Table 1. Respiratory Diseases Associated with Large Animal Farming.

Disease	Symptoms	Diagnosis	Subjects Studied	Pathophysiology	Source
Rhinitis	Congestion, rhinorrhea, sneezing, pruritus	Defined by the presence of one or more symptoms	Swine veterinarians Agricultural workers  -Livestock breeding  -Livestock Handling  -Dairy production	Neutrophil influx IL-8/CXCL8, IL-6 levels	(Slager et al., 2010) (Poole et al., 2007) (Dosman et al., 2000)
Mucous Membrane Syndrome	Combination of nasal, eye and throat complaints with congestion, rhinorrhea and pruritus	No defined criteria, based on reported symptoms in confinement workers	Swine confinement workers	Increased levels of IL-1α, IL-1β, IL-6	(Romberger et al., 2001) (Kirkhorn et al., 2000) (Von Essen et al., 1999)
Asthma	Variable and reoccurring: wheeze, cough, chest tightness, shortness of breath	History of intermittent symptoms with either 1) reversible airflow obstruction by spirometry or peak flow monitoring, or 2) positive bronchoprovocation test	Children of farmers Farmers Agricultural Workers	IgE-Mediated Eosinophilic influx Occupational Workplace Exacerbated	(Lawson et al., 2011) (Riedler et al., 2000) (Merchant et al., 2005) (Eduard et al., 2009) (Kogevinas et al., 1999) (Dosman et al., 2004) (Tarlo 2003)
Asthma-like Syndrome	Cough, chest tightness, dyspnea, wheezing	Symptoms similar to asthma Positive bronchoprovocation if symptomatic No obstruction noted on PFT No eosinophil influx	Swine confinement workers Grain elevator operators	Normal pulmonary function testing Airway hyper- responsiveness to methacholine challenge Increased Neutrophils Absence of eosinophilic infiltrates	(Kirkhorn et al., 2000) (Romberger et al., 2001) (Von Essen et al., 2010)
Chronic Bronchitis COPD	Productive cough for at least 3 months/year for at least 2 consecutive years	Symptoms of chronic cough, sputum production, dyspnea or wheezing Known risk factor exposure FEV1 < 80 % predicted, FEV1/FVC < 70% predicted, decreased DLCO	Farmers  -Swine  -Multiple livestock  -Dairy	Organic dust: multiple agents  -Muramic acid  -Endotoxins  -Storage mites  -Ammonia  -Hydrogen sulfide	(Eduard et al., 2009) (Omland et al., 2002) (Zhiping et al., 1996)
Organic Dust Toxic Syndrome	Fever, malaise, myalgia, chest tightness, headache, nausea	Flu-like illness Occurs 4-8 hrs after exposure No sensitization Resolution of symptoms within days	Farmers  -Grain  -Swine Confinement  Workers	Symptoms start 4-8 hours after exposure Neutrophilia, Neutrophils on BALF Normal imaging, Normal blood gases Normal lung function	(Romberger et al., 2001) (Donham et al., 1990) (Vogelzang et al., 1999) (Von Essen et al., 1990) (May 1986)
Hyper- sensitivity Pneumonitis	Fever, malaise, nausea, chest tightness, headache	Acute exposure -Flu-like illness -Occurs 4-8 hrs after exposure -CXR with infiltrates -Hypoxia Sensitization occurs Chronic exposure -Exposure history -Interstitial disease	Farmers:  -Moldy grain  -Moldy vegetables  -Cattle feed	Specific antigenic exposure with antibody response Lymphocytes influx Granuloma formation Production of TNF, IFN- γ, IL-12, IL-18	(Girard et al., 2010) (Kirkhorn et al., 2000) (Zhiping et al., 1996)