Endotoxin exposure as a major determinant of lung function decline in pig farmers.

Exposure-response relationships for endotoxin as measured in dust and longitudinal decline in lung function were studied. A cohort of 171 pig farmers was followed over a 3-yr period. Long-term average exposure to dust and endotoxin was determined by personal monitoring in summer and winter, using data on farm characteristics and activities. Mean decline in FEV1 was 73 ml/yr and in FVC 55 ml/ yr. Long-term average exposure to dust was 2.63 mg/m3 (geometric SD [GSD] 1.30), and to endotoxin, 105 ng/m3 (GSD 1.5). Annual decline in FEV1 was significantly associated with endotoxin exposure. An increase in exposure with a factor 2 was associated with an extra decline of FEV1 of 19 ml/yr.