Exacerbation of symptoms in agricultural pesticide applicators with asthma

  • Paul K. Henneberger
  • Xiaoming Liang
  • Stephanie J. London
  • David M. Umbach
  • Dale P. Sandler
  • Jane A. Hoppin
Original Article



Exacerbation is a critical event in asthma management. We investigated whether exacerbation of symptoms is associated with farming exposures among agricultural pesticide applicators with asthma.


Participants were pesticide applicators with active asthma (wheezing and breathing problems in past 12 months) who completed enrollment questionnaires for the Agricultural Health Study (AHS). Exacerbation of asthma was defined as having visited a hospital emergency room or doctor for an episode of wheezing or whistling in the past 12 months. Exposures of interest were using 36 specific pesticides in the past 12 months and conducting various agricultural activities. Adjusted odds ratios (ORs) were estimated by logistic regression while controlling for potential confounders.


The 926 AHS adult pesticide applicators with active asthma included 202 (22 %) with exacerbation. Inverse associations with exacerbation were observed for two herbicides [glyphosate, odds ratio (OR) = 0.5, 95 % confidence interval (CI) 0.3, 0.8, and paraquat, OR = 0.3, 95 % CI 0.1, 0.9] and several agricultural activities (repairing engines, grinding metal, driving diesel tractors, and performing veterinary procedures). Only asthma cases with allergies (i.e., doctor-diagnosed hay fever or eczema, 46 %) had positive exacerbation–pesticide associations, with OR = 2.1 (95 % CI 1.1, 4.1) for the herbicide pendimethalin and OR = 10.2 (95 % CI 1.9, 55) for the insecticide aldicarb.


The inverse associations with two pesticides and specific farm activities are consistent with the possibility that asthma cases prone to exacerbation may avoid exposures that trigger symptoms. Although limited by small sample size and a cross-sectional design, our study suggests that use of specific pesticides may contribute to exacerbation of asthma among individuals with allergies.


Asthma Asthma exacerbation Work-related Agriculture Pesticides 


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Copyright information

© Springer-Verlag Berlin Heidelberg (outside the USA) 2013

Authors and Affiliations

  • Paul K. Henneberger
    • 1
  • Xiaoming Liang
    • 1
  • Stephanie J. London
    • 2
  • David M. Umbach
    • 3
  • Dale P. Sandler
    • 2
  • Jane A. Hoppin
    • 2
  1. 1. Division of Respiratory Disease StudiesNational Institute for Occupational Safety and HealthMorgantownUSA
  2. 2.Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS)National Institutes of Health (NIH)Research Triangle ParkUSA
  3. 3.Biostatistics Branch, National Institute of Environmental Health Sciences (NIEHS)National Institutes of Health (NIH)Research Triangle ParkUSA

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