Asthma in pesticide users: an update from the Great Britain Prospective Investigation of Pesticide Applicators’ Health (PIPAH) cohort study
Bibliographic record
Abstract
OBJECTIVES: To define the prevalence and incidence of asthma in a large working population of pesticide workers and to assess which exposures are potentially of relevance to causing or aggravating this condition. METHODS: A baseline cross-sectional study at recruitment (2013-2017, n=5817), with follow-up in 2018 (n=2578), was carried out in predominantly Great Britain based pesticide workers. At baseline, participants completed a health and work questionnaire which included questions on demographic, lifestyle, socioeconomic and work-related factors, pesticide use and doctor diagnosed health conditions. In January 2018, a follow-up questionnaire focused on respiratory ill health, with questions covering self-reported respiratory symptoms and doctor diagnosed respiratory conditions. The associations of various exposures with asthma were estimated using logistic regression adjusting for age as a continuous variable, and for sex where possible. An estimate of hours worked with pesticides in the previous year was calculated for each participant. RESULTS: At baseline, 608 (10.4%) had doctor diagnosed asthma. In 2018 the figure was 297 (11.5% of the follow-up population); the incidence of new asthma cases between surveys was 1.7 cases per 1000 participants per year. At follow-up, 18.1% reported wheeze in the last 12 months, 73.2% of those with self-reported asthma noted it to be persistent and using a more specific definition of asthma (doctor diagnosed asthma with at least one asthma-related symptom in the last year); 6.8% (95% CI 5.9% to 7.9%) fulfilled this definition. At follow-up, 127 participants felt that their asthma was caused or made worse by their work, with 77 (63.6%) nominating organic dust, 13 (10.7%) unspecified dust, 12 (9.9%) chemicals, 9 (7.4%) mixed exposures, 7 (5.8%) physical agents and 3 (2.5%) fumes or other irritants. There was little or no association between high pesticide exposure and doctor diagnosed asthma or self-reported recent wheeze, although there was an elevated risk for work-related wheeze (OR for high exposure=2.67; 95% CI 1.16 to 6.18). High pesticide exposure (high vs low exposure category OR 2.68, 95% CI 1.28 to 5.60) was also associated with work-related chest tightness. Exposure to organic dusts was associated (significantly, p=0.026) with persistent asthma when adjusted for the effects of age and smoking. CONCLUSIONS: This large study of pesticide workers has identified expected levels of doctor diagnosed asthma, and high levels of self-reported respiratory symptoms. Pesticide exposure was associated with an increased risk of self-reported work-related wheeze, but not with asthma or wheeze in general. Further work is needed to identify more clearly which exposures within a complex mixed exposure profile are likely causative in order to best focus interventions to reduce work-related asthma and related conditions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".