Farmers are at an increased risk of developing lung disease

Early diagnosis is very important so this month the Health Hut has turned its focus to this common but often overlooked condition, known in full as chronic obstructive pulmonary disease.

This term covers the lung diseases better known as emphysema and bronchitis. Emphysema is the destruction of the tiny air sacs in the lungs, and bronchitis is associated with long term inflammation and mucous production in the airways. Both conditions cause a gradual but permanent loss of lung function.

Worldwide, COPD is now the fourth most common cause of death and the second most common cause for an emergency admission to hospital. Around 140,000 people in Scotland have a diagnosis of COPD but it is estimated that as many as two thirds of all cases remain undiagnosed.

Early diagnosis and treatment of this disease can improve long-term outcomes and reduce the risk of developing other associated conditions, such as diabetes, heart disease, and lung cancer. However, it is a diagnosis often made at a late stage, mostly because in the early stages of COPD, symptoms may not be obvious and can be dismissed.

RSABI Health Hut logoFarmers can be more at risk to COPD due to exposure to organic and inorganic dust as well as bacteria, spores and chemicals such as pesticides COPD usually affects adults in middle to older age. At this stage of life, people can believe that being a little less fit or a little more tired than they used to be, is just a natural part of aging when this is not always true. Later in the disease, sufferers complain of a chronic cough with the production of mucous, worsening breathlessness, and frequent chest infections. It is not unusual to see a diagnosis made only when a person becomes unwell with an infection and their symptoms can no longer be ignored. Advanced COPD can have a severely limiting impact on daily living and activities, with reduced energy, fitness and strength, making physical work very difficult. There is some overlap between the symptoms of COPD and asthma which can also make a diagnosis challenging.

A diagnosis is usually suspected if there is a history of chronic cough, tiredness and breathlessness. It is confirmed with examination and a simple test known as 'spirometry'. This involves blowing into a special tube attached to a computer, which measures the flexibility and capacity of the lungs. A chest x-ray can also be helpful.

It will be no surprise to hear that at least 75% of cases of COPD are linked to long-term tobacco smoking and in some parts of the world the disease is linked to air pollution. Studies on lung diseases in agriculture have shown evidence that farmers are at an increased risk of developing COPD due to respiratory exposures encountered on the farm. Various hazards have been implicated including organic and inorganic dusts, spores, bacteria, chemicals such as pesticides, toxic gases like ammonia and hydrogen sulphide and diesel and welding fumes. It should not be forgotten that many other occupational lung diseases are associated with farming, especially asthma, and can present with similar symptoms which should not be ignored. This highlights the importance of robust health and safety measures for you and your employees when it comes to these potential hazards around the farm.

Once a person has developed COPD, there is no way to reverse or cure this. Treatment includes inhalers and lung exercises, but keeping as physically fit as possible and stopping smoking as well as limiting exposure to any other damaging substances, is vital to slow progression. Protecting against lung infections by vaccination against flu, pneumonia and COVID -19 can also help reduce flare ups.

The importance of an early diagnosis in this disease is clear. If you are experiencing any of the symptoms described above, especially if you are a smoker or ex-smoker, don’t just dismiss them as a part of ‘getting older’. Please seek advice from your local practice nurse or GP. An earlier diagnosis means that you may stay fitter and active for longer.

If you already living with a diagnosis of COPD, there is excellent support and advice available from Chest, Heart & Stroke Scotland www.chss.org.uk and from Asthma + Lung UK www.asthmaandlung.org.uk

The next RSABI Health Huts will be at Dingwall Mart (Nov 20 and Dec 10), LiveScot, Lanark Mart (Nov 23), Christmas Classic, Thainstone Mart (Nov 25 and 26), Caithness Mart (Dec 3) and Ayr (Dec 3). If you have any worries or concerns about your physical or mental health, our friendly team of health professionals are always happy to discuss them with you and where possible, help to support you with these. Alternatively, you can call 0808 1234 555 or email helpline@rsabi.org.uk for confidential advice and support.

Dr Louise MacLarty has been a general practitioner and occupational health doctor in the Inverness and Dingwall area since 2007. Louise lives on a small farm in the Black Isle and helps to run the family forestry business. Louise is delighted to be a member of the RSABI Health Hut team and is looking forward to promoting better health and wellbeing in the farming community.