PREVALENCE AND CHARACTERISTICS OF CHRONIC RESPIRATORY SYMPTOMS AND LUNG FUNCTION AMONG VINEYARD WORKERS
Keywords:
ventilatory function, viticulturists, smoking, respiratory symptoms, spirometry, job exposure matricesAbstract
Aim: To determine the frequency of chronic respiratory symptoms and ventilatory function in a group of vineyard workers.
Results: Most of the vineyard workers believe that they are sufficiently informed about the health risks related to their work activities and the necessary measures needed for health protection. Also, most of them use the mandatory personal protective equipment, while almost all workers during their work, to a greater or lesser extent, were exposed to occupational respiratory hazards: dust, smoke, fumes, gases and pesticides. About 45% of subjects had one or more respiratory symptoms, and the most common symptoms were cough (40%), cough with phlegm (31.1%), as well as dyspnea and wheezing (22.2%). The frequency of chronic respiratory symptoms was higher in workers with more than 15 years of exposure, with a statistically significant difference in frequency of cough, cough with phlegm, and dyspnea. The risk of respiratory symptoms was about 3 times higher in active smokers and about 2 times higher in vineyard workers with exposure duration longer than 15 years. The mean values of all spirometric parameters were within the reference values, while lung function impairment of obstructive, restrictive and combined pattern was registered in about 20% of them. The mean values of spirometric parameters in vineyard workers with exposure duration longer than 15 years were lower than those with less than 15 years of experience, with a significant difference for small airways flow indices.
Conclusion: The obtained results indicate the need to improve preventive measures.
References
Matese A, Filippo Di Gennaro S. Technology in precision viticulture: a state of the art review. International Journal of Wine Research 2015; 7(1): 69-81. doi: 10.2147/IJWR.S69405.
Taleska M. Republic of Macedonia, a New Wine Tourism Destination – Is It Possible? In: Proceedings. 6th World Conference for Graduate Research in Tourism Hospitality and Leisure. Turkey. 2012.
Respiratory health hazards in agriculture. Am J Respir Crit Care Med 1998; 158(5 Pt 2): S1-S76. doi: 10.1164/ajrccm.158.supplement_1.rccm1585s1.
Colosio C, Ariano E, Somaruga C, Rabozzi G, Vellere F, Brambilla G, Colombi A. The occupational health physician and the health surveillance in agriculture. Med Lav Ergon 2010; 32(4 Suppl): 413-417.
Schenker MB. Agricultural dust exposure and respiratory symptoms among California farm operators. Journal of Occupational and Environmental Medicine 2005; 47(11): 1157-1166.
Senthilselvan A, McDuffie HH, Dosman JA. Association of asthma with use of pesticides. Results of a cross-sectional survey of farmers. Am Rev Respir Dis 1992; 146(4): 884-887. doi: 10.1164/ajrccm/146.4.884.
Faria NM, Facchini LA, Fassa AG, Tomasi E. Trabalho rural, exposição a poeiras e sintomas respiratórios entre agricultores [Farm work, dust exposure and respiratory symptoms among farmers]. Rev Saude Publica 2006; 40(5): 827-836. Portuguese. doi: 10.1590/S0034-89102006005000006.
Zejda JE, McDuffie HH, Dosman JA. Epidemiology of health and safety risks in agriculture and related industries. Practical applications for rural physicians. West J Med 1993; 158(1): 56-63. PMID: 8470386.
Simpson JC, Niven RM, Pickering CA, Fletcher AM, Oldham LA, Francis HM. Prevalence and predictors of work-related respiratory symptoms in workers exposed to organic dusts. Occup Environ Med 1998; 55(10): 668-672. doi: 10.1136/oem.55.10.668.
Dosman J, Graham B, Hall D, Van Loon P, Bhasin P, Froh F. Respiratory symptoms and pulmonary function in farmers. J Occup Med 1987; 29(1): 38-43. PMID: 3819883.
Feleke MG, Alemu Y, Shentema MG, Wakuma S, Emiru Z, Chichiabellu TY. Chronic Respiratory Symptoms and Associated Factors among Fruit and Vegetable Workers in Addis Ababa, Ethiopia: A Comparative Cross sectional Study. Saf Health Work 2023; 14(3): 287-294. doi: 10.1016/j.shaw.2023.07.001.
Hsairi M, Kauffmann F, Chavance M, Brochard P. Personal factors related to the perception of occupational exposure: an application of a job exposure matrix. Int J Epidemiol 1992; 21(5): 972-980. doi: 10.1093/ije/21.5.972.
Minette A. Questionnaire of the European Community for Coal and Steel (ECSC) on respiratory symptoms. 1987 - Updating of the 1962 and 1967 questionnaires for studying chronic bronchitis and emphysema. Eur Respir J 1989; 2(2): 165-177. PMID: 2703044.
European Community Respiratory Health Survey. Variations in the prevalence of respiratory symptoms, self-reported asthma attacks, and use of asthma medication in the European Respiratory Health Survey (ECRHS). Eur Respir J 1996; 9(4):687-695. https://doi.org/10.1183/09031936.96.09040687.
World Health Organization. Guidelines for controlling and monitoring the tobacco epidemic (1998), Geneva: WHO.
Smoking Pack-Years. 2013. Available from: http://smokingpackyears.com/calculate. Last accessed: 15th July 2025.
US Department of Health and Human Services. The Health Consequences of Smoking: Chronic Obstructive Pulmonary Disease. A report of the Surgeon General. 1984. Available at: http://profiles.nlm.nih.gov/ps/access/NNBCCS.pdf. Last accessed: 16th February 2019.
Quajner Ph.H et al. Lung Volumes and Forced Ventilatory Flows: Official Statement of the European Respiratory Society. Eur Respir J 1993; 16(1): 1-100. https://doi.org/10.1183/09041950.005s1693.
Semple S. Exposure matrices: how to create them, how to use them, and what they can tell us. 2016. Available at: www.easom.org/data/summerschools/Semple.ppt. Last accessed: 15th June 2025.
Stoleski S, Minov M, Karadzinska-Bislimovska J, Mijakoski D. Chronic Respiratory Symptoms and Lung Function in a Sample of Agricultural Workers in Skopje Region. Maced J Med Sci 2014; 7(2): 327-334. http://dx.doi.org/10.3889/MJMS.1857-5773.2014.0396.
Stoleski S, Minov J, Karadzinska-Bislimovska J, Mijakoski D. Bronchial Hyperresponsiveness in Farmers: Severity and Work-Relatedness. Maced J Med Sci. 2014; 7(3):536-543. http://dx.doi.org/10.3889/MJMS.1957-5773.2014.0436.
Stoleski S, Minov J, Mijakoski D, Karadzinska-Bislimovska J. Chronic Respiratory Symptoms and Lung Function in Agricultural Workers - Influence of Exposure Duration and Smoking. OA Maced J Med Sci 2015; 3(1): 158-165. doi: 10.3889/oamjms.2015.014.
Bongers P, Houthuijs D, Remijn B, Brouwer R, Biersteker K. Lung functions and respiratory symptoms in pig farmers. Br J Ind Med 1987; 44(2): 819-823. doi: 10.1136/oem.44.12.819.
Karadzinska-Bislimovska J, Minov J, Stoleski S, Mijakoski D, Risteska-Kuc S. Respiratory symptoms, atopic status and lung function tests in agricultural workers. Allergy 2007; 62(83): 283.
Skórska C, Mackiewicz B, Dutkiewicz J, Krysińska-Traczyk E, Milanowski J, Feltovich H, Lange J, Thorne P. Effects of exposure to grain dust in Polish farmers: work-related symptoms and immunologic response to microbial antigens associated with dust. Ann Agric Environ Med 1998; 5(2): 147-153. PMID: 9860817.
Chan-Yeung M, Dimich-Ward H, Enarson DA, Kennedy SM. Five cross-sectional studies of grain elevator workers. Am J Epidemiol 1992; 136(10): 1269-1279. doi: 10.1093/oxfordjournals.aje.a116435.
Danuser B, Weber C, Künzli N, Schindler C, Nowak D. Respiratory symptoms in Swiss farmers: an epidemiological study of risk factors. Am J Ind Med 2001; 39(4): 410-418. doi: 10.1002/ajim.1032.
Omland O, Sigsgaard T, Pedersen OF, Miller MR. The shape of the maximum expiratory flow-volume curve reflects exposure in farming. Ann Agric Environ Med 2000; 7(2): 71-78. PMID: 11153034.
Zock JP, Sunyer J, Kogevinas M, Kromhout H, Burney P, Antó JM. Occupation, chronic bronchitis, and lung function in young adults. An international study. Am J Respir Crit Care Med 2001; 163(7): 1572-1577. doi: 10.1164/ajrccm.163.7.2004195.
Dalphin JC, Dubiez A, Monnet E, Gora D, Westeel V, Pernet D, et al. Prevalence of asthma and respiratory symptoms in dairy farmers in the French province of the Doubs. Am J Respir Crit Care Med 1998; 158(5 Pt 1): 1493-1498. doi: 10.1164/ajrccm.158.5.9709108.
Iversen M, Pedersen B. Relation between respiratory symptoms, type of farming, and lung function disorders in farmers. Thorax 1990; 45(12): 919-923. doi: 10.1136/thx.45.12.919.
Minov J, Stoleski S, Stikova E, Mijakoski D, Atanasovska A, Bislimovska Karadzinska Jovanka. COPD in a sample of general ault population from the Skopje Region. Acad Med J 2022; 2(1): 47-58.
Stoleski S, Minov J, Mijakoski D, Brborović H, Milošević M, Žaja R. COPD prevalence and characteristics among sample of working population. Front Public Health 2025; 13: 1598290. doi: 10.3389/fpubh.2025.1598290.
Stoleski S, Minov J, Mijakoski D, Atanasovska A, Bislimovska D, Panajotovic-Radevska M, Zdraveski D. COPD prevalence and characteristics among retired workers. Acad Med J 2025; 5(1): 95-106. doi: 10.53582/AMJ255195s.
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; 29(1): 38-42. PMID: 3819883
Gautrin D, Ghezzo H, Infante-Rivard C, Malo JL. Incidence and host determinants of work-related rhinoconjunctivitis in apprentice pastry-makers. Allergy 2002; 57(10): 913-918. doi: 10.1034/j.1398-9995.2002.23636.x.
Zuskin E, Mustajbegovic J, Schachter EN, Kern J, Pavicic D. Respiratory function in vineyard and orchard workers. Am J Ind Med 1997; 31(2): 250-255. doi: 10.1002/(sici)1097-0274(199702)31:2<250::aid-ajim15>3.0.co; 2-0.
Hashemi N, Mirsadraee M, Shakeri MT, Varasteh AR. Prevalence of work-related respiratory symptoms in Iranian farmers. Can Respir J 2006; 13(4): 198-202. doi: 10.1155/2006/967895.
Wilkins JR 3rd, Engelhardt HL, Rublaitus SM, Crawford JM, Fisher JL, Bean TL. Prevalence of chronic respiratory symptoms among Ohio cash grain farmers. Am J Ind Med 1999; 35(2): 150-163. doi: 10.1002/(sici)1097-0274(199902)35:2<150::aid-ajim7>3.0.co;2-5.
Chakraborty S, Mukherjee S, Roychoudhury S, Siddique S, Lahiri T, Ray MR. Chronic exposures to cholinesterase-inhibiting pesticides adversely affect respiratory health of agricultural workers in India. J Occup Health 2009; 51(6): 488-497. doi: 10.1539/joh.l9070.
Hoppin JA, Umbach DM, London SJ, Lynch CF, Alavanja MC, Sandler DP. Pesticides and adult respiratory outcomes in the agricultural health study. Ann N Y Acad Sci 2006; 1076: 343-354. doi: 10.1196/annals.1371.044.
Zuskin E, Mustajbegovic J, Schachter EN, Kern J, Deckovic-Vukres V, Trosic I, et al. Respiratory function in pesticide workers. J Occup Environ Med 2008; 50(11): 1299-1305. doi: 10.1097/JOM.0b013e3181845f6c.
Hernández AF, Casado I, Pena G, Gil F, Villanueva E, Pla A. Low level of exposure to pesticides leads to lung dysfunction in occupationally exposed subjects. Inhal Toxicol 2008; 20(9): 839-849. doi: 10.1080/08958370801905524.
Schenker MB, Stoecklin M, Lee K, Lupercio R, Zeballos RJ, Enright P, et al. Pulmonary function and exercise-associated changes with chronic low-level paraquat exposure. Am J Respir Crit Care Med 2004; 170(7): 773-779. doi: 10.1164/rccm.200403-266OC.
Perotin JM, Barbe C, Nguyen KL, Fontaine JF, Gabignon Y, Nardi J, et al. Work-related respiratory symptoms in Champagne vineyard workers. Eur Ann Allergy Clin Immunol 2015; 47(5): 140-144. PMID: 26356997.
Bauchau V, Durham SR. Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J 2004; 24(5): 758-764. doi: 10.1183/09031936.04.00013904.
Spiewak R, Góra A, Horoch A, Dutkiewicz J. Atopy, allergic diseases and work-related symptoms among students of agricultural schools: first results of the Lublin study. Ann Agric Environ Med 2001; 8(2): 261-267. PMID: 11748886.
Chatzi L, Prokopakis E, Tzanakis N, Alegakis A, Bizakis I, Siafakas N, et al. Allergic rhinitis, asthma, and atopy among grape farmers in a rural population in Crete, Greece. Chest 2005; 127(1): 372-378. doi: 10.1378/chest.127.1.372.
Fareed M, Pathak MK, Bihari V, Kamal R, Srivastava AK, Kesavachandran CN. Adverse respiratory health and hematological alterations among agricultural workers occupationally exposed to organophosphate pesticides: a cross-sectional study in North India. PLoS One 2013; 8(7): e69755. doi: 10.1371/journal.pone.0069755. Erratum in: PLoS One 2013; 8(8). doi: 10.1371/annotation/b7bc0625-6200-4433-9971-f4e571203432.
Sprince NL, Lewis MQ, Whitten PS, Reynolds SJ, Zwerling C. Respiratory symptoms: associations with pesticides, silos, and animal confinement in the Iowa Farm Family Health and Hazard Surveillance Project. Am J Ind Med 2000; 38(4): 455-462. doi: 10.1002/1097-0274(200010)38:4<455::aid-ajim12>3.0.co;2-l.
Kauffmann F, Drouet D, Lellouch J, Brille D. Occupational exposure and 12-year spirometric changes among Paris area workers. Br J Ind Med 1982; 39(3): 221-332. doi: 10.1136/oem.39.3.221.
Terho EO. Work-related respiratory disorders among Finnish farmers. Am J Ind Med 1990; 18(3): 269-272. doi: 10.1002/ajim.4700180305.
Le Moual N, Bakke P, Orlowski E, Heederik D, Kromhout H, Kennedy SM, et al. Performance of population specific job exposure matrices (JEMs): European collaborative analyses on occupational risk factors for chronic obstructive pulmonary disease with job exposure matrices (ECOJEM). Occup Environ Med 2000; 57(2): 126-132. doi: 10.1136/oem.57.2.126.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Sasho Stoleski , Jordan Minov, Dragan Mijakoski, Aneta Atanasovska, Dragana Bislimovska, Maja Panajotovic-Radevska
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under CC BY 4.0 
