Swine confinement facility workers have a high prevalence of respiratory inflammatory disorders as a result of their work environment. The swine confinement facility environment is characterized by the presence of multiple factors that are implicated in eliciting systemic and respiratory tract inflammation symptoms. These factors include organic dust, endotoxin, microbial-associated component, molds, and ammonia. Workers in swine barns are at increased risk of developing respiratory disorders such as chronic bronchitis, exacerbation of underlying asthma, and mucous membrane irritation syndrome. The host response to the swine confinement exposure environment is complex. Naïve subjects with no prior exposure can experience fevers, increases in serum and airway proinflammatory mediators, increased bronchial hyperresponsiveness, and increased neutrophils and macrophages in bronchoalveolar lavage fluid after a short-term exposure. The inflammatory response is attenuated in workers repetitively exposed, suggesting an adaptation response. However, despite adaptation, workers are at an increased risk of developing chronic bronchitis, and there is a significant decline in lung function over time in exposed persons compared to non-exposed persons.  Understanding the mechanisms underlying the modulated inflammatory host response to the swine facility environment may lead to improvement in the health of these agriculture workers.