ABSTRACT
Clinical Features Swine confinement workers commonly develop symptoms of airway disease, including cough that may or may not be productive of sputum, chest tightness, wheezing, and dyspnea on exertion (1,5). They often report nocturnal cough, wheeze, and chest tightness (2). Their symptoms commonly are worse after work in the swine confinement barns and may be improved after time spent away from the farm. There is a dose-response relationship between hours worked inside the hog barn and respiratory symptoms (6). Rarely, persons with these complaints are found to suffer from asthma secondary to an allergic response to porcine proteins, with elevated IgE levels (7,8). IgG antibodies to porcine proteins are commonly identified in the serum of workers but are not associated with clinical symptoms (8). Other individuals may have underlying asthma or chronic obstructive pulmonary disease (COPD) that is exacerbated by exposure to the swine confinement barn environment. However, many workers who develop airway disease symptoms have
on a farm as a swine confinement unit manager. His duties included the daily care and feeding of the animals as well as cleaning the barns using a pressure washer.
