research.
