Cattle allergic patients with rhinitis and asthma are of major importance to the Occupational Accident Insurance (Berufsgenossenschaft) in Germany as they impel extensive prevention measures. With decreasing lung function, costs are magnified considerably. The object of this epidemiological study was to compare the number of cattle allergic patients in all different regions of Germany especially on the basis of reported and confirmed occupational disease cases and the extent of occupational disability (Minderung der ErwerbsfΓ€higkeit, MdE). According to data of the Berufsgenossenschaft all patients recorded in the last decade with a suspected occupational airway disease caused by cattle husbandry were included in this study. Their files were evaluated with regard to individual medical history, allergological and pneumological diagnostic results, work history, technical conditions of the individual farming surrounding and aspects of the occupational disease liability compensation case. In Germany, 517 symptomatic patients (54% male and 46% female), almost all of them farmers, had been registered since the beginning of 1990. The cattle related symptoms of 42% of these patients had been officially acknowledged as an occupational disease. 65% showed initially a reduction in MdE of 20% or above. Interestingly, higher numbers of such cattle allergy cases were observed in southern Germany (3 regions, range 61%-81%) than in the north (46%), considering only the 4 regions with more than 25 cases with recorded MdE. We conclude that cattle allergic farmers are of major quantitative relevance for the Occupational Accident Insurance in Germany. The high inital occupational disability indicates the need to improve preventive strategies such as risk screening and early diagnostic methods to reduce the degree of health impairment. Our results underline the high public health relevance of cattle allergy.