The domestication of animals occurred independently in a number of areas of the Old and New World over 10,000 years ago. Until domestication, hunting and gathering was the predominant subsistence pattern. The transformation to human control over animal and plant production and reproduction processes resulted in revolutionary changes in the structure of human societies and their relationships to the environment. The change to agriculture marked an increase in labour intensity and work time spent in food procurement-related activities. Small nuclear families, adapted to nomadic hunting and gathering groups, were transformed into large, extended, sedentary social units suited to labour-intensive domesticated food production.

The domestication of animals increased human susceptibility to animal-related injuries and diseases. Larger non-nomadic populations quartered in close proximity to animals provided greater opportunity for transmission of disease between animals and humans. The development of larger herds of more intensely handled livestock also increased the likelihood of injuries. Throughout the world, differing forms of animal agriculture are associated with varying risks for injury and disease. For example, the 50 million inhabitants who practice swidden (cut and burn) agriculture in equatorial regions face different problems from the 35 million pastoral nomads across Scandinavia and through central Asia or the 48 million food producers who practise an industrialized form of agriculture.

In this article, we provide an overview of selected injury patterns, infectious diseases, respiratory diseases and skin diseases associated with livestock production. The treatment is topically and geographically uneven because most research has been conducted in industrialized countries, where intensive forms of livestock production are common.

Overview

Types of human health problems and disease patterns associated with livestock production can be grouped according to the type of contact between animals and people (see table 1). Contact can occur via direct physical interaction, or contact with an organic or inorganic agent. Health problems associated with all types of livestock production can be grouped into each of these areas.

Table 1. Types of human health problems associated with livestock production

Health problems from direct physical contact

Allergic contact dermatitis
Allergic rhinitis
Bites, kicks, crushing
Envenomation and possible hypersensitivity
Asthma
Scratches
Traumatic injury

Health problems from organic agents

Agrochemical poisoning
Antibiotic resistance
Chronic bronchitis
Contact dermatitis
Allergies from drug residue food exposures
Food-borne illnesses
“Farmer’s lung”
Hypersensitivity pneumonitis
Mucous membrane irritation
Occupational asthma
Organic dust toxic syndrome (ODTS)
Allergies from pharmaceutical exposures
Zoonotic diseases

Health problems from physical agents

Hearing loss
Machinery-related trauma
Methane emission and greenhouse effect
Musculoskeletal disorders
Stress

Direct human contact with livestock ranges from the brute force of large animals such as the Chinese buffalo to the undetected skin contact by microscopic hairs of the Japanese oriental tussock moth. A corresponding range of health problems can result, from the temporary irritant to the debilitating physical blow. Notable problems include traumatic injuries from handling large livestock, venom hypersensitivity or toxicosis from venomous arthropod bites and stings, and contact and allergic contact skin dermatitis.

A number of organic agents utilize various pathways from livestock to humans, resulting in a range of health problems. Among the most globally important are zoonotic diseases. Over 150 zoonotic diseases have been identified worldwide, with approximately 40 significant for human health (Donham 1985). The importance of zoonotic diseases depends on regional factors such as agricultural practices, environment and a region’s social and economic status. The health consequences of zoonotic diseases range from the relatively benign flu-like symptoms of brucellosis to debilitating tuberculosis or potentially lethal strains of Escherichia coli or rabies.

Other organic agents include those associated with respiratory disease. Intensive livestock production systems in confined buildings create enclosed environments where dust, including microbes and their by-products, becomes concentrated and aerosolized along with gases that are in turned breathed by people. Approximately 33% of swine confinement workers in the United States suffer from organic dust toxic syndrome (ODTS) (Thorne et al. 1996).

Comparable problems exist in dairy barns, where dust containing endotoxin and/or other biologically active agents in the environment contributes to bronchitis, occupational asthma and inflammation of the mucous membrane. While these problems are most notable in developed countries where industrialized agriculture is widespread, the increasing export of confined livestock production technologies to developing areas such as Southeast Asia and Central America increases the risks for workers there.

Health problems from physical agents typically involve tools or machinery either directly or indirectly involved with livestock production in the agricultural work environment. Tractors are the leading cause of farm fatalities in developed countries. In addition, elevated rates of hearing loss associated with machinery and confined livestock production noises, and musculoskeletal disorders from repetitive motions, are also consequences of industrialized forms of animal agriculture. Agricultural industrialization, characterized by the use of capital-intensive technologies which interface between humans and the physical environment to produce food, is behind the growth of physical agents as significant livestock-related health factors.

Injuries

Direct contact with livestock is a leading cause of injuries in many industrialized regions of the world. In the United States, the national Traumatic Injury Surveillance of Farmers (NIOSH 1993) indicates that livestock is the primary source of injury, with cattle, swine and sheep constituting 18% of all agricultural injuries and accounting for the highest rate of lost workdays. This is consistent with a 1980-81 survey conducted by the US National Safety Council (National Safety Council 1982).

Regional US studies consistently show livestock as a leading cause of injury in agricultural work. Early work on hospital visits by farmers in New York from 1929 to 1948 revealed livestock accounting for 17% of farm-related injuries, second only to machinery (Calandruccio and Powers 1949). Such trends continue, as research indicates livestock account for at least one-third of agricultural injuries among Vermont dairy farmers (Waller 1992), 19% of injuries among a random sample of Alabama farmers (Zhou and Roseman 1995), and 24% of injuries among Iowa farmers (Iowa Department of Public Health 1995). One of the few studies to analyse risk factors for livestock-specific injuries indicates such injuries may be related to the organization of production and specific features of the livestock rearing environment (Layde et al. 1996).

Evidence from other industrialized agricultural areas of the world reveals similar patterns. Research from Australia indicates that livestock workers have the second-highest occupational fatal injury rates in the country (Erlich et al. 1993). A study of accident records and emergency department visits of British farmers in West Wales (Cameron and Bishop 1992) reveals livestock were the leading source of injuries, accounting for 35% of farm-related accidents. In Denmark, a study of 257 hospital-treated agricultural injuries revealed livestock as the second-leading cause of injuries, accounting for 36% of injuries treated (Carstensen, Lauritsen and Rasmussen 1995). Surveillance research is necessary to address the lack of systematic data on livestock-related injury rates in developing areas of the world.

Prevention of livestock-related injuries involves understanding animal behaviour and respecting dangers by acting appropriately and using appropriate control technologies. Understanding animal habits related to feeding behaviours and environmental fluctuations, social relationships such as animals isolated from their herd, nurturing and protective instincts of female animals and the variable territorial nature and feeding patterns of livestock are critical in reducing the risk of injury. Prevention of injury also depends on using and maintaining livestock control equipment such as fences, pens, stalls and cages. Children are at particular risk and should be supervised in designated play areas well away from livestock holding areas.

Infectious Diseases

Zoonotic diseases can be classified according to their modes of transmission, which are in turn linked to forms of agriculture, human social organization and the ecosystem. The four general routes of transmission are:

1. direct single vertebrate host
2. cyclical multiple vertebrate host
3. combination vertebrate-invertebrate host
4. inanimate intermediary host.

Zoonotic diseases can be generally characterized as follows: they are non-fatal, infrequently diagnosed and sporadic rather than epidemic; they mimic other diseases; and humans are typically the dead-end hosts. Primary zoonotic diseases by region are listed in table 2.

Table 2. Primary zoonoses by world region

Rates of zoonotic diseases among human populations are largely unknown owing to the lack of epidemiological data and to misdiagnoses. Even in industrialized countries such as the United States, zoonotic diseases such as leptospirosis are frequently mistaken for influenza. Symptoms are non-specific, making diagnosis difficult, a characteristic of many zoonoses.

Prevention of zoonotic diseases consists of a combination of disease eradication, animal vaccinations, human vaccinations, work environment sanitation, cleaning and protecting open wounds, appropriate food handling and preparation techniques (such as pasteurization of milk and thorough cooking of meat), use of personal protection equipment (such as boots in rice fields) and prudent use of antibiotics to reduce the growth of resistant strains. Control technologies and preventive behaviours should be conceptualized in terms of pathways, agents and hosts and specifically targeted to the four routes of transmission.

Respiratory Diseases

Given the variety and extent of exposures related to livestock production, respiratory diseases may be the major health problem. Studies in some sectors of livestock production in developed areas of the world reveal that 25% of livestock workers suffer from some form of respiratory disease (Thorne et al. 1996). The kinds of work most commonly associated with respiratory problems include grain production and handling and working in animal confinement units and dairy farming.

Agricultural respiratory diseases may result from exposures to a variety of dusts, gases, agricultural chemicals and infectious agents. Dust exposures may be divided into those primarily consisting of organic components and those consisting mainly of inorganic components. Field dust is the primary source of inorganic dust exposures. Organic dust is the major respiratory exposure to agricultural production workers. Disease results from periodic short-term exposures to agricultural organic dust containing large numbers of microbes.

ODTS is the acute flu-like illness seen following periodic short-term exposure to high concentrations of dust (Donham 1986). This syndrome has features very similar to those of acute farmer’s lung, but does not carry the risk of pulmonary impairment associated with farmer’s lung. Bronchitis affecting agricultural workers has both an acute and chronic form (Rylander 1994). Asthma, as defined by reversible airway obstruction associated with airway inflammation, can also be caused by agricultural exposures. In most cases this type of asthma is related to chronic inflammation of the airways rather than a specific allergy.

A second common exposure pattern is daily exposure to a lower level of organic dust. Typically, total dust levels are 2 to 9 mg/m³, microbe counts are at 10³ to 10⁵ organisms/m³ and endotoxin concentration is 50 to 900 EU/m³. Examples of such exposures include work in a swine confinement unit, a dairy barn or a poultry-growing facility. Usual symptoms seen with these exposures include those of acute and chronic bronchitis, an asthma-like syndrome and symptoms of mucous membrane irritation.

Gases play an important role in causing lung disorders in the agricultural setting. In swine confinement buildings and in poultry facilities, ammonia levels often contribute to respiratory problems. Exposure to the fertilizer anhydrous ammonia has both acute and long-term effects on the respiratory tract. Acute poisoning from hydrogen sulphide gas released from manure storage facilities in dairy barns and swine confinement units can cause fatalities. Inhalation of insecticidal fumigants can also lead to death.

Prevention of respiratory illnesses may be aided by controlling the source of dusts and other agents. In livestock buildings, this includes managing a correctly designed ventilation system and frequent cleaning to prevent build-up of dust. However, engineering controls alone are likely insufficient. Correct selection and use of a dust respirator is also needed. Alternatives to confinement operations can also be considered, including pasture-based and partially enclosed production arrangements, which can be as profitable as confined operations, particularly when occupational health costs are considered.

Skin Problems

Skin problems can be categorized as contact dermatitis, sun-related, infectious or insect-induced. Estimates indicate that agricultural workers are at highest occupational risk for certain dermatoses (Mathias 1989). While prevalence rates are lacking, particularly in developing regions, studies in the United States indicate that occupational skin disease may account for up to 70% of all occupational diseases among agricultural workers in certain regions (Hogan and Lane 1986).

There are three types of contact dermatoses: irritant dermatitis, allergic dermatitis and photocontact dermatitis. The most common form is irritant contact dermatitis, while allergic contact dermatitis is less common and photocontact reactions are rare (Zuehlke, Mutel and Donham 1980). Common sources of contact dermatitis on the farm include fertilizers, plants and pesticides. Of particular note is dermatitis from contact with livestock feed. Feeds containing additives such as antibiotics may result in allergic dermatitis.

Light-complexioned farmers in developing areas of the world are at particular risk for chronic sun-induced skin problems, including wrinkling, actinic keratoses (scaly non-cancerous lesions) and skin cancer. The two most common types of skin cancer are squamous and basal cell carcinomas. Epidemiological work in Canada indicates that farmers are at higher risk for squamous cell carcinoma than non-farmers (Hogan and Lane 1986). Squamous cell carcinomas often arise from actinic keratoses. Approximately 2 out of 100 squamous cell carcinomas metastasize, and they are most common on the lips. Basal cell carcinomas are more common and occur on the face and ears. While locally destructive, basal cell carcinomas rarely metastasize.

Infectious dermatoses most relevant for livestock workers are ringworm (dermatophytic fungi), orf (contagious ecthyma) and milker’s nodule. Ringworm infections are superficial skin infections that appear as red scaling lesions that result from contact with infected livestock, particularly dairy cattle. A study from India, where cattle generally roam free, revealed over 5% of rural inhabitants suffering from ringworm infections (Chaterjee et al. 1980). Orf, by contrast, is a pox virus usually contracted from infected sheep or goats. The result is typically lesions on the backs of hands or fingers which usually disappear with some scarring in about 6 weeks. Milker’s nodules result from infection with the pseudocowpox poxvirus, typically from contact with infected udders or teats of milk cows. These lesions appear similar to those of orf, though they are more often multiple.

Insect-induced dermatoses result primarily from bites and stings. Infections from mites that parasitize livestock or contaminate grains is particularly notable among livestock handlers. Chigger bites and scabies are typical skin problems from mites that result in various forms of reddened irritations that usually heal spontaneously. More serious are bites and stings from various insects such as bees, wasps, hornets or ants that result in anaphylactic reactions. Anaphylactic shock is a rare hypersensitivity reaction that occurs with an overproduction of chemicals emitted from white blood cells that result in constriction of the airways and can lead to cardiac arrest.

All of these skin problems are largely preventable. Contact dermatitis can be prevented by reducing exposures through use of protective clothing, gloves and appropriate personal hygiene. Additionally, insect-related problems can be prevented by wearing light-coloured and nonflowery clothing and by avoiding scented skin applications. The risk of skin cancer can be dramatically reduced by using appropriate clothing to minimize exposure, such as a wide-brimmed hat. Use of appropriate sunscreen lotions can also be helpful, but should not be relied upon.

Conclusion

The number of livestock worldwide has grown apace with the increase in human population. There are approximately 4 billion cattle, pigs, sheep, goats, horses, buffalo and camels in the world (Durning and Brough 1992). However, there is a notable lack of data on livestock-related human health problems in developing areas of the world such as China and India, where much of the livestock currently reside and where future growth is likely to occur. However, given the emergence of industrialized agriculture worldwide, it can be anticipated that many of the health problems documented in North American and European livestock production will likely accompany the emergence of industrialized livestock production elsewhere. It is also anticipated that health services in these areas will be inadequate to deal with the health and safety consequences of industrialized livestock production generally described here.

The worldwide emergence of industrialized livestock production with its attendant human health consequences will accompany fundamental changes in the social, economic and political order comparable to those that followed from the domestication of animals over 10,000 years ago. Preventing human health problems will require broad understanding and appropriate engagement of these new forms of human adaptation and the place of livestock production within them.

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