Abstract
Background: An estimated 263 million people are engaged in farming in India. Use of pesticides has increased in recent years to improve crop yield. We aimed to study the prevalence of COPD among farmers in rural India and to study whether farmers using pesticide sprays have a higher disease burden.
Methods: All male and female resident farmers above the age of 25yrs from 4 randomly selected villages of rural India were invited to participate. A pre-tested questionnaire were administered to obtain information about use of pesticides and other exposures such as smoking history and biomass exposure, using a mobile phone device. Post bronchodilator spirometry was performed to determine the prevalence of COPD (FEV1/FVC < 70%).
Results: 938 participants (Mean age: 45.3 ± 13.2; M: 53.4%) completed the questionnaire and performed acceptable spirometry. The prevalence of COPD among farmers was 4.9% (M:6.2%, F: 3.4%). Farmers using pesticide sprays had a greater odds of having small airways obstruction on spirometry (FEF25-75% < 65%); 45.2% vs 32.5% {OR: 1.71 (CI: 1.27-2.29) p <0.0001}. However, there was no difference in the prevalence of COPD between pesticide users and non-users (5.4% vs 3.9%; p=0.34). Although 67% of the farmers who had COPD never smoked, smoking was associated with a greater risk of COPD {OR: 7.65 (CI: 3.9 – 15.0) p<0.0001}.
Conclusion: Two thirds of farmers who have COPD in rural India are never smokers, although smoking increased the risk further by 7 fold. Farmers using pesticides have greater prevalence of small airways obstruction.
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