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The Western Journal of Medicine logoLink to The Western Journal of Medicine
. 1993 Jan;158(1):56–63.

Epidemiology of health and safety risks in agriculture and related industries. Practical applications for rural physicians.

J E Zejda 1, H H McDuffie 1, J A Dosman 1
PMCID: PMC1021941  PMID: 8470386

Abstract

Epidemiologic studies document that work in the agricultural sector is associated with many occupational health hazards. Exposure to organic dusts and airborne microorganisms and their toxins may lead to respiratory disorders. The burden of exposure-related chronic bronchitis, asthma, hypersensitivity pneumonitis, organic-dust toxic syndrome, and chronic airflow limitation can be diminished by appropriate preventive measures. The contribution of exposures to agricultural chemicals to cancers and neurodegenerative disorders is being investigated. Some studies document that farmers and those in related industries are at higher risk for the development of cancer of the stomach, soft tissue sarcoma, non-Hodgkin's lymphoma, and multiple myeloma. Chronic encephalopathy and Parkinson's and Alzheimer's diseases are being studied in relation to agricultural chemicals. The possible carcinogenicity and neurotoxicity of pesticides emphasize the need to promote the safe use of chemicals. Another area for health promotion programs is disabling injuries and traumatic deaths. Farm accidents are important because of their frequent occurrence among young people and disturbing fatality rates. Other health issues of concern in these industries include skin diseases, hearing loss, and stress.

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Selected References

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  1. Anger W. K., Moody L., Burg J., Brightwell W. S., Taylor B. J., Russo J. M., Dickerson N., Setzer J. V., Johnson B. L., Hicks K. Neurobehavioral evaluation of soil and structural fumigators using methyl bromide and sulfuryl fluoride. Neurotoxicology. 1986 Fall;7(3):137–156. [PubMed] [Google Scholar]
  2. Barbeau A., Roy M., Cloutier T., Plasse L., Paris S. Environmental and genetic factors in the etiology of Parkinson's disease. Adv Neurol. 1987;45:299–306. [PubMed] [Google Scholar]
  3. Blair A., Grauman D. J., Lubin J. H., Fraumeni J. F., Jr Lung cancer and other causes of death among licensed pesticide applicators. J Natl Cancer Inst. 1983 Jul;71(1):31–37. [PubMed] [Google Scholar]
  4. Blair A., Malker H., Cantor K. P., Burmeister L., Wiklund K. Cancer among farmers. A review. Scand J Work Environ Health. 1985 Dec;11(6):397–407. doi: 10.5271/sjweh.2208. [DOI] [PubMed] [Google Scholar]
  5. Blair A., McDuffie H. H., Dosman J. A. Cancer in rural areas. CMAJ. 1987 May 1;136(9):924–925. [PMC free article] [PubMed] [Google Scholar]
  6. Bongers P., Houthuijs D., Remijn B., Brouwer R., Biersteker K. Lung function and respiratory symptoms in pig farmers. Br J Ind Med. 1987 Dec;44(12):819–823. doi: 10.1136/oem.44.12.819. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Broder I., Mintz S., Hutcheon M. A., Corey P. N., Kuzyk J. Effect of layoff and rehire on respiratory variables of grain elevator workers. Am Rev Respir Dis. 1980 Oct;122(4):601–608. doi: 10.1164/arrd.1980.122.4.601. [DOI] [PubMed] [Google Scholar]
  8. Brownson R. C., Reif J. S., Chang J. C., Davis J. R. Cancer risks among Missouri farmers. Cancer. 1989 Dec 1;64(11):2381–2386. doi: 10.1002/1097-0142(19891201)64:11<2381::aid-cncr2820641131>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
  9. Burns R. S., Chiueh C. C., Markey S. P., Ebert M. H., Jacobowitz D. M., Kopin I. J. A primate model of parkinsonism: selective destruction of dopaminergic neurons in the pars compacta of the substantia nigra by N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. Proc Natl Acad Sci U S A. 1983 Jul;80(14):4546–4550. doi: 10.1073/pnas.80.14.4546. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Calne D. B., Eisen A., McGeer E., Spencer P. Alzheimer's disease, Parkinson's disease, and motoneurone disease: abiotrophic interaction between ageing and environment? Lancet. 1986 Nov 8;2(8515):1067–1070. doi: 10.1016/s0140-6736(86)90469-1. [DOI] [PubMed] [Google Scholar]
  11. Campbell A. R., Swanson M. C., Fernandez-Caldas E., Reed C. E., May J. J., Pratt D. S. Aeroallergens in dairy barns near Cooperstown, New York and Rochester, Minnesota. Am Rev Respir Dis. 1989 Aug;140(2):317–320. doi: 10.1164/ajrccm/140.2.317. [DOI] [PubMed] [Google Scholar]
  12. Chan-Yeung M., Chan H., Salari H., Wall R., Tse K. S. Grain-dust extract induced direct release of mediators from human lung tissue. J Allergy Clin Immunol. 1987 Sep;80(3 Pt 1):279–284. doi: 10.1016/0091-6749(87)90032-7. [DOI] [PubMed] [Google Scholar]
  13. Chan-Yeung M., Schulzer M., MacLean L., Dorken E., Grzybowski S. Epidemiologic health survey of grain elevator workers in British Columbia. Am Rev Respir Dis. 1980 Feb;121(2):329–338. doi: 10.1164/arrd.1980.121.2.329. [DOI] [PubMed] [Google Scholar]
  14. Cockcroft A. E., McDermott M., Edwards J. H., McCarthy P. Grain exposure--symptoms and lung function. Eur J Respir Dis. 1983 Apr;64(3):189–196. [PubMed] [Google Scholar]
  15. Cotton D. J., Graham B. L., Li K. Y., Froh F., Barnett G. D., Dosman J. A. Effects of grain dust exposure and smoking on respiratory symptoms and lung function. J Occup Med. 1983 Feb;25(2):131–141. [PubMed] [Google Scholar]
  16. Davies J. E. Neurotoxic concerns of human pesticide exposures. Am J Ind Med. 1990;18(3):327–331. doi: 10.1002/ajim.4700180314. [DOI] [PubMed] [Google Scholar]
  17. Denis W. B. Causes of health and safety hazards in Canadian agriculture. Int J Health Serv. 1988;18(3):419–436. doi: 10.2190/Q6KB-TMW2-61CB-Q0VD. [DOI] [PubMed] [Google Scholar]
  18. Donham K. J. Health effects from work in swine confinement buildings. Am J Ind Med. 1990;17(1):17–25. doi: 10.1002/ajim.4700170105. [DOI] [PubMed] [Google Scholar]
  19. Donham K. J., Zavala D. C., Merchant J. Acute effects of the work environment on pulmonary functions of swine confinement workers. Am J Ind Med. 1984;5(5):367–375. doi: 10.1002/ajim.4700050505. [DOI] [PubMed] [Google Scholar]
  20. Donham K., Haglind P., Peterson Y., Rylander R., Belin L. Environmental and health studies of farm workers in Swedish swine confinement buildings. Br J Ind Med. 1989 Jan;46(1):31–37. doi: 10.1136/oem.46.1.31. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Donna A., Betta P. G., Robutti F., Crosignani P., Berrino F., Bellingeri D. Ovarian mesothelial tumors and herbicides: a case-control study. Carcinogenesis. 1984 Jul;5(7):941–942. doi: 10.1093/carcin/5.7.941. [DOI] [PubMed] [Google Scholar]
  22. Dosman J. A. Chronic obstructive pulmonary disease and smoking in grain workers. Ann Intern Med. 1977 Dec;87(6):784–786. doi: 10.7326/0003-4819-87-6-784. [DOI] [PubMed] [Google Scholar]
  23. Dosman J. A., Graham B. L., Hall D., Pahwa P., McDuffie H. H., Lucewicz M., To T. Respiratory symptoms and alterations in pulmonary function tests in swine producers in Saskatchewan: results of a survey of farmers. J Occup Med. 1988 Sep;30(9):715–720. [PubMed] [Google Scholar]
  24. Dosman J. A., Graham B. L., Hall D., Van Loon P., Bhasin P., Froh F. Respiratory symptoms and pulmonary function in farmers. J Occup Med. 1987 Jan;29(1):38–43. [PubMed] [Google Scholar]
  25. Dosman J. A., McDuffie H. H., Pahwa P. Atopic status as a factor in job decision making in grain workers. J Occup Med. 1991 Sep;33(9):1007–1010. [PubMed] [Google Scholar]
  26. Emanuel D. A. A case for medical, environmental, and safety screening. Am J Ind Med. 1990;18(4):413–419. doi: 10.1002/ajim.4700180411. [DOI] [PubMed] [Google Scholar]
  27. Emanuel D. A., Draves D. L., Nycz G. R. Occupational health services for farmers. Am J Ind Med. 1990;18(2):149–162. doi: 10.1002/ajim.4700180207. [DOI] [PubMed] [Google Scholar]
  28. Emanuel D. A., Kryda M. J. Farmer's lung disease. Clin Rev Allergy. 1983 Dec;1(4):509–532. [PubMed] [Google Scholar]
  29. Ferraz H. B., Bertolucci P. H., Pereira J. S., Lima J. G., Andrade L. A. Chronic exposure to the fungicide maneb may produce symptoms and signs of CNS manganese intoxication. Neurology. 1988 Apr;38(4):550–553. doi: 10.1212/wnl.38.4.550. [DOI] [PubMed] [Google Scholar]
  30. Fink J. N. Hypersensitivity pneumonitis. J Allergy Clin Immunol. 1984 Jul;74(1):1–10. doi: 10.1016/0091-6749(84)90077-0. [DOI] [PubMed] [Google Scholar]
  31. Frank R., Rasper J., Smout M. S., Braun H. E. Organochlorine residues in adipose tissues, blood and milk from Ontario residents, 1976-1985. Can J Public Health. 1988 May-Jun;79(3):150–158. [PubMed] [Google Scholar]
  32. Gallagher R. P., Spinelli J. J., Elwood J. M., Skippen D. H. Allergies and agricultural exposure as risk factors for multiple myeloma. Br J Cancer. 1983 Dec;48(6):853–857. doi: 10.1038/bjc.1983.277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Hardell L., Eriksson M., Lenner P., Lundgren E. Malignant lymphoma and exposure to chemicals, especially organic solvents, chlorophenols and phenoxy acids: a case-control study. Br J Cancer. 1981 Feb;43(2):169–176. doi: 10.1038/bjc.1981.25. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Hardell L., Sandström A. Case-control study: soft-tissue sarcomas and exposure to phenoxyacetic acids or chlorophenols. Br J Cancer. 1979 Jun;39(6):711–717. doi: 10.1038/bjc.1979.125. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Harrison J. E., Frommer M. S., Ruck E. A., Blyth F. M. Deaths as a result of work-related injury in Australia, 1982-1984. Med J Aust. 1989 Feb 6;150(3):118–125. doi: 10.5694/j.1326-5377.1989.tb136388.x. [DOI] [PubMed] [Google Scholar]
  36. Hertzman C., Wiens M., Bowering D., Snow B., Calne D. Parkinson's disease: a case-control study of occupational and environmental risk factors. Am J Ind Med. 1990;17(3):349–355. doi: 10.1002/ajim.4700170307. [DOI] [PubMed] [Google Scholar]
  37. Ho S. C., Woo J., Lee C. M. Epidemiologic study of Parkinson's disease in Hong Kong. Neurology. 1989 Oct;39(10):1314–1318. doi: 10.1212/wnl.39.10.1314. [DOI] [PubMed] [Google Scholar]
  38. Hoar S. K., Blair A., Holmes F. F., Boysen C. D., Robel R. J., Hoover R., Fraumeni J. F., Jr Agricultural herbicide use and risk of lymphoma and soft-tissue sarcoma. JAMA. 1986 Sep 5;256(9):1141–1147. [PubMed] [Google Scholar]
  39. Husman K., Koskenvuo M., Kaprio J., Terho E. O., Vohlonen I. Role of environment in the development of chronic bronchitis. Eur J Respir Dis Suppl. 1987;152:57–63. [PubMed] [Google Scholar]
  40. Iversen M., Dahl R., Korsgaard J., Hallas T., Jensen E. J. Respiratory symptoms in Danish farmers: an epidemiological study of risk factors. Thorax. 1988 Nov;43(11):872–877. doi: 10.1136/thx.43.11.872. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. James A. L., Zimmerman M. J., Ee H., Ryan G., Musk A. W. Exposure to grain dust and changes in lung function. Br J Ind Med. 1990 Jul;47(7):466–472. doi: 10.1136/oem.47.7.466. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Kilburn K. H. Is the human nervous system most sensitive to environmental toxins? Arch Environ Health. 1989 Nov-Dec;44(6):343–344. doi: 10.1080/00039896.1989.9935903. [DOI] [PubMed] [Google Scholar]
  43. Koller W., Vetere-Overfield B., Gray C., Alexander C., Chin T., Dolezal J., Hassanein R., Tanner C. Environmental risk factors in Parkinson's disease. Neurology. 1990 Aug;40(8):1218–1221. doi: 10.1212/wnl.40.8.1218. [DOI] [PubMed] [Google Scholar]
  44. Korsak R. J., Sato M. M. Effects of chronic organophosphate pesticide exposure on the central nervous system. Clin Toxicol. 1977;11(1):83–95. doi: 10.3109/15563657708989822. [DOI] [PubMed] [Google Scholar]
  45. Langston J. W. Current theories on the cause of Parkinson's disease. J Neurol Neurosurg Psychiatry. 1989 Jun;Suppl:13–17. doi: 10.1136/jnnp.52.suppl.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Madsen D., Klock L. E., Wenzel F. J., Robbins J. L., Schmidt C. D. The prevalence of farmer's lung in an agricultural population. Am Rev Respir Dis. 1976 Feb;113(2):171–174. doi: 10.1164/arrd.1976.113.2.171. [DOI] [PubMed] [Google Scholar]
  47. Maizlish N., Schenker M., Weisskopf C., Seiber J., Samuels S. A behavioral evaluation of pest control workers with short-term, low-level exposure to the organophosphate diazinon. Am J Ind Med. 1987;12(2):153–172. doi: 10.1002/ajim.4700120205. [DOI] [PubMed] [Google Scholar]
  48. Malmberg P., Rask-Andersen A., Höglund S., Kolmodin-Hedman B., Read Guernsey J. Incidence of organic dust toxic syndrome and allergic alveolitis in Swedish farmers. Int Arch Allergy Appl Immunol. 1988;87(1):47–54. doi: 10.1159/000234647. [DOI] [PubMed] [Google Scholar]
  49. Marttila R. J., Rinne U. K. Epidemiological approaches to the etiology of Parkinson's disease. Acta Neurol Scand Suppl. 1989;126:13–18. doi: 10.1111/j.1600-0404.1989.tb01777.x. [DOI] [PubMed] [Google Scholar]
  50. Marx J. J., Guernsey J., Emanuel D. A., Merchant J. A., Morgan D. P., Kryda M. Cohort studies of immunologic lung disease among Wisconsin dairy farmers. Am J Ind Med. 1990;18(3):263–268. doi: 10.1002/ajim.4700180304. [DOI] [PubMed] [Google Scholar]
  51. May J. J. Issues in agricultural health and safety. Am J Ind Med. 1990;18(2):121–131. doi: 10.1002/ajim.4700180205. [DOI] [PubMed] [Google Scholar]
  52. May J. J., Marvel L. H., Pratt D. S., Coppolo D. P. Organic dust toxic syndrome: a follow-up study. Am J Ind Med. 1990;17(1):111–113. doi: 10.1002/ajim.4700170137. [DOI] [PubMed] [Google Scholar]
  53. McDuffie H. H., Klaassen D. J., Dosman J. A. Is pesticide use related to the risk of primary lung cancer in Saskatchewan? J Occup Med. 1990 Oct;32(10):996–1002. [PubMed] [Google Scholar]
  54. Mes J., Campbell D. S., Robinson R. N., Davies D. J. Polychlorinated biphenyl and organochlorine pesticide residues in adipose tissue of Canadians. Bull Environ Contam Toxicol. 1977 Feb;17(2):196–203. doi: 10.1007/BF01685550. [DOI] [PubMed] [Google Scholar]
  55. Morgan D. C., Smyth J. T., Lister R. W., Pethybridge R. J., Gilson J. C., Callaghan P., Thomas G. O. Chest symptoms in farming communities with special reference to farmer's lung. Br J Ind Med. 1975 Aug;32(3):228–234. doi: 10.1136/oem.32.3.228. [DOI] [PMC free article] [PubMed] [Google Scholar]
  56. Murphy D. J., Seltzer B. L., Yesalis C. E. Comparison of two methodologies to measure agricultural occupational fatalities. Am J Public Health. 1990 Feb;80(2):198–200. doi: 10.2105/ajph.80.2.198. [DOI] [PMC free article] [PubMed] [Google Scholar]
  57. Ohlson C. G., Hogstedt C. Parkinson's disease and occupational exposure to organic solvents, agricultural chemicals and mercury--a case-referent study. Scand J Work Environ Health. 1981 Dec;7(4):252–256. doi: 10.5271/sjweh.2549. [DOI] [PubMed] [Google Scholar]
  58. Ojanen T., Terho E. O., Tukiainen H., Mäntyjärvi R. A. Class-specific antibodies during follow up of patients with farmer's lung. Eur Respir J. 1990 Mar;3(3):257–260. [PubMed] [Google Scholar]
  59. Peters H. A., Levine R. L., Matthews C. G., Chapman L. J. Extrapyramidal and other neurologic manifestations associated with carbon disulfide fumigant exposure. Arch Neurol. 1988 May;45(5):537–540. doi: 10.1001/archneur.1988.00520290069016. [DOI] [PubMed] [Google Scholar]
  60. Popendorf W., Donham K. J., Easton D. N., Silk J. A synopsis of agricultural respiratory hazards. Am Ind Hyg Assoc J. 1985 Mar;46(3):154–161. doi: 10.1080/15298668591394572. [DOI] [PubMed] [Google Scholar]
  61. Purschwitz M. A., Field W. E. Scope and magnitude of injuries in the agricultural workplace. Am J Ind Med. 1990;18(2):179–192. doi: 10.1002/ajim.4700180210. [DOI] [PubMed] [Google Scholar]
  62. Rajput A. H., Uitti R. J., Stern W., Laverty W. Early onset Parkinson's disease and childhood environment. Adv Neurol. 1987;45:295–297. [PubMed] [Google Scholar]
  63. Rocca W. A., Bonaiuto S., Lippi A., Luciani P., Turtù F., Cavarzeran F., Amaducci L. Prevalence of clinically diagnosed Alzheimer's disease and other dementing disorders: a door-to-door survey in Appignano, Macerata Province, Italy. Neurology. 1990 Apr;40(4):626–631. doi: 10.1212/wnl.40.4.626. [DOI] [PubMed] [Google Scholar]
  64. Rosenstock L., Daniell W., Barnhart S., Schwartz D., Demers P. A. Chronic neuropsychological sequelae of occupational exposure to organophosphate insecticides. Am J Ind Med. 1990;18(3):321–325. doi: 10.1002/ajim.4700180313. [DOI] [PubMed] [Google Scholar]
  65. Rylander R., Burrell R. Endotoxins in inhalation research. Summary of conclusions of a workshop held at Clearwater, Florida, U.S.A., 28-30 September 1987. Ann Occup Hyg. 1988;32(4):553–556. doi: 10.1093/annhyg/32.4.553. [DOI] [PubMed] [Google Scholar]
  66. Saftlas A. F., Blair A., Cantor K. P., Hanrahan L., Anderson H. A. Cancer and other causes of death among Wisconsin farmers. Am J Ind Med. 1987;11(2):119–129. doi: 10.1002/ajim.4700110202. [DOI] [PubMed] [Google Scholar]
  67. Savage E. P., Keefe T. J., Mounce L. M., Heaton R. K., Lewis J. A., Burcar P. J. Chronic neurological sequelae of acute organophosphate pesticide poisoning. Arch Environ Health. 1988 Jan-Feb;43(1):38–45. doi: 10.1080/00039896.1988.9934372. [DOI] [PubMed] [Google Scholar]
  68. Stanford C. F., Hall G., Chivers A., Martin B., Nicholls D. P., Evans J. Farmer's lung in Northern Ireland. Br J Ind Med. 1990 May;47(5):314–316. doi: 10.1136/oem.47.5.314. [DOI] [PMC free article] [PubMed] [Google Scholar]
  69. Sterling T. D., Weinkam J. J. Smoking patterns by occupation, industry, sex, and race. Arch Environ Health. 1978 Nov-Dec;33(6):313–317. doi: 10.1080/00039896.1978.10667354. [DOI] [PubMed] [Google Scholar]
  70. Tanner C. M., Chen B., Wang W., Peng M., Liu Z., Liang X., Kao L. C., Gilley D. W., Goetz C. G., Schoenberg B. S. Environmental factors and Parkinson's disease: a case-control study in China. Neurology. 1989 May;39(5):660–664. doi: 10.1212/wnl.39.5.660. [DOI] [PubMed] [Google Scholar]
  71. Terho E. O., Husman K., Vohlonen I. Prevalence and incidence of chronic bronchitis and farmer's lung with respect to age, sex, atopy, and smoking. Eur J Respir Dis Suppl. 1987;152:19–28. [PubMed] [Google Scholar]
  72. Tetrud J. W., Langston J. W. MPTP-induced parkinsonism as a model for Parkinson's disease. Acta Neurol Scand Suppl. 1989;126:35–40. doi: 10.1111/j.1600-0404.1989.tb01780.x. [DOI] [PubMed] [Google Scholar]
  73. Unger M., Olsen J., Clausen J. Organochlorine compounds in the adipose tissue of deceased persons with and without cancer: a statistical survey of some potential confounders. Environ Res. 1982 Dec;29(2):371–376. doi: 10.1016/0013-9351(82)90038-x. [DOI] [PubMed] [Google Scholar]
  74. Vineis P., Terracini B., Ciccone G., Cignetti A., Colombo E., Donna A., Maffi L., Pisa R., Ricci P., Zanini E. Phenoxy herbicides and soft-tissue sarcomas in female rice weeders. A population-based case-referent study. Scand J Work Environ Health. 1987 Feb;13(1):9–17. doi: 10.5271/sjweh.2077. [DOI] [PubMed] [Google Scholar]
  75. Vohlonen I., Tupi K., Terho E. O., Husman K. Prevalence and incidence of chronic bronchitis and farmer's lung with respect to the geographical location of the farm and to the work of farmers. Eur J Respir Dis Suppl. 1987;152:37–46. [PubMed] [Google Scholar]
  76. Warren C. P., Holford-Strevens V. Induction of histamine release in vitro from rat peritoneal mast cells by extracts of grain dust. Environ Health Perspect. 1986 Apr;66:55–59. doi: 10.1289/ehp.866655. [DOI] [PMC free article] [PubMed] [Google Scholar]
  77. Warren C. P., Holford-Strevens V., Manfreda J. Respiratory disorders among Canadian farmers. Eur J Respir Dis Suppl. 1987;154:10–14. [PubMed] [Google Scholar]
  78. Whorton M. D., Obrinsky D. L. Persistence of symptoms after mild to moderate acute organophosphate poisoning among 19 farm field workers. J Toxicol Environ Health. 1983 Mar;11(3):347–354. doi: 10.1080/15287398309530348. [DOI] [PubMed] [Google Scholar]
  79. Wiklund K., Holm L. E. Trends in cancer risks among Swedish agricultural workers. J Natl Cancer Inst. 1986 Sep;77(3):657–664. doi: 10.1093/jnci/77.3.657. [DOI] [PubMed] [Google Scholar]
  80. Woods J. S., Polissar L., Severson R. K., Heuser L. S., Kulander B. G. Soft tissue sarcoma and non-Hodgkin's lymphoma in relation to phenoxyherbicide and chlorinated phenol exposure in western Washington. J Natl Cancer Inst. 1987 May;78(5):899–910. [PubMed] [Google Scholar]
  81. Yach D., Myers J., Bradshaw D., Benatar S. R. A respiratory epidemiologic survey of grain mill workers in Cape Town, South Africa. Am Rev Respir Dis. 1985 Apr;131(4):505–510. doi: 10.1164/arrd.1985.131.4.505. [DOI] [PubMed] [Google Scholar]
  82. Yesalis C. E., 3rd, Lemke J. H., Wallace R. B., Kohout F. J., Morris M. C. Health status of the rural elderly according to farm work history: the Iowa 65 + rural health study. Arch Environ Health. 1985 Sep-Oct;40(5):245–253. doi: 10.1080/00039896.1985.10545927. [DOI] [PubMed] [Google Scholar]
  83. Zayed J., Ducic S., Campanella G., Panisset J. C., André P., Masson H., Roy M. Facteurs environnementaux dans l'étiologie de la maladie de Parkinson. Can J Neurol Sci. 1990 Aug;17(3):286–291. [PubMed] [Google Scholar]
  84. doPico G. A., Flaherty D., Bhansali P., Chavaje N. Grain fever syndrome induced by inhalation of airborne grain dust. J Allergy Clin Immunol. 1982 May;69(5):435–443. doi: 10.1016/0091-6749(82)90118-x. [DOI] [PubMed] [Google Scholar]
  85. doPico G. A. Health effects of organic dusts in the farm environment. Report on diseases. Am J Ind Med. 1986;10(3):261–265. doi: 10.1002/ajim.4700100310. [DOI] [PubMed] [Google Scholar]
  86. doPico G. A., Reddan W., Anderson S., Flaherty D., Smalley E. Acute effects of grain dust exposure during a work shift. Am Rev Respir Dis. 1983 Sep;128(3):399–404. doi: 10.1164/arrd.1983.128.3.399. [DOI] [PubMed] [Google Scholar]
  87. doPico G. Guidelines for evaluation of clinical cases. Am J Ind Med. 1990;17(1):132–135. doi: 10.1002/ajim.4700170145. [DOI] [PubMed] [Google Scholar]

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