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Son JY, Heo S, Byun G, Foo D, Song Y, Lewis BM, Stewart R, Choi HM, Bell ML. A systematic review of animal feeding operations including concentrated animal feeding operations (CAFOs) for exposure, health outcomes, and environmental justice. ENVIRONMENTAL RESEARCH 2024; 259:119550. [PMID: 38964578 DOI: 10.1016/j.envres.2024.119550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 06/03/2024] [Accepted: 07/02/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Despite growing literature on animal feeding operations (AFOs) including concentrated animal feeding operations (CAFOs), research on disproportionate exposure and associated health burden is relatively limited and shows inconclusive findings. OBJECTIVE We systematically reviewed previous literature on AFOs/CAFOs, focusing on exposure assessment, associated health outcomes, and variables related to environmental justice (EJ) and potentially vulnerable populations. METHODS We conducted a systematic search of databases (MEDLINE/PubMed and Web of Science) and performed citation screening. Screening of titles, abstracts, and full-text articles and data extraction were performed independently by pairs of reviewers. We summarized information for each study (i.e., study location, study period, study population, study type, study design, statistical methods, and adjusted variables (if health association was examined), and main findings), AFO/CAFO characteristics and exposure assessment (i.e., animal type, data source, measure of exposure, and exposure assessment), health outcomes or symptoms (if health association was examined), and information related to EJ and potentially vulnerable populations (in relation to exposure and/or health associations, vulnerable populations considered, related variables, and main findings in relation to EJ and vulnerable populations). RESULTS After initial screening of 10,963 papers, we identified 76 eligible studies. This review found that a relatively small number of studies (20 studies) investigated EJ and vulnerability issues related to AFOs/CAFOs exposure and/or associated health outcomes (e.g., respiratory diseases/symptoms, infections). We found differences in findings across studies, populations, the metrics used for AFO/CAFO exposure assessment, and variables related to EJ and vulnerability. The most commonly used metric for AFO/CAFO exposure assessment was presence of or proximity to facilities or animals. The most investigated variables related to disparities were race/ethnicity and socioeconomic status. CONCLUSION Findings from this review provide suggestive evidence that disparities exist with some subpopulations having higher exposure and/or health response in relation to AFO/CAFO exposure, although results varied across studies.
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Affiliation(s)
- Ji-Young Son
- School of the Environment, Yale University, New Haven, CT, USA.
| | - Seulkee Heo
- School of the Environment, Yale University, New Haven, CT, USA
| | - Garam Byun
- School of the Environment, Yale University, New Haven, CT, USA
| | - Damien Foo
- School of the Environment, Yale University, New Haven, CT, USA
| | - Yimeng Song
- School of the Environment, Yale University, New Haven, CT, USA
| | - Brandon M Lewis
- School of the Environment, Yale University, New Haven, CT, USA
| | - Rory Stewart
- School of the Environment, Yale University, New Haven, CT, USA
| | | | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA; School of Health Policy and Management, College of Health Sciences, Korea University, Seoul, Republic of Korea
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Cornu Hewitt B, Smit LAM, van Kersen W, Wouters IM, Heederik DJJ, Kerckhoffs J, Hoek G, de Rooij MMT. Residential exposure to microbial emissions from livestock farms: Implementation and evaluation of land use regression and random forest spatial models. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 346:123590. [PMID: 38387543 DOI: 10.1016/j.envpol.2024.123590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/10/2024] [Accepted: 02/14/2024] [Indexed: 02/24/2024]
Abstract
Adverse health effects have been linked with exposure to livestock farms, likely due to airborne microbial agents. Accurate exposure assessment is crucial in epidemiological studies, however limited studies have modelled bioaerosols. This study used measured concentrations in air of livestock commensals (Escherichia coli (E. coli) and Staphylococcus species (spp.)), and antimicrobial resistance genes (tetW and mecA) at 61 residential sites in a livestock-dense region in the Netherlands. For each microbial agent, land use regression (LUR) and random forest (RF) models were developed using Geographic Information System (GIS)-derived livestock-related characteristics as predictors. The mean and standard deviation of annual average concentrations (gene copies/m3) of E. coli, Staphylococcus spp., tetW and mecA were as follows: 38.9 (±1.98), 2574 (±3.29), 20991 (±2.11), and 15.9 (±2.58). Validated through 10-fold cross-validation (CV), the models moderately explained spatial variation of all microbial agents. The best performing model per agent explained respectively 38.4%, 20.9%, 33.3% and 27.4% of the spatial variation of E. coli, Staphylococcus spp., tetW and mecA. RF models had somewhat better performance than LUR models. Livestock predictors related to poultry and pig farms dominated all models. To conclude, the models developed enable enhanced estimates of airborne livestock-related microbial exposure in future epidemiological studies. Consequently, this will provide valuable insights into the public health implications of exposure to specific microbial agents.
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Affiliation(s)
- Beatrice Cornu Hewitt
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands.
| | - Lidwien A M Smit
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Warner van Kersen
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Inge M Wouters
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Dick J J Heederik
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Jules Kerckhoffs
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Myrna M T de Rooij
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
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Cotton CC, Jensen ET, Hoffman K, Green DJ, Tapia AL, Turner KO, Genta RM, Dellon ES. Proximity to Swine Farming Operations as a Risk Factor for Eosinophilic Esophagitis. JPGN REPORTS 2023; 4:e391. [PMID: 38034427 PMCID: PMC10684208 DOI: 10.1097/pg9.0000000000000391] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/09/2023] [Indexed: 12/02/2023]
Abstract
We aimed to determine whether residential proximity to permitted swine facilities was associated with an increased risk of eosinophilic esophagitis (EoE) by conducting a case-control study using 2 complementary data sources: 1 from a tertiary care center (n = 401 cases and 1805 controls) and 1 from a large pathology group (n = 904 cases and 4074 controls). Addresses of the subjects and swine facilities were geocoded, and adjusted odds of EoE relative to proximity to and density of swine facilities were calculated. We observed a positive association between proximity to a permitted swine facility (<1 mile) and odds of EoE (adjusted odds ratio R, 2.56; 95% CI, 1.33-4.95) in the tertiary center data; density of farms (>10 farms/census tract) was also positively associated (adjusted odds ratio, 2.76; 95% CI, 1.30-5.84). However, this association was not observed in the pathology database. Though proximity to and density of swine operations were associated with EoE, associations were sensitive to the database used.
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Affiliation(s)
- Cary C. Cotton
- From the Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Elizabeth T. Jensen
- Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Wake Forest University School of Medicine, Department of Epidemiology and Prevention, Winston-Salem, NC
| | - Kate Hoffman
- Duke University, Durham, NC, Carolina School of Medicine, Chapel Hill, NC
| | - Daniel J. Green
- From the Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Amanda L. Tapia
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Kevin O. Turner
- Inform Diagnostics, Fulgent, Irving, TX
- Department of Pathology, University of Minnesota Medical School, Minneapolis, MN
| | - Robert M. Genta
- Inform Diagnostics, Fulgent, Irving, TX
- Departments of Pathology and Medicine (Gastroenterology), Baylor College of Medicine, Houston, TX
| | - Evan S. Dellon
- From the Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Malamardi S, Lambert K, Siddaiah JB, Erbas B, Mahesh PA. Effects of Ambient Air Pollutants on Hospital Admissions among Children Due to Asthma and Wheezing-Associated Lower Respiratory Infections in Mysore, India: A Time Series Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1322. [PMID: 37628320 PMCID: PMC10453753 DOI: 10.3390/children10081322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 08/27/2023]
Abstract
Air pollutants are known to trigger asthma and wheezing-associated lower respiratory infections in children, but evidence regarding their effect on hospital admissions in India is limited. We conducted a time-series study over a period of five years to assess the role of ambient air pollutants in daily asthma-related hospital admissions in children in Mysore, India. Daily asthma and wheeze (associated with lower respiratory infections) admissions were modelled using a generalised additive model (GAM) to examine the non-linear effects and generalised linear models (GLM) for linear effects, if any. Models were adjusted by day of the week and lag days, with smooth terms for time, maximum temperature, and relative humidity, and they were stratified by sex and age group. Of the 362 children admitted, more than 50% were boys, and the mean age was 5.34 years (±4.66). The GAMs showed non-linear associations between NO2, PM2.5, and NH3. For example, a 10 µgm-3 (or 10%) increase in NO2 increased admissions by 2.42. These non-linear effects were more pronounced in boys. A linear effect was detected for PM10 with a relative risk (95% CI) of 1.028, 1.013, and 1.043 with admission. Further research is needed to explore whether these findings can be replicated in different cities in India. Air pollution needs to be controlled, and policies that focus on lower cut-off levels for vulnerable populations are necessary.
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Affiliation(s)
- Sowmya Malamardi
- Department of Public Health, School of Psychology & Public Health, College of Science Health and Engineering, La Trobe University, Melbourne, VIC 3083, Australia; (S.M.); (K.L.); (B.E.)
| | - Katrina Lambert
- Department of Public Health, School of Psychology & Public Health, College of Science Health and Engineering, La Trobe University, Melbourne, VIC 3083, Australia; (S.M.); (K.L.); (B.E.)
| | - Jayaraj Biligere Siddaiah
- Department of Respiratory Medicine, JSS Academy of Higher Education & Research (JSSAHER), JSS Medical College, Mysore 570015, Karnataka, India;
| | - Bircan Erbas
- Department of Public Health, School of Psychology & Public Health, College of Science Health and Engineering, La Trobe University, Melbourne, VIC 3083, Australia; (S.M.); (K.L.); (B.E.)
| | - Padukudru Anand Mahesh
- Department of Respiratory Medicine, JSS Academy of Higher Education & Research (JSSAHER), JSS Medical College, Mysore 570015, Karnataka, India;
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Kiss P, de Rooij MMT, Koppelman GH, Boer J, Vonk JM, Vermeulen R, Hogerwerf L, Sterk HAM, Huss A, Smit LAM, Gehring U. Residential exposure to livestock farms and lung function in adolescence - The PIAMA birth cohort study. ENVIRONMENTAL RESEARCH 2023; 219:115134. [PMID: 36563981 DOI: 10.1016/j.envres.2022.115134] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/07/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND There is a growing interest in the impact of air pollution from livestock farming on respiratory health. Studies in adults suggest adverse effects of livestock farm emissions on lung function, but so far, studies involving children and adolescents are lacking. OBJECTIVES To study the association of residential proximity to livestock farms and modelled particulate matter ≤10 μm (PM10) from livestock farms with lung function in adolescence. METHODS We performed a cross-sectional study among 715 participants of the Dutch prospective PIAMA (Prevention and Incidence of Asthma and Mite Allergy) birth cohort study. Relationships of different indicators of residential livestock farming exposure (distance to farms, distance-weighted number of farms, cattle, pigs, poultry, horses and goats within 3 km; modelled atmospheric PM10 concentrations from livestock farms) with forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) at age 16 were assessed by linear regression taking into account potential confounders. Associations were expressed per interquartile range increase in exposure. RESULTS Higher exposure to livestock farming was consistently associated with a lower FEV1, but not with FVC among participants living in less urbanized municipalities (<1500 addresses/km2, N = 402). Shorter distances of homes to livestock farms were associated with a 1.4% (0.2%; 2.7%) lower FEV1. Larger numbers of farms within 3 km and higher concentrations of PM10 from livestock farming were associated with a 1.8% (0.8%, 2.9%) and 0.9% (0.4%,1.5%) lower FEV1, respectively. CONCLUSIONS Our findings suggest that higher exposure to livestock farming is associated with a lower FEV1 in adolescents. Replication and more research on the etiologic agents involved in these associations and the underlying mechanisms is needed.
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Affiliation(s)
- Pauline Kiss
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Myrna M T de Rooij
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Gerard H Koppelman
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Department of Pediatric Pulmonology and Pediatric Allergology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands
| | - Jolanda Boer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Judith M Vonk
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Lenny Hogerwerf
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Hendrika A M Sterk
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Anke Huss
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Lidwien A M Smit
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
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Wyer KE, Kelleghan DB, Blanes-Vidal V, Schauberger G, Curran TP. Ammonia emissions from agriculture and their contribution to fine particulate matter: A review of implications for human health. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 323:116285. [PMID: 36261990 DOI: 10.1016/j.jenvman.2022.116285] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/22/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Atmospheric ammonia (NH3) released from agriculture is contributing significantly to acidification and atmospheric NH3 may have on human health is much less readily available. The potential direct impact of NH3 on the health of the general public is under-represented in scientific literature, though there have been several studies which indicate that NH3 has a direct effect on the respiratory health of those who handle livestock. These health impacts can include a reduced lung function, irritation to the throat and eyes, and increased coughing and phlegm expulsion. More recent studies have indicated that agricultural NH3 may directly influence the early on-set of asthma in young children. In addition to the potential direct impact of ammonia, it is also a substantial contributor to the fine particulate matter (PM2.5) fraction (namely the US and Europe); where it accounts for the formation of 30% and 50% of all PM2.5 respectively. PM2.5 has the ability to penetrate deep into the lungs and cause long term illnesses such as Chronic Obstructive Pulmonary Disease (COPD) and lung cancer. Hence, PM2.5 causes economic losses which equate to billions of dollars (US) to the global economy annually. Both premature deaths associated with the health impacts from PM2.5 and economic losses could be mitigated with a reduction in NH3 emissions resulting from agriculture. As agriculture contributes to more than 81% of all global NH3 emissions, it is imperative that food production does not come at a cost to the world's ability to breathe; where reductions in NH3 emissions can be easier to achieve than other associated pollutants.
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Affiliation(s)
- Katie E Wyer
- UCD School of Biosystems and Food Engineering, University College Dublin, Belfield, Dublin 4, Ireland.
| | - David B Kelleghan
- Teagasc, Environment, Soils and Land-Use Department, Johnstown Castle, Co. Wexford, Y35 TC97, Ireland
| | - Victoria Blanes-Vidal
- Applied AI and Data Science (AID), Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark
| | - Günther Schauberger
- Department of Physiology and Biophysics, University of Veterinary Medicine, Vienna, A-1210 Wien, Veterinärplatz 1, Austria
| | - Thomas P Curran
- UCD School of Biosystems and Food Engineering, University College Dublin, Belfield, Dublin 4, Ireland
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van Kersen W, Bossers A, de Steenhuijsen Piters WAA, de Rooij MMT, Bonten M, Fluit AC, Heederik D, Paganelli FL, Rogers M, Viveen M, Bogaert D, Leavis HL, Smit LAM. Air pollution from livestock farms and the oropharyngeal microbiome of COPD patients and controls. ENVIRONMENT INTERNATIONAL 2022; 169:107497. [PMID: 36088872 DOI: 10.1016/j.envint.2022.107497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/22/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Air pollution from livestock farms is known to affect respiratory health of patients with chronic obstructive pulmonary disease (COPD). The mechanisms behind this relationship, however, remain poorly understood. We hypothesise that air pollutants could influence respiratory health through modulation of the airway microbiome. Therefore, we studied associations between air pollution exposure and the oropharyngeal microbiota (OPM) composition of COPD patients and controls in a livestock-dense area. Oropharyngeal swabs were collected from 99 community-based (mostly mild) COPD cases and 184 controls (baseline), and after 6 and 12 weeks. Participants were non-smokers or former smokers. Annual average livestock-related outdoor air pollution at the home address was predicted using dispersion modelling. OPM composition was analysed using 16S rRNA-based sequencing in all baseline samples and 6-week and 12-week repeated samples of 20 randomly selected subjects (n = 323 samples). A random selection of negative control swabs, taken every sampling day, were also included in the downstream analysis. Both farm-emitted endotoxin and PM10 levels were associated with increased OPM richness in COPD patients (p < 0.05) but not in controls. COPD case-control status was not associated with community structure, while correcting for known confounders (multivariate PERMANOVA p > 0.05). However, members of the genus Streptococcus were more abundant in COPD patients (Benjamini-Hochberg adjusted p < 0.01). Moderate correlation was found between ordinations of 20 subjects analysed at 0, 6, and 12 weeks (Procrustes r = 0.52 to 0.66; p < 0.05; Principal coordinate analysis of Bray-Curtis dissimilarity), indicating that the OPM is relatively stable over a 12 week period and that a single sample sufficiently represents the OPM. Air pollution from livestock farms is associated with OPM richness of COPD patients, suggesting that the OPM of COPD patients is susceptible to alterations induced by exposure to air pollutants.
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Affiliation(s)
- Warner van Kersen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Alex Bossers
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Wouter A A de Steenhuijsen Piters
- University Medical Center Utrecht, Utrecht, the Netherlands; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Myrna M T de Rooij
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Marc Bonten
- University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ad C Fluit
- University Medical Center Utrecht, Utrecht, the Netherlands
| | - Dick Heederik
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | | | - Malbert Rogers
- University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marco Viveen
- University Medical Center Utrecht, Utrecht, the Netherlands
| | - Debby Bogaert
- University Medical Center Utrecht, Utrecht, the Netherlands; University of Edinburgh Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Helen L Leavis
- University Medical Center Utrecht, Utrecht, the Netherlands
| | - Lidwien A M Smit
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
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Van Horne YO, Farzan SF, Razafy M, Johnston JE. Respiratory and allergic health effects in children living near agriculture: A review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 832:155009. [PMID: 35381238 PMCID: PMC9167771 DOI: 10.1016/j.scitotenv.2022.155009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/08/2022] [Accepted: 03/30/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Exposure to pesticides and agricultural burning are likely to co-occur in agricultural communities, but these exposures have remained distinct bodies of research. We reviewed epidemiological studies to identify the respiratory health effects of children exposed to pesticides and agricultural burning through a systematic evaluation of peer-reviewed publications of children living in industrial agricultural areas. METHODS Two academic search databases (PubMed and Scopus) were queried for all available studies published in English before May 31st, 2021. The initial search combining both exposure metrics (pesticides and agricultural burning) yielded zero publications and thus the queries were performed and presented separately. RESULTS Studies were categorized based on main exposure of interest (i.e., pesticides or agricultural burning) and by respiratory health outcome assessment (i.e., self-reported asthma, acute respiratory symptoms, and lung function measurements). In total we identified 25 studies that focused on pesticide exposures and children's respiratory health, and 12 studies that focused on exposure to agricultural burning and children's respiratory health. A majority of the pesticide studies (18/25) reported a positive association between exposure to pesticides and adverse childhood respiratory health effects. Similarly, most (11/12) of the agricultural burning studies also reported a positive association between exposure to agricultural burning and adverse respiratory health effects. CONCLUSION The most frequently studied health outcomes in these publications were acute respiratory symptoms (n = 11 pesticides, n = 3 agricultural burning), followed by asthma (n = 9 pesticides, n = 3 agricultural burning), and lung function measurements (n = 5 pesticides, n = 6 agricultural burning). Although health outcome assessment differed between pesticide studies and agricultural burning studies, similar adverse respiratory health effects were observed across the majority of studies.
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Affiliation(s)
- Yoshira Ornelas Van Horne
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA.
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Mitiasoa Razafy
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA
| | - Jill E Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90032, USA
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Ulu A, Velazquez JV, Burr A, Sveiven SN, Yang J, Bravo C, Hammock BD, Nordgren TM. Sex-Specific Differences in Resolution of Airway Inflammation in Fat-1 Transgenic Mice Following Repetitive Agricultural Dust Exposure. Front Pharmacol 2022; 12:785193. [PMID: 35095496 PMCID: PMC8793679 DOI: 10.3389/fphar.2021.785193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/23/2021] [Indexed: 11/13/2022] Open
Abstract
In agriculture industries, workers are at increased risk for developing pulmonary diseases due to inhalation of agricultural dusts, particularly when working in enclosed confinement facilities. Agricultural dusts inhalation leads to unresolved airway inflammation that precedes the development and progression of lung disease. We have previously shown beneficial effects of the omega-3 polyunsaturated fatty acid (ω-3 PUFA) DHA in protecting against the negative inflammatory effects of repetitive dust exposure in the lung. Dietary manipulation of pulmonary disease risk is an attractive and timely approach given the contribution of an increased ω-6 to ω-3 PUFA ratio to low grade inflammation and chronic disease in the Western diet. To prevent any confounding factors that comes with dietary supplementation of ω-3 PUFA (different sources, purity, dose, and duration), we employed a Fat-1 transgenic mouse model that convert ω-6 PUFA to ω-3 PUFA, leading to a tissue ω-6 to ω-3 PUFA ratio of approximately 1:1. Building on our initial findings, we hypothesized that attaining elevated tissue levels of ω-3 PUFA would attenuate agricultural dust-induced lung inflammation and its resolution. To test this hypothesis, we compared wild-type (WT) and Fat-1 transgenic mice in their response to aqueous extracts of agricultural dust (DE). We also used a soluble epoxide hydrolase inhibitor (sEH) to potentiate the effects of ω-3 PUFA, since sEH inhibitors have been shown to stabilize the anti-inflammatory P450 metabolites derived from both ω-3 and ω-6 PUFA and promote generation of specialized pro-resolving lipid mediators from ω-3 PUFA. Over a three-week period, mice were exposed to a total of 15 intranasal instillations of DE obtained from swine confinement buildings in the Midwest. We observed genotype and sex-specific differences between the WT vs. Fat-1 transgenic mice in response to repetitive dust exposure, where three-way ANOVA revealed significant main effects of treatment, genotype, and sex. Also, Fat-1 transgenic mice displayed reduced lymphoid aggregates in the lung following DE exposure as compared to WT animals exposed to DE, suggesting improved resilience to the DE-induced inflammatory effects. Overall, our data implicate a protective role of ω-3 FA in the lung following repetitive dust exposure.
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Affiliation(s)
- Arzu Ulu
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Jalene V Velazquez
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Abigail Burr
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Stefanie N Sveiven
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Jun Yang
- Department of Entomology and Nematology, University of California Davis Comprehensive Cancer Center, University of California, Davis, Davis, CA, United States
| | - Carissa Bravo
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Bruce D Hammock
- Department of Entomology and Nematology, University of California Davis Comprehensive Cancer Center, University of California, Davis, Davis, CA, United States
| | - Tara M Nordgren
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, Riverside, CA, United States.,Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, United States
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Son JY, Miranda ML, Bell ML. Exposure to concentrated animal feeding operations (CAFOs) and risk of mortality in North Carolina, USA. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 799:149407. [PMID: 34365264 PMCID: PMC8530906 DOI: 10.1016/j.scitotenv.2021.149407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 06/13/2023]
Abstract
Concentrated animal feeding operations (CAFOs) have emerged as an environmental justice issue due to disproportionate siting in low-income and minority communities. However, CAFOs' impact on health is not fully understood. We examined risk of cause-specific mortality associated with CAFOs in North Carolina (NC) for 2000-2017 and health disparities. We obtained data on individual-level cause-specific mortality and on permitted animal facilities. We estimated associations between exposure to CAFOs and cause-specific mortality using logistic regression, controlling for demographics (e.g., age) and area-level covariates. To estimate exposure to CAFOs, we considered (1) a binary indicator (presence or absence) of CAFOs within a buffer around individual residence based on several buffer sizes, and (2) four levels of exposure (no, low, medium, and high) based on the number of CAFOs within 15 km around each residence. We considered individual-level (sex, race/ethnicity, age, education) and community-level (median household income, urbanicity, and region) factors. Under all buffer sizes used to estimate CAFOs exposure, people living near CAFOs had significantly higher risk of cardiovascular mortality than other persons. Comparing those living near CAFOs to the no exposure group, odds ratios (ORs) for cardiovascular mortality were 1.01 (95% confidence interval (CI) 1.00, 1.03), 1.04 (1.03, 1.06), and 1.06 (1.05, 1.07) for low, medium, and high CAFOs exposure, respectively, indicating a trend of higher risk with higher exposure. Those in the high CAFOs exposure group had significantly higher risk of anemia and kidney disease mortality than those with no exposure. Results suggest higher mortality risk from CAFOs for some subpopulations, however differences were not statistically significant. Findings provide evidence of excess mortality risk from CAFOs in NC. These results have implications for future studies of environmental justice and CAFOs.
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Affiliation(s)
- Ji-Young Son
- School of the Environment, Yale University, New Haven, CT, USA.
| | - Marie Lynn Miranda
- Department of Applied and Computational Mathematics and Statistics, University of Notre Dame, Notre Dame, IN, USA
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA
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11
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Andersén H, Ilmarinen P, Honkamäki J, Tuomisto LE, Hisinger-Mölkänen H, Backman H, Lundbäck B, Rönmark E, Lehtimäki L, Sovijärvi A, Piirilä P, Kankaanranta H. Influence of Childhood Exposure to a Farming Environment on Age at Asthma Diagnosis in a Population-Based Study. J Asthma Allergy 2021; 14:1081-1091. [PMID: 34522104 PMCID: PMC8434911 DOI: 10.2147/jaa.s323504] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 08/21/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose Asthma is a heterogeneous disease, and factors associated with different asthma phenotypes are poorly understood. Given the higher prevalence of farming exposure and late diagnosis of asthma in more rural Western Finland as compared with the capital of Helsinki, we investigated the relationship between childhood farming environment and age at asthma diagnosis. Methods A cross-sectional population-based study was carried out with subjects aged 20–69 years in Western Finland. The response rate was 52.5%. We included 3864 participants, 416 of whom had physician-diagnosed asthma at a known age and with data on the childhood environment. The main finding was confirmed in a similar sample from Helsinki. Participants were classified as follows with respect to asthma diagnosis: early diagnosis (0–11 years), intermediate diagnosis (12–39 years), and late diagnosis (40–69 years). Results The prevalence of asthma was similar both without and with childhood exposure to a farming environment (11.7% vs 11.3%). Allergic rhinitis, family history of asthma, ex-smoker, occupational exposure, and BMI ≥ 30 kg/m2 were associated with a higher likelihood of asthma. Childhood exposure to a farming environment did not increase the odds of having asthma (aOR, 1.10; 95% CI, 0.87–1.40). It did increase the odds of late diagnosis (aOR, 2.30; 95% CI, 1.12–4.69), but the odds were lower for early (aOR, 0.49; 95% CI, 0.30–0.80) and intermediate diagnosis of asthma (aOR, 0.75; 95% CI, 0.47–1.18). Conclusion Odds were lower for early diagnosis of asthma and higher for late diagnosis of asthma in a childhood farming environment. This suggests a new hypothesis concerning the etiology of asthma when it is diagnosed late. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/BdY2eA86hV8
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Affiliation(s)
- Heidi Andersén
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Pinja Ilmarinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jasmin Honkamäki
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Leena E Tuomisto
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Etelä-Pohjanmaa, Finland
| | | | - Helena Backman
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Norrbotten, Sweden
| | - Bo Lundbäck
- Department of Internal Medicine, Krefting Research Center, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Västra Götaland, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Norrbotten, Sweden
| | - Lauri Lehtimäki
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Anssi Sovijärvi
- Faculty of Medicine, University of Helsinki, Helsinki, Uusimaa, Finland
| | - Päivi Piirilä
- Faculty of Medicine, University of Helsinki, Helsinki, Uusimaa, Finland
| | - Hannu Kankaanranta
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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Relation of repeated exposures to air emissions from swine industrial livestock operations to sleep duration and awakenings in nearby residential communities. Sleep Health 2021; 7:528-534. [PMID: 34193392 DOI: 10.1016/j.sleh.2021.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Since waste from swine industrial livestock operations (ILOs) produces air pollutants associated with negative health outcomes among nearby residents, we assessed the impact of odorant emissions on sleep duration and awakenings. DESIGN A repeated-measures design. SETTING Sixteen residential communities in eastern North Carolina hosting swine ILOs. PARTICIPANTS Eighty participants residing in eastern North Carolina from 2003 to 2005. INTERVENTION (IF ANY) Not applicable. MEASUREMENTS Study participants completed twice-daily diaries in which they rated the strength of hog odors and indicated whether they were asleep or awake per hour for 2 weeks. Simultaneously, a monitoring trailer placed in a central location in each community measured the atmospheric concentration of hydrogen sulfide (H2S). Subject-conditional fixed-effects regression models were used to estimate associations between 2 markers of swine ILO pollutant exposures (H2S and swine odor) and 2 self-reported sleep outcomes (nightly sleep duration and awakening from sleep). RESULTS Among 80 participants, nightly (across a 12-hour period) swine odor was associated with lower nightly sleep duration (mean difference = -14.3 minutes, 95% confidence interval -25.0 to -3.3 minutes) compared to odor-free nights and detection of nightly hydrogen sulfide was associated with an increased risk of awakening (hazard ratio = 1.23, 95% confidence interval 0.98 to 1.55) compared to nights with no detection of hydrogen sulfide. CONCLUSIONS These results suggest that environmental odorants are important considerations for sleep health and highlight the importance of sleep as a potential mediator between environmental air pollution and health outcomes impacted by poor sleep.
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Abstract
Ambient air pollution is produced by sources including vehicular traffic, coal-fired power plants, hydraulic fracturing, agricultural production, and forest fires. It consists of primary pollutants generated by combustion and secondary pollutants formed in the atmosphere from precursor gases. Air pollution causes and exacerbates climate change, and climate change worsens health effects of air pollution. Infants and children are uniquely sensitive to air pollution, because their organs are developing and they have higher air per body weight intake. Health effects linked to air pollution include not only exacerbations of respiratory diseases but also reduced lung function development and increased asthma incidence. Additional outcomes of concern include preterm birth, low birth weight, neurodevelopmental disorders, IQ loss, pediatric cancers, and increased risks for adult chronic diseases. These effects are mediated by oxidative stress, chronic inflammation, endocrine disruption, and genetic and epigenetic mechanisms across the life span. Natural experiments demonstrate that with initiatives such as increased use of public transportation, both air quality and community health improve. Similarly, the Clean Air Act has improved air quality, although exposure inequities persist. Other effective strategies for reducing air pollution include ending reliance on coal, oil, and gas; regulating industrial emissions; reducing exposure with attention to proximity of residences, schools, and child care facilities to traffic; and a greater awareness of the Air Quality Index. This policy reviews both short- and long-term health consequences of ambient air pollution, especially in relation to developmental exposures. It examines individual, community, and legislative strategies to mitigate air pollution.
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Affiliation(s)
- Heather L Brumberg
- Division of Neonatology, Maria Fareri Children's Hospital, Westchester Medical Center and Departments of Pediatrics and Public Health, New York Medical College, Valhalla, New York; and
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14
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Aerts R, Dujardin S, Nemery B, Van Nieuwenhuyse A, Van Orshoven J, Aerts JM, Somers B, Hendrickx M, Bruffaerts N, Bauwelinck M, Casas L, Demoury C, Plusquin M, Nawrot TS. Residential green space and medication sales for childhood asthma: A longitudinal ecological study in Belgium. ENVIRONMENTAL RESEARCH 2020; 189:109914. [PMID: 32980008 DOI: 10.1016/j.envres.2020.109914] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/03/2020] [Accepted: 07/03/2020] [Indexed: 05/03/2023]
Abstract
BACKGROUND Living in green environments has been associated with various health benefits, but the evidence for positive effects on respiratory health in children is ambiguous. OBJECTIVE To investigate if residential exposure to different types of green space is associated with childhood asthma prevalence in Belgium. METHODS Asthma prevalence was estimated from sales data of reimbursed medication for obstructive airway disease (OAD) prescribed to children between 2010 and 2014, aggregated at census tract level (n = 1872) by sex and age group (6-12 and 13-18 years). Generalized log-linear mixed effects models with repeated measures were used to estimate effects of relative covers of forest, grassland and garden in the census tract of the residence on OAD medication sales. Models were adjusted for air pollution (PM10), housing quality and administrative region. RESULTS Consistent associations between OAD medication sales and relative covers of grassland and garden were observed (unadjusted parameter estimates per IQR increase of relative cover, range across four strata: grassland, β = 0.15-0.17; garden, β = 0.13-0.17). The associations remained significant after adjusting for housing quality and chronic air pollution (adjusted parameter estimates per IQR increase of relative cover, range across four strata: grassland, β = 0.10-0.14; garden, β = 0.07-0.09). There was no association between OAD medication sales and forest cover. CONCLUSIONS Based on aggregated data, we found that living in close proximity to areas with high grass cover (grasslands, but also residential gardens) may negatively impact child respiratory health. Potential allergic and non-allergic mechanisms that underlie this association include elevated exposure to grass pollen and fungi and reduced exposure to environmental biodiversity. Reducing the dominance of grass in public and private green space might be beneficial to reduce the childhood asthma burden and may simultaneously improve the ecological value of urban green space.
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Affiliation(s)
- Raf Aerts
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium; Division Ecology, Evolution and Biodiversity Conservation, University of Leuven (KU Leuven), Kasteelpark Arenberg 31-2435, BE-3001, Leuven, Belgium; Division Forest, Nature and Landscape, University of Leuven (KU Leuven), Celestijnenlaan 200E-2411, BE-3001, Leuven, Belgium; Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590, Diepenbeek, Hasselt, Belgium; Mycology and Aerobiology, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium.
| | - Sebastien Dujardin
- Division Forest, Nature and Landscape, University of Leuven (KU Leuven), Celestijnenlaan 200E-2411, BE-3001, Leuven, Belgium; Department of Geography, Institute of Life Earth and Environment (ILEE), University of Namur, Namur, Belgium
| | - Benoit Nemery
- Center for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Herestraat 49-706, BE-3000, Leuven, Belgium
| | - An Van Nieuwenhuyse
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium; Center for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Herestraat 49-706, BE-3000, Leuven, Belgium
| | - Jos Van Orshoven
- Division Forest, Nature and Landscape, University of Leuven (KU Leuven), Celestijnenlaan 200E-2411, BE-3001, Leuven, Belgium
| | - Jean-Marie Aerts
- Division Animal and Human Health Engineering, University of Leuven (KU Leuven), Leuven, Belgium
| | - Ben Somers
- Division Forest, Nature and Landscape, University of Leuven (KU Leuven), Celestijnenlaan 200E-2411, BE-3001, Leuven, Belgium
| | - Marijke Hendrickx
- Mycology and Aerobiology, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium
| | - Nicolas Bruffaerts
- Mycology and Aerobiology, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Pleinlaan 5, BE-1050, Brussels, Belgium
| | - Lidia Casas
- Center for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Herestraat 49-706, BE-3000, Leuven, Belgium; Epidemiology and Social Medicine, University of Antwerp, Universiteitsplein 1-R.232, BE-2610, Wilrijk, Antwerp, Belgium
| | - Claire Demoury
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium
| | - Michelle Plusquin
- Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590, Diepenbeek, Hasselt, Belgium
| | - Tim S Nawrot
- Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590, Diepenbeek, Hasselt, Belgium; Center for Environment and Health, Department of Public Health and Primary Care, University of Leuven, Herestraat 49-706, BE-3000, Leuven, Belgium
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15
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Barton KT, Conklin DR, Ranabhat RS, Harper M, Holmes-Cobb LM, Martinez Soto MH, Waterman JT. Methacholine induced airway contraction in porcine precision cut lung slices from indoor and outdoor reared pigs. Am J Transl Res 2020; 12:2805-2813. [PMID: 32655811 PMCID: PMC7344084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/20/2020] [Indexed: 06/11/2023]
Abstract
Repetitive exposure to bioaerosols in swine production facilities (SPF) promotes respiratory dysfunction in workers and animals. An adequate understanding of the impact of the SPF environment on pulmonary physiology is needed. However, there is currently no sufficient ex vivo model to investigate the cause for agriculture-related lung disease. The precision cut lung slices (PCLS) technique represents a practical and useful procedure for ex vivo studies. Our goal was to use the PCLS technique to develop a model of agriculture-related lung diseases using a physiologically relevant animal model, the domesticated pig. Freshly prepared pig lung tissue cores were sectioned into 300 µm slices and viability was measured by lactate dehydrogenase activity and live/dead staining. Airway contractility in response to a methacholine (MCh) dose gradient (10-7-10-4 M) was measured. After the last MCh dose, PCLS were incubated with 1 mM chloroquine to allow airways to relax. Time-lapse images were taken every minute for 35 minutes and used to determine airway lumen area changes. Porcine PCLS remained viable and demonstrated metabolic activity for three days. PCLS from indoor and outdoor pigs contracted in response to MCh exposure and relaxed when incubated with chloroquine. Notably, PCLS of indoor pigs showed greater airway constriction in response to 10-5 M MCh exposure compared to outdoor pig PCLS (P<0.05). These data suggest that exposure to the indoor pig production environment may be associated with hyperresponsiveness in swine airways, and support future studies to investigate lung response to inflammatory substances using the porcine PCLS model.
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Affiliation(s)
- Ke’Yona T Barton
- Department of Animal Sciences, North Carolina Agricultural and Technical State UniversityGreensboro, USA
| | - Dawn R Conklin
- Department of Animal Sciences, North Carolina Agricultural and Technical State UniversityGreensboro, USA
| | - Rohit S Ranabhat
- Department of Animal Sciences, North Carolina Agricultural and Technical State UniversityGreensboro, USA
- Applied Science and Technology Program, North Carolina Agricultural and Technical State UniversityGreensboro, USA
| | - Marquis Harper
- Department of Animal Sciences, North Carolina Agricultural and Technical State UniversityGreensboro, USA
| | - La’Neesa M Holmes-Cobb
- Department of Animal Sciences, North Carolina Agricultural and Technical State UniversityGreensboro, USA
| | - Margarita H Martinez Soto
- Department of Animal Sciences, North Carolina Agricultural and Technical State UniversityGreensboro, USA
| | - Jenora T Waterman
- Department of Animal Sciences, North Carolina Agricultural and Technical State UniversityGreensboro, USA
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Baliatsas C, Dückers M, Smit LA, Heederik D, Yzermans J. Morbidity Rates in an Area with High Livestock Density: A Registry-Based Study Including Different Groups of Patients with Respiratory Health Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1591. [PMID: 32121551 PMCID: PMC7084699 DOI: 10.3390/ijerph17051591] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/17/2020] [Accepted: 02/24/2020] [Indexed: 01/12/2023]
Abstract
There is continuing debate and public health concern regarding the previously confirmed association between high livestock density and human health. The primary aim of the current study is to assess the prevalence of respiratory and other health problems in a livestock dense area in the Netherlands, based on recent longitudinal health data and a large sample. Analyses are expanded with the investigation of different subgroups of patients with respiratory health problems and the inclusion of various chronic and acute health outcomes, as well as prescribed medication. Prevalence of health symptoms and chronic conditions was assessed for the period 2014-2016, based on electronic health records registered in 26 general practices located in areas with intensive livestock farming in the Netherlands ("livestock dense area", n = 117,459 unique residents in total). These were compared with corresponding health data from general practices (n = 22) in different rural regions with a low density of livestock farms or other major environmental exposures ("control area", n = 85,796 unique residents in total). Multilevel regression models showed a significantly higher prevalence of pneumonia in the total sample in the livestock dense area, which was also observed among susceptible subgroups of children, the elderly, and patients with chronic obstructive pulmonary disease (COPD). Lower respiratory tract infections, respiratory symptoms, vertigo, and depression were also more common in the livestock dense area compared to the control area. In general, there were no significant differences in chronic conditions such as asthma, COPD, or lung cancer. Prescription rates for broad-spectrum antibiotics were more common among patients with pneumonia in the livestock dense area. Acute respiratory infections and symptoms, but not chronic conditions, were considerably more common in areas with a high livestock density. Identification of causal pathogens on the basis of serological analyses could further elucidate the underlying mechanisms behind the observed health effects.
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Affiliation(s)
- Christos Baliatsas
- Department of Disasters and Environmental Hazards, Netherlands Institute for Health Services Research (NIVEL), 3513 CR Utrecht, The Netherlands; (M.D.)
| | - Michel Dückers
- Department of Disasters and Environmental Hazards, Netherlands Institute for Health Services Research (NIVEL), 3513 CR Utrecht, The Netherlands; (M.D.)
| | - Lidwien A.M. Smit
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CM Utrecht, The Netherlands; (L.A.M.S.)
| | - Dick Heederik
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584 CM Utrecht, The Netherlands; (L.A.M.S.)
| | - Joris Yzermans
- Department of Disasters and Environmental Hazards, Netherlands Institute for Health Services Research (NIVEL), 3513 CR Utrecht, The Netherlands; (M.D.)
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17
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de Rooij MMT, Smit LAM, Erbrink HJ, Hagenaars TJ, Hoek G, Ogink NWM, Winkel A, Heederik DJJ, Wouters IM. Endotoxin and particulate matter emitted by livestock farms and respiratory health effects in neighboring residents. ENVIRONMENT INTERNATIONAL 2019; 132:105009. [PMID: 31387023 DOI: 10.1016/j.envint.2019.105009] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND Living in livestock-dense areas has been associated with health effects, suggesting airborne exposures to livestock farm emissions to be relevant for public health. Livestock farm emissions involve complex mixtures of various gases and particles. Endotoxin, a pro-inflammatory agent of microbial origin, is a constituent of livestock farm emitted particulate matter (PM) that is potentially related to the observed health effects. Quantification of livestock associated endotoxin exposure at residential addresses in relation to health outcomes has not been performed earlier. OBJECTIVES We aimed to assess exposure-response relations for a range of respiratory endpoints and atopic sensitization in relation to livestock farm associated PM10 and endotoxin levels. METHODS Self-reported respiratory symptoms of 12,117 persons participating in a population-based cross-sectional study were analyzed. For 2494 persons, data on lung function (spirometry) and serologically assessed atopic sensitization was additionally available. Annual-average PM10 and endotoxin concentrations at home addresses were predicted by dispersion modelling and land-use regression (LUR) modelling. Exposure-response relations were analyzed with generalized additive models. RESULTS Health outcomes were generally more strongly associated with exposure to livestock farm emitted endotoxin compared to PM10. An inverse association was observed for dispersion modelled exposure with atopic sensitization (endotoxin: p = .004, PM10: p = .07) and asthma (endotoxin: p = .029, PM10: p = .022). Prevalence of respiratory symptoms decreased with increasing endotoxin concentration at the lower range, while at the higher range prevalence increased with increasing concentration (p < .05). Associations between lung function parameters with exposure to PM10 and endotoxin were not statistically significant (p > .05). CONCLUSIONS Exposure to livestock farm emitted particulate matter is associated with respiratory health effects and atopic sensitization in non-farming residents. Results indicate endotoxin to be a potentially plausible etiologic agent, suggesting non-infectious aspects of microbial emissions from livestock farms to be important with respect to public health.
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Affiliation(s)
- Myrna M T de Rooij
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands.
| | - Lidwien A M Smit
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | | | - Thomas J Hagenaars
- Wageningen Bioveterinary Research, Wageningen University and Research, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | - Nico W M Ogink
- Wageningen Livestock Research, Wageningen University and Research, the Netherlands
| | - Albert Winkel
- Wageningen Livestock Research, Wageningen University and Research, the Netherlands
| | - Dick J J Heederik
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | - Inge M Wouters
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
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18
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Loftus C, Afsharinejad Z, Sampson P, Vedal S, Torres E, Arias G, Tchong-French M, Karr C. Estimated time-varying exposures to air emissions from animal feeding operations and childhood asthma. Int J Hyg Environ Health 2019; 223:187-198. [PMID: 31543304 DOI: 10.1016/j.ijheh.2019.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/08/2019] [Accepted: 09/08/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND/AIM Industrial-scale animal feeding operations (AFOs) have adverse impacts on regional air quality. Air emissions include endotoxins and other pro-inflammatory components, and exposure may cause airway inflammation and respiratory effects in susceptible individuals residing nearby. We aimed to develop and validate metrics for estimating time-varying exposure to AFO air pollution in surrounding communities and, secondly, to determine whether exposure is associated with health effects in children with asthma. METHODS We conducted a longitudinal panel study of N = 58 children with asthma in an agricultural region of Washington State with a high density of dairy AFOs. Children were followed for up to 26 months with repeated measures of respiratory health (N = 2023 interviews; N = 3853 lung function measurements); urine was collected in a subcohort (N = 16) at six-day intervals over three months and analyzed for leukotriene E4 (LTE4), a biomarker of systemic inflammation (N = 138 measurements). We developed an approach to estimate daily exposure to AFO airborne emissions based on distance to AFOs, AFO size, and daily wind speed and direction, and validated the estimates against direct measurements of ammonia, a chemical marker of AFO emissions, measured biweekly at 18 sites across the region for 14 months. Short-term relationships between AFO pollutant exposure and outcomes were assessed using regression models accounting for within-participant correlation and several potential confounders. RESULTS Estimates of daily AFO air pollution correlated moderately well with outdoor ammonia measurements (N = 842; r = 0.62). Forced expiratory volume in 1 s (FEV1) as percent of predicted was 2.0% (95% CI: 0.5, 3.5) lower with each interquartile increase in previous day exposure, but no associations with asthma symptoms were observed. There was suggestive evidence that LTE4 concentrations were higher following days of elevated exposure to AFO emissions (p = 0.06). CONCLUSIONS A simple metric of time-varying exposure to AFO emissions was correlated with daily outdoor ammonia levels. Children with asthma may be adversely affected by exposure to AFO emissions.
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Affiliation(s)
- Christine Loftus
- Department of Environmental and Occupational Health Sciences, School of Public Health, Box 357234, University of Washington, Seattle, WA, 98195, United States.
| | - Zahra Afsharinejad
- Department of Environmental and Occupational Health Sciences, School of Public Health, Box 357234, University of Washington, Seattle, WA, 98195, United States
| | - Paul Sampson
- Department of Statistics, College of Arts and Sciences, Box 354322, University of Washington, Seattle, WA, 98195, United States
| | - Sverre Vedal
- Department of Environmental and Occupational Health Sciences, School of Public Health, Box 357234, University of Washington, Seattle, WA, 98195, United States
| | - Elizabeth Torres
- Northwest Communities Education Center, Radio KDNA, 121 Sunnyside Ave, Granger, WA, 98932, United States
| | - Griselda Arias
- Yakima Valley Farm Workers Clinic, Yakima, WA, United States
| | - Maria Tchong-French
- Department of Environmental and Occupational Health Sciences, School of Public Health, Box 357234, University of Washington, Seattle, WA, 98195, United States
| | - Catherine Karr
- Department of Environmental and Occupational Health Sciences, School of Public Health, Box 357234, University of Washington, Seattle, WA, 98195, United States; Department of Pediatrics, School of Medicine, Box 356320, University of Washington, Seattle, WA, 98195, United States
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19
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Schultz AA, Peppard P, Gangnon RE, Malecki KMC. Residential proximity to concentrated animal feeding operations and allergic and respiratory disease. ENVIRONMENT INTERNATIONAL 2019; 130:104911. [PMID: 31238264 DOI: 10.1016/j.envint.2019.104911] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 06/07/2019] [Accepted: 06/08/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Air emissions from concentrated animal feeding operations (CAFO) have been associated with respiratory and allergic symptoms among farm workers, primarily on swine farms. Despite the increasing prevalence of CAFOs, few studies have assessed respiratory health implications among residents living near CAFOs and few have looked at the health impacts of dairy CAFOs. OBJECTIVES The goal of this study was to examine objective and subjective measures of respiratory and allergic health among rural residents living near dairy CAFOs in a general population living in the Upper Midwest of the United States. METHODS Data were from the 2008-2016 Survey of the Health of Wisconsin (SHOW) cohort (n = 5338), a representative, population based sample of rural adults (age 18+). The association between distance to the nearest CAFO and the prevalence of self-reported physician-diagnosed allergies, asthma, episodes of asthma in the last 12 months, and asthma medication use was examined using logistic regression, adjusting for covariates and sampling design. Similarly, the association between distance to the nearest CAFO and lung function, measured using spirometry, was examined using multivariate linear regression. Restricted cubic splines accounted for nonlinear relationships between distance to the nearest CAFO and the aforementioned outcomes. RESULTS Living 1.5 miles from a CAFO was associated with increased odds of self-reported nasal allergies (OR = 2.08; 95% CI: 1.38, 3.14), lung allergies (OR = 2.72; 95% CI: 1.59, 4.66), asthma (OR = 2.67; 95% CI: 1.39, 5.13), asthma medication (OR = 3.31; 95% CI: 1.65 6.62), and uncontrolled asthma, reported as an asthma episode in last 12 months (OR = 2.34; 95% CI: 1.11, 4.92) when compared to living 5 miles from a CAFO. Predicted FEV1 was 7.72% (95% CI: -14.63, -0.81) lower at a residential distance 1.5 miles from a CAFO when compared with a residence distance of 3 miles from a CAFO. CONCLUSIONS Results suggest CAFOs may be an important source of adverse air quality associated with reduced respiratory and allergic health among rural residents living in close proximity to a CAFO.
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Affiliation(s)
- Amy A Schultz
- Department of Population Health Sciences, University of Wisconsin, Madison, WI, United States of America
| | - Paul Peppard
- Department of Population Health Sciences, University of Wisconsin, Madison, WI, United States of America
| | - Ron E Gangnon
- Department of Population Health Sciences, University of Wisconsin, Madison, WI, United States of America; Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, WI, United States of America
| | - Kristen M C Malecki
- Department of Population Health Sciences, University of Wisconsin, Madison, WI, United States of America.
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20
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Mbareche H, Morawska L, Duchaine C. On the interpretation of bioaerosol exposure measurements and impacts on health. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2019; 69:789-804. [PMID: 30821643 DOI: 10.1080/10962247.2019.1587552] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Bioaerosols are recognized as one of the main transmission routes for infectious diseases and are responsible for other various types of health effects through inhalation and potential ingestion. Associating exposure with bioaerosol and health problems is challenging, and adequate exposure monitoring is a top priority for aerosol scientists. The multiple factors affecting bioaerosol content, the variability in the focus of each bioaerosol exposure study, and the variations in experimental design and the standardization of methods make bioaerosol exposure studies very difficult. Therefore, the health impacts of bioaerosol exposure are still poorly understood. This paper presents a brief description of a state-of-the-art development in bioaerosol exposure studies supported by studies on several related subjects. The main objective of this paper is to propose new considerations for bioaerosol exposure guidelines and the development of tools and study designs to better interpret bioaerosol data. The principal observations and findings are the discrepancy of the applicable methods in bioaerosol studies that makes result comparison impossible. Furthermore, the silo mentality helps in creating a bigger gap in the knowledge accumulated about bioaerosol exposure. Innovative and original ideas are presented for aerosol scientists and health scientists to consider and discuss. Although many examples cited herein are from occupational exposure, the discussion has relevance to any human environment. This work gives concrete suggestions for how to design a full bioaerosol study that includes all of the key elements necessary to help understand the real impacts of bioaerosol exposure in the short term. The creation of the proposed bioaerosol public database could give crucial information to control the public health. Implications: How can we move toward a bioaerosol exposure guidelines? The creation of the bioaerosol public database will help accumulate information for long-term association studies and help determine specific exposure biomarkers to bioaerosols. The implementation of such work will lead to a deeper understanding and more efficient utilization of bioaerosol studies to prevent public health hazards.
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Affiliation(s)
- Hamza Mbareche
- a Centre de recherche de l'institut universitaire de cardiologie et de pneumologie de Québec , Quebec City , Quebec , Canada
- b Département de biochimie, de microbiologie et de bio-informatique , Faculté des sciences et de génie, Université Laval , Quebec City , Quebec , Canada
| | - Lidia Morawska
- c School of Chemistry, Physics, and Mechanical Engineering, Department of Environmental Technologies , Queensland University of Technology , Brisbane , Queensland , Australia
| | - Caroline Duchaine
- a Centre de recherche de l'institut universitaire de cardiologie et de pneumologie de Québec , Quebec City , Quebec , Canada
- b Département de biochimie, de microbiologie et de bio-informatique , Faculté des sciences et de génie, Université Laval , Quebec City , Quebec , Canada
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21
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Lam Y, Fry JP, Nachman KE. Applying an environmental public health lens to the industrialization of food animal production in ten low- and middle-income countries. Global Health 2019; 15:40. [PMID: 31196114 PMCID: PMC6567672 DOI: 10.1186/s12992-019-0479-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/09/2019] [Indexed: 01/22/2023] Open
Abstract
Background Industrial food animal production (IFAP) is characterized by dense animal housing, high throughput, specialization, vertical integration, and corporate consolidation. Research in high-income countries has documented impacts on public health, the environment, and animal welfare. IFAP is proliferating in some low- and middle-income countries (LMICs), where increased consumption of animal-source foods has occurred alongside rising incomes and efforts to address undernutrition. However, in these countries IFAP’s negative externalities could be amplified by inadequate infrastructure and resources to document issues and implement controls. Methods Using UN FAOSTAT data, we selected ten LMICs where food animal production is expanding and assessed patterns of IFAP growth. We conducted a mixed methods review to explore factors affecting growth, evidence of impacts, and information gaps; we searched several databases for sources in English, Spanish, and Portuguese. Data were extracted from 450+ sources, comprising peer-reviewed literature, government documents, NGO reports, and news articles. Results In the selected LMICs, not only has livestock production increased, but the nature of expansion appears to have involved industrialized methods, to varying extents based on species and location. Expansion was promoted in some countries by explicit government policies. Animal densities, corporate structure, and pharmaceutical reliance in some areas mirrored conditions found in high-income countries. There were many reported weaknesses in regulation and capacity for enforcement surrounding production and animal welfare. Global trade increasingly influences movement of and access to inputs such as feed. There was a nascent, compelling body of scientific literature documenting IFAP’s negative environmental and public health externalities in some countries. Conclusions LMICs may be attracted to IFAP for economic development and food security, as well as the potential for increasing access to animal-source foods and the role these foods can play in alleviating undernutrition. IFAP, however, is resource intensive. Industrialized production methods likely result in serious negative public health, environmental, and animal welfare impacts in LMICs. To our knowledge, this is the first systematic effort to assess IFAP trends through an environmental public health lens for a relatively large group of LMICs. It contributes to the literature by outlining urgent research priorities aimed at informing national and international decisions about the future of food animal production and efforts to tackle global undernutrition.
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Affiliation(s)
- Yukyan Lam
- Johns Hopkins Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, 111 Market Place, Suite 840, Baltimore, MD, 21202, USA
| | - Jillian P Fry
- Johns Hopkins Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, 111 Market Place, Suite 840, Baltimore, MD, 21202, USA.,Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA
| | - Keeve E Nachman
- Johns Hopkins Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, 111 Market Place, Suite 840, Baltimore, MD, 21202, USA. .,Department of Environmental Health & Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, 21205, USA. .,Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA. .,Risk Sciences and Public Policy Institute, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., W7007, Baltimore, MD, 21205, USA.
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22
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Baliatsas C, Smit LAM, Dückers MLA, van Dijk CE, Heederik D, Yzermans CJ. Patients with overlapping diagnoses of asthma and COPD: is livestock exposure a risk factor for comorbidity and coexisting symptoms and infections? BMC Pulm Med 2019; 19:105. [PMID: 31182085 PMCID: PMC6558812 DOI: 10.1186/s12890-019-0865-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/21/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Epidemiological research on health effects of livestock exposure in population subgroups with compromised respiratory health is still limited. The present study explored the association between livestock exposure and comorbid/concurrent conditions in patients with overlapping diagnoses of asthma and COPD. METHODS Electronic health record data from 23 general practices in the Netherlands were collected from 425 patients diagnosed with both asthma and COPD, living in rural areas with high livestock density ("study area"). Data of 341 patients with the same overlapping diagnoses, living in rural areas with lower livestock density ("control areas") were obtained from 19 general practices. First, the prevalence of comorbid disorders and symptoms/infections were compared between the study and control area. Second, the examined health outcomes were analyzed in relation to measures of individual livestock exposure. RESULTS Pneumonia was twice as common among patients living in areas with a high livestock density (OR 2.29, 99% CI 0.96-5.47); however, there were generally no statistically significant differences in the investigated outcomes between the study and control area. Significant associations were observed between presence of goats within 1000 m and allergic rhinitis (OR 5.71, 99% CI 1.11-29.3, p < 0.01), number of co-occurring symptoms (IRR 1.69, 99% CI 1.03-2.77, p < 0.01) and anxiety (OR 8.18, 99% 1.5-44.7, p < 0.01). Presence of cattle within 500 m was associated with pneumonia prevalence (OR 2.48, 99% CI 1.05-5.84, p < 0.01). CONCLUSION Livestock exposure is not associated with comorbid chronic conditions but appears to be a risk factor for symptomatic effects in patients with overlapping diagnoses of asthma and COPD.
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Affiliation(s)
- Christos Baliatsas
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Michel L. A. Dückers
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
| | - Christel E. van Dijk
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
| | - Dick Heederik
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - C. Joris Yzermans
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
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23
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Ammonia, ammonium, and the risk of asthma: A register-based case–control study in Danish children. Environ Epidemiol 2018. [DOI: 10.1097/ee9.0000000000000019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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24
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Burkes RM, Gassett AJ, Ceppe AS, Anderson W, O'Neal WK, Woodruff PG, Krishnan JA, Barr RG, Han MK, Martinez FJ, Comellas AP, Lambert AA, Kaufman JD, Dransfield MT, Wells JM, Kanner RE, Paine R, Bleecker ER, Paulin LM, Hansel NN, Drummond MB. Rural Residence and Chronic Obstructive Pulmonary Disease Exacerbations. Analysis of the SPIROMICS Cohort. Ann Am Thorac Soc 2018; 15:808-816. [PMID: 29584453 PMCID: PMC6207115 DOI: 10.1513/annalsats.201710-837oc] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 03/06/2018] [Indexed: 12/13/2022] Open
Abstract
Rationale: Rural residence is associated with poor outcomes in several chronic diseases. The association between rural residence and chronic obstructive pulmonary disease (COPD) exacerbations remains unclear.Objectives: In this work, we sought to determine the independent association between rural residence and COPD-related outcomes, including COPD exacerbations, airflow obstruction, and symptom burden.Methods: A total of 1,684 SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study) participants with forced expiratory volume in 1 second/forced vital capacity < 0.70 had geocoding-defined rural-urban residence status determined (N = 204 rural and N = 1,480 urban). Univariate and multivariate logistic and negative binomial regressions were performed to assess the independent association between rurality and COPD outcomes, including exacerbations, lung function, and symptom burden. The primary exposure of interest was rural residence, determined by geocoding of the home address to the block level at the time of study enrollment. Additional covariates of interest included demographic and clinical characteristics, occupation, and occupational exposures. The primary outcome measures were exacerbations determined over a 1-year course after enrollment by quarterly telephone calls and at an annual research clinic visit. The odds ratio (OR) and incidence rate ratio (IRR) of exacerbations that required treatment with medications, including steroids or antibiotics (total exacerbations), and exacerbations leading to hospitalization (severe exacerbations) were determined after adjusting for relevant covariates.Results: Rural residence was independently associated with a 70% increase in the odds of total exacerbations (OR, 1.70 [95% confidence interval (CI), 1.13-2.56]; P = 0.012) and a 46% higher incidence rate of total exacerbations (IRR 1.46 [95% CI, 1.02-2.10]; P = 0.039). There was no association between rural residence and severe exacerbations. Agricultural occupation was independently associated with increased odds and incidence of total and severe exacerbations. Inclusion of agricultural occupation in the analysis attenuated the association between rural residence and the odds and incidence rate of total exacerbations (OR, 1.52 [95% CI, 1.00-2.32]; P = 0.05 and IRR 1.39 [95% CI, 0.97-1.99]; P = 0.07). There was no difference in symptoms or airflow obstruction between rural and urban participants.Conclusions: Rural residence is independently associated with increased odds and incidence of total, but not severe, COPD exacerbations. These associations are not fully explained by agriculture-related exposures, highlighting the need for future research into potential mechanisms of the increased risk of COPD exacerbations in the rural population.
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Affiliation(s)
| | - Amanda J Gassett
- Department of Environmental and Occupational Health Sciences, School of Public Health, and
| | - Agathe S Ceppe
- Marsico Lung Institute/Cystic Fibrosis Research Center, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Wayne Anderson
- Marsico Lung Institute/Cystic Fibrosis Research Center, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Wanda K O'Neal
- Marsico Lung Institute/Cystic Fibrosis Research Center, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Prescott G Woodruff
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine and Cardiovascular Research Institute, University of California San Francisco, School of Medicine, San Francisco, California
| | - Jerry A Krishnan
- Division of Pulmonary, Critical Care, Sleep, and Allergy, University of Illinois, Chicago, Illinois
| | - R Graham Barr
- Department of Medicine, Columbia University Medical Center, New York, New York
| | - MeiLan K Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, Michigan
| | - Fernando J Martinez
- Department of Medicine, Weill Cornell Medical College, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York
| | | | - Allison A Lambert
- Division of Pulmonary and Critical Care, University of Washington, Seattle, Washington
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, and
| | - Mark T Dransfield
- Division of Pulmonary and Critical Care, University of Alabama at Birmingham, Birmingham, Alabama
| | - J Michael Wells
- Division of Pulmonary and Critical Care, University of Alabama at Birmingham, Birmingham, Alabama
| | - Richard E Kanner
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Robert Paine
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Eugene R Bleecker
- Division of Pulmonary, Critical Care, Allergy and Immunologic Diseases, Wake Forest University, Winston-Salem, North Carolina; and
| | - Laura M Paulin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
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Müller-Rompa SEK, Markevych I, Hose AJ, Loss G, Wouters IM, Genuneit J, Braun-Fahrländer C, Horak E, Boznanski A, Heederik D, von Mutius E, Heinrich J, Ege MJ. An approach to the asthma-protective farm effect by geocoding: Good farms and better farms. Pediatr Allergy Immunol 2018; 29:275-282. [PMID: 29314275 DOI: 10.1111/pai.12861] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND The highly consistent association of growing up on a farm with a reduced asthma risk has so far been attributed to direct farm exposure. In contrast, geographic determinants of the larger environment have never been assessed. In this study, the effects of proximity to farms and environmental variables in relation to the residential address on asthma and atopy were assessed. METHODS Addresses of 2265 children of the Bavarian arm of the GABRIELA study were converted into geocodes. Proximity to the nearest cow farm was calculated, and environmental characteristics were derived from satellite data or terrestrial monitoring. Bacterial diversity in mattress dust samples was assessed in 501 children by sequencing of the 16S rRNA amplicons. Logistic regression models were used to calculate associations between outcomes and exposure variables. RESULTS Asthma and atopy were inversely associated with the presence of a farm within a radius of maximum 100 m. The environmental variables greenness, tree cover, soil sealing, altitude, air pollution differed not only between farm and non-farm children but also between farm children with and without another farm nearby. The latter distinction revealed strong associations with characteristics of traditional farms including a broader diversity of microbial exposure, which mainly contributed to the protective effect on asthma. In non-farm children, the protective effect of a farm nearby was completely explained by consumption of farm milk. CONCLUSIONS Clustering of farms within a neighborhood of 100 m is strongly associated with the protective effect on asthma and may represent a more traditional style of farming with broader microbial exposure.
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Affiliation(s)
| | - I Markevych
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Institute for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - A J Hose
- Dr von Hauner Children's Hospital, LMU Munich, Munich, Germany
| | - G Loss
- Dr von Hauner Children's Hospital, LMU Munich, Munich, Germany.,Departments of Pediatrics and Computer Science & Engineering, University of California at San Diego, San Diego, CA, USA
| | - I M Wouters
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - J Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - C Braun-Fahrländer
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - E Horak
- Innsbruck Medical University, Innsbruck, Austria
| | | | - D Heederik
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - E von Mutius
- Dr von Hauner Children's Hospital, LMU Munich, Munich, Germany.,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany.,Institute for Asthma and Allergy Prevention, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - J Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - M J Ege
- Dr von Hauner Children's Hospital, LMU Munich, Munich, Germany.,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
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Douglas P, Robertson S, Gay R, Hansell AL, Gant TW. A systematic review of the public health risks of bioaerosols from intensive farming. Int J Hyg Environ Health 2018; 221:134-173. [PMID: 29133137 DOI: 10.1016/j.ijheh.2017.10.019] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 10/27/2017] [Accepted: 10/27/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Population growth, increasing food demands, and economic efficiency have been major driving forces behind farming intensification over recent decades. However, biological emissions (bioaerosols) from intensified livestock farming may have the potential to impact human health. Bioaerosols from intensive livestock farming have been reported to cause symptoms and/or illnesses in occupational-settings and there is concern about the potential health effects on people who live near the intensive farms. As well as adverse health effects, some potential beneficial effects have been attributed to farm exposures in early life. The aim of the study was to undertake a systematic review to evaluate potential for adverse health outcomes in populations living near intensive livestock farms. MATERIAL AND METHODS Two electronic databases (PubMed and Scopus) and bibliographies were searched for studies reporting associations between health outcomes and bioaerosol emissions related to intensive farming published between January 1960 and April 2017, including both occupational and community studies. Two authors independently assessed studies for inclusion and extracted data. Risk of bias was assessed using a customized score. RESULTS 38 health studies met the inclusion criteria (21 occupational and 1 community study measured bioaerosol concentrations, 16 community studies using a proxy measure for exposure). The majority of occupational studies found a negative impact on respiratory health outcomes and increases in inflammatory biomarkers among farm workers exposed to bioaerosols. Studies investigating the health of communities living near intensive farms had mixed findings. All four studies of asthma in children found increased reported asthma prevalence among children living or attending schools near an intensive farm. Papers principally investigated respiratory and immune system outcomes. CONCLUSIONS The review indicated a potential impact of intensive farming on childhood respiratory health, based on a small number of studies using self-reported outcomes, but supported by findings from occupational studies. Further research is needed to measure and monitor exposure in community settings and relate this to objectively measured health outcomes.
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Affiliation(s)
- Philippa Douglas
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom.
| | - Sarah Robertson
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Didcot, Oxfordshire, United Kingdom.
| | - Rebecca Gay
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Didcot, Oxfordshire, United Kingdom.
| | - Anna L Hansell
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Imperial College London, London, United Kingdom; Public Health and Primary Care, Imperial College Healthcare NHS Trust, United Kingdom.
| | - Timothy W Gant
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Didcot, Oxfordshire, United Kingdom.
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27
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de Rooij MMT, Heederik DJJ, van Nunen EJHM, van Schothorst IJ, Maassen CBM, Hoek G, Wouters IM. Spatial Variation of Endotoxin Concentrations Measured in Ambient PM 10 in a Livestock-Dense Area: Implementation of a Land-Use Regression Approach. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:017003. [PMID: 29329101 PMCID: PMC6014694 DOI: 10.1289/ehp2252] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 05/04/2023]
Abstract
BACKGROUND Results from studies on residential health effects of livestock farming are inconsistent, potentially due to simple exposure proxies used (e.g., livestock density). Accuracy of these proxies compared with measured exposure concentrations is unknown. OBJECTIVES We aimed to assess spatial variation of endotoxin in PM10 (particulate matter ≤10μm) at residential level in a livestock-dense area, compare simple livestock exposure proxies to measured endotoxin concentrations, and evaluate whether land-use regression (LUR) can be used to explain spatial variation of endotoxin. METHODS The study area (3,000 km2) was located in Netherlands. Ambient PM10 was collected at 61 residential sites representing a variety of surrounding livestock-related characteristics. Three to four 2-wk averaged samples were collected at each site. A local reference site was used for temporal variation adjustment. Samples were analyzed for PM10 mass by weighing and for endotoxin by using the limulus amebocyte lysate assay. Three LUR models were developed, first a model based on general livestock-related GIS predictors only, followed by models that also considered species-specific predictors and farm type-specific predictors. RESULTS Variation in concentrations measured between sites was substantial for endotoxin and more limited for PM10 (coefficient of variation: 43%, 8%, respectively); spatial patterns differed considerably. Simple exposure proxies were associated with endotoxin concentrations although spatial variation explained was modest (R2<26%). LUR models using a combination of animal-specific livestock-related characteristics performed markedly better, with up to 64% explained spatial variation. CONCLUSION The considerable spatial variation of ambient endotoxin concentrations measured in a livestock-dense area can largely be explained by LUR modeling based on livestock-related characteristics. Application of endotoxin LUR models seems promising for residential exposure estimation within health studies. https://doi.org/10.1289/EHP2252.
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Affiliation(s)
- Myrna M T de Rooij
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Dick J J Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Erik J H M van Nunen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Isabella J van Schothorst
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Catharina B M Maassen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Gerard Hoek
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Inge M Wouters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
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28
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Borlée F, Yzermans CJ, Aalders B, Rooijackers J, Krop E, Maassen CBM, Schellevis F, Brunekreef B, Heederik D, Smit LAM. Air Pollution from Livestock Farms Is Associated with Airway Obstruction in Neighboring Residents. Am J Respir Crit Care Med 2017; 196:1152-1161. [DOI: 10.1164/rccm.201701-0021oc] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Floor Borlée
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
- Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - C. Joris Yzermans
- Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Bernadette Aalders
- Netherlands Expertise Centre for Occupational Respiratory Disorders, Utrecht, the Netherlands
| | - Jos Rooijackers
- Netherlands Expertise Centre for Occupational Respiratory Disorders, Utrecht, the Netherlands
| | - Esmeralda Krop
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | - Catharina B. M. Maassen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - François Schellevis
- Netherlands Institute for Health Services Research, Utrecht, the Netherlands
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute, Vrije Universiteit, University Medical Center, Amsterdam, the Netherlands; and
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands
| | - Dick Heederik
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
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Nachman KE, Lam J, Schinasi LH, Smith TC, Feingold BJ, Casey JA. O'Connor et al. systematic review regarding animal feeding operations and public health: critical flaws may compromise conclusions. Syst Rev 2017; 6:179. [PMID: 28859697 PMCID: PMC5580209 DOI: 10.1186/s13643-017-0575-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 08/22/2017] [Indexed: 12/27/2022] Open
Abstract
In this comment, we summarize several scientific concerns with the recently published systematic review from O'Connor and colleagues that examined the relationship between proximity to animal-feeding operations and health of individuals in nearby communities. The authors utilized a bias tool not designed for environmental health research, erroneously excluded important studies, and incorrectly interpreted others. As a result, the conclusions drawn in the review misrepresent the evidence from the published literature, limiting its value to policymakers, researchers, and the public.
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Affiliation(s)
- Keeve E Nachman
- Johns Hopkins Center for a Livable Future, Johns Hopkins University, Baltimore, MD, USA.
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Suite W7010-E, Baltimore, MD, 21205, USA.
- Johns Hopkins Risk Sciences and Public Policy Institute, Baltimore, MD, USA.
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Juleen Lam
- Program on Reproductive Health and the Environment, Department of OB/GYN & RS, University of California, San Francisco, CA, USA
| | - Leah H Schinasi
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Tara C Smith
- Department of Epidemiology, University of Iowa College of Public Health, 145N. Riverside Drive, Iowa City, IA, USA
- Center for Emerging Infectious Diseases, University of Iowa College of Public Health, Coralville, IA, USA
- Department of Biostatistics, Environmental Health Sciences and Epidemiology, College of Public Health, Kent State University, Kent, OH, USA
| | - Beth J Feingold
- Department of Environmental Health Sciences, University at Albany School of Public Health, State University of New York, Rensselaer, NY, USA
| | - Joan A Casey
- School of Public Health, University of California, Berkeley, CA, USA
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Estrada RD, Ownby DR. Rural Asthma: Current Understanding of Prevalence, Patterns, and Interventions for Children and Adolescents. Curr Allergy Asthma Rep 2017; 17:37. [PMID: 28484946 PMCID: PMC6533905 DOI: 10.1007/s11882-017-0704-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE OF REVIEW Asthma is the most common chronic illness of children and adolescents in the USA. While asthma has been understood to disproportionately affect urban dwellers, recent investigations have revealed rural pediatric asthma prevalence to be very similar to urban and to be more closely correlated with socioeconomic and environmental factors than geographic location or population density. RECENT FINDINGS Rural children experience factors unique to location that impact asthma development and outcomes, including housing quality, cigarette smoke exposure, and small/large-scale farming. Additionally, there are challenging barriers to appropriate asthma care that frequently are more severe for those living in rural areas, including insurance status, lack of primary care providers and pulmonary specialists, knowledge deficits (both patient and provider), and a lack of culturally tailored asthma interventions. Interventions designed to address rural pediatric asthma disparities are more likely to be successful when targeted to specific challenges, such as the use of school-based services or telemedicine to mitigate asthma care access issues. Continued research on understanding the complex interaction of specific rural environmental factors with host factors can inform future interventions designed to mitigate asthma disparities.
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Affiliation(s)
| | - Dennis R Ownby
- Allergy & Immunology, Augusta University, Augusta, GA, USA
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Lothrop N, Hussaini K, Billheimer D, Beamer P. Community-level characteristics and environmental factors of child respiratory illnesses in Southern Arizona. BMC Public Health 2017; 17:516. [PMID: 28545417 PMCID: PMC5445507 DOI: 10.1186/s12889-017-4424-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 05/15/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Lower respiratory illnesses (LRIs) and asthma are common diseases in children <5 years of age. Few studies have investigated the relationships between multiple, home-based social and environmental risk factors and asthma and LRIs in children. Of those that have, none have focused exclusively on children <5 years of age, who are more physiologically vulnerable and spend more time at home compared to older children. Further, no studies have done so at the community level. METHODS We modeled relationships between emergency department visits and hospitalization rates for asthma and LRIs for children <5 years and geographic risk factors, including socio-economic and housing characteristics, ambient air pollution levels, and population density in Maricopa and Pima Counties, Arizona, from 2005 to 2009. We used a generalized linear model with a negative binomial observation distribution and an offset for the population of very young children in each tract. To reduce multicollinearity among predictors, socio-economic characteristics, and ambient air pollutant levels were combined into unit-less indices using the principal components analysis (PCA). Housing characteristics variables did not exhibit moderate-to-high correlations and thus were not included in PCA. Spatial autocorrelation among regression model residuals was assessed with the Global Moran's I test. RESULTS Following the regression analyses, almost all predictors were significantly related to at least one disease outcome. Lower socio-economic status (SES) and reduced population density were associated with asthma hospitalization rates and both LRI outcomes (p values <0.001). After adjusting for differences between counties, Pima County residence was associated with lower asthma and LRI hospitalization rates. No spatial autocorrelation was found among multiple regression model residuals (p values >0.05). CONCLUSIONS Our study revealed complex, multi-factorial associations between predictors and outcomes. Findings indicate that many rural areas with lower SES have distinct factors for childhood respiratory diseases that require further investigation. County-wide differences in maternal characteristics or agricultural land uses (not tested here) may also play a role in Pima County residence protecting against hospitalizations, when compared to Maricopa County. By better understanding this and other relationships, more focused public health interventions at the community level could be developed to reduce and better control these diseases in children <5 years, who are more physiologically vulnerable.
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Affiliation(s)
- Nathan Lothrop
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., PO 245210, Tucson, AZ 85724 USA
| | - Khaleel Hussaini
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., PO 245210, Tucson, AZ 85724 USA
- Biomedical Informatics, College of Medicine, University of Arizona, Tucson, AZ 85724 USA
| | - Dean Billheimer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., PO 245210, Tucson, AZ 85724 USA
- BIO5 Institute, University of Arizona, Tucson, AZ 85724 USA
| | - Paloma Beamer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., PO 245210, Tucson, AZ 85724 USA
- BIO5 Institute, University of Arizona, Tucson, AZ 85724 USA
- Arizona Respiratory Center, University of Arizona, Tucson, AZ 85724 USA
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Rasmussen SG, Casey JA, Bandeen-Roche K, Schwartz BS. Proximity to Industrial Food Animal Production and Asthma Exacerbations in Pennsylvania, 2005-2012. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E362. [PMID: 28362334 PMCID: PMC5409563 DOI: 10.3390/ijerph14040362] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 03/28/2017] [Accepted: 03/30/2017] [Indexed: 11/28/2022]
Abstract
The research on industrial food animal production (IFAP) and asthma exacerbations in the United States has relied on small sample sizes and/or self-reported outcomes. We assessed associations of proximity to large-scale and densely stocked swine and dairy/veal IFAP with three types of asthma exacerbations: hospitalizations, emergency encounters, and oral corticosteroid (OCS) medication orders from Geisinger Clinic in Pennsylvania. We used a diagnosis code (International Classification of Diseases, 9th Revision, Clinical Modification code 493.x) and medication orders from electronic health records to identify these exacerbations among asthma patients (n = 35,269) from 2005-2012. We compared residential proximity to swine or dairy/veal IFAP (dichotomized as <3 miles (4.8 km) or ≥3 miles) among asthma patients with and without exacerbations and estimated odds ratios using multilevel logistic regression. In adjusted models, proximity to IFAP was associated (odds ratio (95% confidence interval)) with OCS orders (1.11 (1.04-1.19)) and hospitalizations (1.29 (1.15-1.46)), but not emergency encounters (1.12 (0.91-1.37)). This study contributes to growing evidence that IFAP may impact health, in this case clinically-documented asthma exacerbations. No prior study has evaluated the association of IFAP and clinically-documented asthma exacerbations in the United States.
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Affiliation(s)
- Sara G Rasmussen
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Joan A Casey
- Department of Environmental Science, Policy & Management, University of California, Berkeley, Berkeley, CA 94720, USA.
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Brian S Schwartz
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
- Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, PA 17822, USA.
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
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van Dijk CE, Zock JP, Baliatsas C, Smit LAM, Borlée F, Spreeuwenberg P, Heederik D, Yzermans CJ. Health conditions in rural areas with high livestock density: Analysis of seven consecutive years. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 222:374-382. [PMID: 28043740 DOI: 10.1016/j.envpol.2016.12.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/07/2016] [Accepted: 12/11/2016] [Indexed: 05/16/2023]
Abstract
Previous studies investigating health conditions of individuals living near livestock farms generally assessed short time windows. We aimed to take time-specific differences into account and to compare the prevalence of various health conditions over seven consecutive years. The sample consisted of 156,690 individuals registered in 33 general practices in a (rural) area with a high livestock density and 101,015 patients from 23 practices in other (control) areas in the Netherlands. Prevalence of health conditions were assessed using 2007-2013 electronic health record (EHR) data. Two methods were employed to assess exposure: 1) Comparisons between the study and control areas in relation to health problems, 2) Use of individual estimates of livestock exposure (in the study area) based on Geographic Information System (GIS) data. A higher prevalence of chronic bronchitis/bronchiectasis, lower respiratory tract infections and vertiginous syndrome and lower prevalence of respiratory symptoms and emphysema/COPD was found in the study area compared with the control area. A shorter distance to the nearest farm was associated with a lower prevalence of upper respiratory tract infections, respiratory symptoms, asthma, COPD/emphysema, allergic rhinitis, depression, eczema, vertiginous syndrome, dizziness and gastrointestinal infections. Especially exposure to cattle was associated with less health conditions. Living within 500m of mink farms was associated with increased chronic enteritis/ulcerative colitis. Livestock-related exposures did not seem to be an environmental risk factor for the occurrence of health conditions. Nevertheless, lower respiratory tract infections, chronic bronchitis and vertiginous syndrome were more common in the area with a high livestock density. The association between exposure to minks and chronic enteritis/ulcerative colitis remains to be elucidated.
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Affiliation(s)
- Christel E van Dijk
- NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
| | - Jan-Paul Zock
- NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513 CR Utrecht, The Netherlands; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Dr. Aiguader 88, E-08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta, 0 28029 Madrid, Spain
| | - Christos Baliatsas
- NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
| | - Lidwien A M Smit
- Utrecht University, Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Yalelaan 2, 2584 CM Utrecht, The Netherlands
| | - Floor Borlée
- NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513 CR Utrecht, The Netherlands; Utrecht University, Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Yalelaan 2, 2584 CM Utrecht, The Netherlands
| | - Peter Spreeuwenberg
- NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
| | - Dick Heederik
- Utrecht University, Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Yalelaan 2, 2584 CM Utrecht, The Netherlands
| | - C Joris Yzermans
- NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513 CR Utrecht, The Netherlands.
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Guidry VT, Kinlaw AC, Johnston J, Hall D, Wing S. Hydrogen sulfide concentrations at three middle schools near industrial livestock facilities. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2017; 27:167-174. [PMID: 27094997 DOI: 10.1038/jes.2016.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 11/13/2015] [Accepted: 11/17/2015] [Indexed: 06/05/2023]
Abstract
Safe school environments are essential for healthy development, yet some schools are near large-scale livestock facilities that emit air pollution. Hydrogen sulfide (H2S) from decomposing manure is an indicator of livestock-related air pollution. We measured outdoor concentrations of H2S at three public middle schools near livestock facilities in North Carolina. We used circular graphs to relate H2S detection and wind direction to geospatial distributions of nearby livestock barns. We also used logistic and linear regression to model H2S in relation to upwind, distance-weighted livestock barn area. Circular graphs suggested an association between upwind livestock barns and H2S detection. The log-odds of H2S detection per 1000 m2 increased with upwind weighted swine barn area (School A: β-coefficient (β)=0.43, SE=0.06; School B: β=0.64, SE=0.24) and upwind weighted poultry barn area (School A: β=0.05, SE=0.01), with stronger associations during periods of atmospheric stability than atmospheric instability (School A stable: β=0.69, SE=0.11; School A unstable: β=0.32, SE=0.09). H2S concentration also increased linearly with upwind swine barn area, with greater increases during stable atmospheric conditions (stable: β=0.16 parts per billion (p.p.b.), SE=0.01; unstable: β=0.05 p.p.b., SE=0.01). Off-site migration of pollutants from industrial livestock operations can decrease air quality at nearby schools.
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Affiliation(s)
- Virginia T Guidry
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Alan C Kinlaw
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jill Johnston
- Division of Environmental Health, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Devon Hall
- Rural Empowerment Association for Community Help, Warsaw, North Carolina, USA
| | - Steve Wing
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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de Rooij MMT, Heederik DJJ, Borlée F, Hoek G, Wouters IM. Spatial and temporal variation in endotoxin and PM10 concentrations in ambient air in a livestock dense area. ENVIRONMENTAL RESEARCH 2017; 153:161-170. [PMID: 27984760 DOI: 10.1016/j.envres.2016.12.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/02/2016] [Accepted: 12/03/2016] [Indexed: 05/19/2023]
Abstract
Several studies have reported associations between farming and respiratory health in neighboring residents. Health effects are possibly linked to fine dust and endotoxin emissions from livestock farms. Little is known about levels of these air pollutants in ambient air in livestock dense areas. We aimed to explore temporal and spatial variation of PM10 and endotoxin concentrations, and the association with livestock-related spatial and meteorological temporal determinants. From March till September 2011, one week average PM10 samples were collected using Harvard Impactors at eight sites (residential gardens) representing a variety of nearby livestock-related characteristics. A background site was included in the study area, situated at least 500m away from the nearest farm. PM10 mass was determined by gravimetric analysis and endotoxin level by means of Limulus-Amebocyte-Lysate assay. Data were analyzed using mixed models. The range between sites of geometric mean concentrations was for PM10 19.8-22.3µg/m3 and for endotoxin 0.46-0.66EU/m3. PM10 concentrations and spatial variation were very similar for all sites, while endotoxin concentrations displayed a more variable pattern over time with larger differences between sites. Nonetheless, the temporal pattern at the background location was highly comparable to the sites mean temporal pattern both for PM10 and endotoxin (Pearson correlation: 0.92, 0.62). Spatial variation was larger for endotoxin than for PM10 (within/between site variance ratio: 0.63, 2.03). Spatial livestock-related characteristics of the surroundings were more strongly related to endotoxin concentrations, while temporal determinants were more strongly related to PM10 concentrations. The effect of local livestock-related sources on PM10 concentration was limited in this study carried out in a livestock dense area. The effect on endotoxin concentrations was more profound. To gain more insight in the effect of livestock-related sources on ambient levels of PM10 and endotoxin, measurements should be based on a broader set of locations.
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Affiliation(s)
- Myrna M T de Rooij
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, The Netherlands.
| | - Dick J J Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, The Netherlands
| | - Floor Borlée
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, The Netherlands
| | - Gerard Hoek
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, The Netherlands
| | - Inge M Wouters
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, The Netherlands
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Lawson JA, Chu LM, Rennie DC, Hagel L, Karunanayake CP, Pahwa P, Dosman JA. Prevalence, risk factors, and clinical outcomes of atopic and nonatopic asthma among rural children. Ann Allergy Asthma Immunol 2017; 118:304-310. [PMID: 28087381 DOI: 10.1016/j.anai.2016.11.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 11/19/2016] [Accepted: 11/29/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Because of time and cost constraints, objective classification of atopic and nonatopic asthma has been limited in large epidemiologic studies. However, as we try to better understand exposure-outcome associations and ensure appropriate treatment of asthma, it is important to focus on phenotype-defined asthma classification. OBJECTIVE To compare atopic and nonatopic asthma in rural children with regard to risk factors and clinical outcomes. METHODS We conducted a cross-sectional study in rural Saskatchewan, Canada, in 2011. Parents of 6- to 14-year-old children completed a health and exposure survey. Skin prick tests were completed in a subsample of 529 children. Asthma was based physician diagnosis. Asthma status was defined as no asthma, nonatopic asthma, and atopic asthma. RESULTS Asthma prevalence was 14.7% of which 32.1% of cases were atopic. After adjustment, early respiratory illness and a family history of asthma were predictors of childhood asthma, regardless of atopic status (P < .05). Being overweight and having a dog in the home were associated with an increased risk of nonatopic asthma (P < .05). A mother with a history of smoking increased the risk of atopic asthma (P = .01). Compared with those with nonatopic asthma, in the past 12 months, children with atopic asthma were more likely to report a sneezy, runny, or blocked nose or have shortness of breath (odds ratio >2), whereas those with nonatopic asthma were more likely to have parents who missed work (odd ratio >3). Those with nonatopic asthma had significantly lower forced expiratory volume in 1 second compared w2ith those with atopic asthma. CONCLUSION Exposures may contribute differentially to atopic and nonatopic asthma and result in differential clinical presentation or burden. The study of these characteristics is important for etiologic understanding and management decisions.
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Affiliation(s)
- Joshua A Lawson
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| | - Luan M Chu
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Health Sciences Program, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Donna C Rennie
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Louise Hagel
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Chandima P Karunanayake
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Punam Pahwa
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - James A Dosman
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Loftus C, Yost M, Sampson P, Torres E, Arias G, Breckwich Vasquez V, Hartin K, Armstrong J, Tchong-French M, Vedal S, Bhatti P, Karr C. Ambient Ammonia Exposures in an Agricultural Community and Pediatric Asthma Morbidity. Epidemiology 2016; 26:794-801. [PMID: 26352250 DOI: 10.1097/ede.0000000000000368] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Large-scale animal feeding operations compromise regional air quality in the rural US through emission of pollutants, such as ammonia gas. Exposure to airborne pollution from animal feeding operations may cause pediatric asthma exacerbations in surrounding communities. OBJECTIVES To describe spatial and temporal patterns in ambient ammonia concentrations in an agricultural region, and to investigate associations between short-term fluctuations in ammonia and subsequent changes in respiratory health in children with asthma. METHODS For 13 months in the Yakima Valley of Washington State, 14 monitors sampled ammonia in outdoor air for 24-hour periods every 6 days. School-age children with asthma (n = 51) were followed for two health outcomes: biweekly reports of asthma symptoms and quick relief medication usage, and daily measurements of forced expiratory volume in 1 second. We assessed associations between each outcome and ammonia using generalized estimating equations. RESULTS Twenty-four-hour ammonia concentrations varied from 0.2 to 238.1 μg/m during the study period and displayed a strong correlation with proximity to animal feeding operations. The percentage of forced expiratory volume in 1 second was 3.8% lower (95% confidence interval = 0.2, 7.3) per interquartile increase in 1-day lagged ammonia concentration and 3.0% lower (95% confidence interval = 0.5, 5.8) for 2-day lagged concentration. We observed no associations between self-reported asthma symptoms or medication usage and estimated ammonia exposure. CONCLUSIONS Ammonia concentrations were elevated in this community and strongly predicted by proximity to animal feeding operations. Ammonia's association with acute lung function decrements in children with asthma in the surrounding community may be causal or, alternatively, ammonia may be a marker for other pollutants from animal feeding operations associated with respiratory effects.
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Affiliation(s)
- Christine Loftus
- From the aDepartment of Epidemiology, University of Washington, Seattle, WA; bDepartment of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA; cDepartment of Statistics, College of Arts and Sciences, University of Washington, Seattle, WA; dNorthwest Communities Education Center, Radio KDNA, Granger, WA; eYakima Valley Farm Workers Clinic, Yakima, WA; fPacific Northwest Agricultural Safety and Health Center, School of Public Health, University of Washington, Seattle, WA; and gDepartment of Pediatrics, School of Medicine, University of Washington, Seattle, WA
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Abstract
PURPOSE OF REVIEW Occupational exposures in the agricultural industry are associated with numerous lung diseases, including chronic obstructive pulmonary disease, asthma, hypersensitivity pneumonitis, lung cancer, and interstitial lung diseases. Efforts are ongoing to ascertain contributing factors to these negative respiratory outcomes and improve monitoring of environmental factors leading to disease. In this review, recently published studies investigating the deleterious effects of occupational exposures in the agricultural industry are discussed. RECENT FINDINGS Occupational exposures to numerous agricultural environment aerosols, including pesticides, fungi, and bacteria are associated with impaired respiratory function and disease. Increases in certain farming practices, including mushroom and greenhouse farming, present new occupational exposure concerns. Improved detection methods may provide opportunities to better monitor safe exposure levels to known lung irritants. SUMMARY In the agricultural industry, occupational exposures to organic and inorganic aerosols lead to increased risk for lung disease among workers. Increased awareness of respiratory risks and improved monitoring of agricultural environments are necessary to limit pulmonary health risks to exposed populations.
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Affiliation(s)
| | - Kristina L. Bailey
- VA Nebraska Western Iowa Health Care System, Omaha, NE
- University of Nebraska Medical Center, Pulmonary, Critical Care, Sleep & Allergy Division, Omaha, NE
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39
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Associations between proximity to livestock farms, primary health care visits and self-reported symptoms. BMC FAMILY PRACTICE 2016; 17:22. [PMID: 26895761 PMCID: PMC4759919 DOI: 10.1186/s12875-016-0421-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 02/14/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Living in a neighbourhood with a high density of livestock farms has been associated with adverse respiratory health effects, but less is known about healthcare utilisation. This study aimed at investigating the associations between livestock exposure and primary health care visits and self-reported symptoms. In addition, we examined the potentially confounding effect of distance from home to general practice. METHODS Contact data between 2006 and 2009 were obtained from electronic medical records of 54,777 persons registered within 16 general practices in an area with a high density of livestock farms in the Netherlands. Data on self-reported symptoms were used from a cross-sectional sample of 531 patients in 2010. Livestock presence in a 500 m radius from home was computed using Geographic Information System data. RESULTS In general, livestock exposure was associated with fewer contacts and self-reported symptoms for respiratory and other conditions. The number of poultry within 500 m was positively associated with the number of contacts. A longer distance to general practice was associated with fewer contacts, but did not confound associations. CONCLUSIONS People living close to livestock farms less often see their general practitioner and report symptoms.
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Hooiveld M, Smit LAM, van der Sman-de Beer F, Wouters IM, van Dijk CE, Spreeuwenberg P, Heederik DJJ, Yzermans CJ. Doctor-diagnosed health problems in a region with a high density of concentrated animal feeding operations: a cross-sectional study. Environ Health 2016; 15:24. [PMID: 26888643 PMCID: PMC4758110 DOI: 10.1186/s12940-016-0123-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 02/15/2016] [Indexed: 05/28/2023]
Abstract
BACKGROUND There is growing interest in health risks of residents living near concentrated animal feeding operations (CAFOs). Previous research mostly focused on swine CAFOs and self-reported respiratory conditions. The aim was to study the association between the presence of swine, poultry, cattle and goat CAFOs and health of Dutch neighbouring residents using electronic medical records from general practitioners (GPs). METHODS Data for the year 2009 were collected of 119,036 inhabitants of a rural region with a high density of CAFOs using information from GIAB (high exposed population). A comparison was made with GP data from 78,060 inhabitants of rural areas with low densities of CAFOs (low exposed population). Associations between the number of CAFOs near residents' homes and morbidity were determined by multilevel (cross-classified) logistic regression. RESULTS In 2009, the prevalence of most respiratory and gastrointestinal conditions was similar in the high and low exposed population. Exceptions were pneumonia, atopic eczema and unspecified infectious diseases with an increased prevalence, and sinusitis with a decreased prevalence in the high exposed population. Within the high CAFO density region, the number of poultry, cattle and swine CAFOs near residents' homes was not associated with allergic, respiratory or gastrointestinal conditions. Conversely, each additional goat CAFO within the postal code area of residents' homes significantly increased the odds of unspecified infectious disease and pneumonia by 87 and 41 percent, respectively. CONCLUSIONS Using GP records, pneumonia and unspecified infectious diseases were positively associated with the number of goat CAFOs near residents' homes, but no association was found between swine, cattle, and poultry CAFOs and respiratory, allergic or gastrointestinal conditions.
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Affiliation(s)
- Mariëtte Hooiveld
- />NIVEL, Netherlands institute for health services research, P.O. Box 1568, 3500BN Utrecht, The Netherlands
| | - Lidwien A. M. Smit
- />Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands
| | - Femke van der Sman-de Beer
- />NIVEL, Netherlands institute for health services research, P.O. Box 1568, 3500BN Utrecht, The Netherlands
| | - Inge M. Wouters
- />Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands
| | - Christel E. van Dijk
- />NIVEL, Netherlands institute for health services research, P.O. Box 1568, 3500BN Utrecht, The Netherlands
| | - Peter Spreeuwenberg
- />NIVEL, Netherlands institute for health services research, P.O. Box 1568, 3500BN Utrecht, The Netherlands
| | - Dick J. J. Heederik
- />Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands
| | - C. Joris Yzermans
- />NIVEL, Netherlands institute for health services research, P.O. Box 1568, 3500BN Utrecht, The Netherlands
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41
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Casey JA, Kim BF, Larsen J, Price LB, Nachman KE. Industrial Food Animal Production and Community Health. Curr Environ Health Rep 2016; 2:259-71. [PMID: 26231503 DOI: 10.1007/s40572-015-0061-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Industrial food animal production (IFAP) is a source of environmental microbial and chemical hazards. A growing body of literature suggests that populations living near these operations and manure-applied crop fields are at elevated risk for several health outcomes. We reviewed the literature published since 2000 and identified four health outcomes consistently and positively associated with living near IFAP: respiratory outcomes, methicillin-resistant Staphylococcus aureus (MRSA), Q fever, and stress/mood. We found moderate evidence of an association of IFAP with quality of life and limited evidence of an association with cognitive impairment, Clostridium difficile, Enterococcus, birth outcomes, and hypertension. Distance-based exposure metrics were used by 17/33 studies reviewed. Future work should investigate exposure through drinking water and must improve exposure assessment with direct environmental sampling, modeling, and high-resolution DNA typing methods. Investigators should not limit study to high-profile pathogens like MRSA but include a broader range of pathogens, as well as other disease outcomes.
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Affiliation(s)
- Joan A Casey
- Robert Wood Johnson Foundation Health and Society Scholars Program, UC San Francisco and UC Berkeley, 50 University Hall, Room 583, Berkeley, CA, 94720-7360, USA,
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42
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van Dijk CE, Garcia-Aymerich J, Carsin AE, Smit LAM, Borlée F, Heederik DJ, Donker GA, Yzermans CJ, Zock JP. Risk of exacerbations in COPD and asthma patients living in the neighbourhood of livestock farms: Observational study using longitudinal data. Int J Hyg Environ Health 2016; 219:278-87. [PMID: 26831047 DOI: 10.1016/j.ijheh.2016.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 12/23/2015] [Accepted: 01/19/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Living in an area with a high density of livestock farms has been associated with adverse respiratory health effects in some studies. As patients with COPD and asthma already have a compromised respiratory function and chronic airway inflammation, they are expected to be at increased risk for adverse respiratory health effects. The objective of this study was to assess the association between livestock exposure and exacerbations in COPD and asthma. METHODS 899 COPD and 2546 asthma patients from 15 general practices in a rural area with a high livestock density and 933 COPD and 2310 asthma patients from 15 practices in a control area in the Netherlands were included. Occurrence of exacerbations was based on the pharmaceutical treatment of exacerbations in COPD and asthma patients using 2006-2012 prescription data of electronic medical records. Farm exposure was assessed by comparing the study area with the control area, and with individual exposure estimates in the study area using Geographic Information System data. RESULTS The exacerbation rate was higher in the study area compared with the control area in COPD (IRR: 1.28; 95%CI: 1.06-1.55), but not in asthma patients (IRR: 0.87; 95%CI: 0.72-1.05). In general, individual exposure estimates in the study area were not associated with exacerbations. COPD patients living within a 500m radius of up to12,499 chickens had a 36% higher exacerbation rate (IRR: 1.36; 95%CI: 1.03-1.79). CONCLUSIONS Living in an area with a high livestock density is a risk factor for exacerbations in COPD patients. The environmental exposure responsible for this increased risk remains to be elucidated.
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Affiliation(s)
- Christel E van Dijk
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
| | - Judith Garcia-Aymerich
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Anne-Elie Carsin
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Lidwien A M Smit
- Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, The Netherlands
| | - Floor Borlée
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, The Netherlands
| | - Dick J Heederik
- Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, The Netherlands
| | - Gé A Donker
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - C Joris Yzermans
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Jan-Paul Zock
- NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Borlée F, Yzermans CJ, van Dijk CE, Heederik D, Smit LAM. Increased respiratory symptoms in COPD patients living in the vicinity of livestock farms. Eur Respir J 2015; 46:1605-14. [PMID: 26250492 DOI: 10.1183/13993003.00265-2015] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 06/22/2015] [Indexed: 01/13/2023]
Abstract
Several studies have investigated the effect of livestock farm emissions on the respiratory health of local residents, but results are inconsistent. This study aims to explore associations between the presence of livestock farms and respiratory health in an area of high-density livestock farming in the Netherlands. We focused especially on associations between farm exposures and respiratory symptoms within subgroups of potentially susceptible patients with a pre-existing lung disease.In total, 14 875 adults (response rate 53.4%) completed a questionnaire concerning respiratory health, smoking habits and personal characteristics. Different indicators of livestock farm exposures relative to the home address were computed using a geographic information system.Prevalence of chronic obstructive pulmonary disease (COPD) and asthma was lower among residents living within 100 m of a farm (OR 0.47, 95% CI 0.24-0.91 and OR 0.65, 95% CI 0.45-0.93, respectively). However, >11 farms in 1000 m compared to fewer than four farms in 1000 m (fourth quartile versus first quartile) was associated with wheezing among COPD patients (OR 1.71, 95% CI 1.01-2.89). Using general practitioners' electronic medical records, we demonstrated that selection bias did not affect the observed associations.Our data suggest a protective effect of livestock farm emissions on the respiratory health of residents. Nonetheless, COPD patients living near livestock farms reported more respiratory symptoms, suggesting an increased risk of exacerbations.
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Affiliation(s)
- Floor Borlée
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - C Joris Yzermans
- Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | | | - Dick Heederik
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Lidwien A M Smit
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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Guidry VT, Lowman A, Hall D, Baron D, Wing S. Challenges and benefits of conducting environmental justice research in a school setting. New Solut 2015; 24:153-70. [PMID: 25085828 DOI: 10.2190/ns.24.2.c] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Environmental justice (EJ) research requires attention to consequences for research participants beyond those typically considered by institutional review boards. The imbalance of power between impacted communities and those who create and regulate pollution creates challenges for participation, yet research can also benefit those involved. Our community-academic partnership designed the Rural Air Pollutants and Children's Health (RAPCH) study to provide positive impacts while measuring health effects at three low-resource public middle schools near concentrated animal feeding operations (CAFOs) in North Carolina. We evaluated perceived benefits and challenges of study involvement by interviewing school staff and community liaisons who facilitated data collection. Reported benefits included enhancement of students' academic environment and increased community environmental awareness; challenges were associated mainly with some participants' immaturity. Leadership from a strong community-based organization was crucial to recruitment, yet our approach entailed minimal focus on EJ, which may have limited opportunities for community education or organizing for environmental health.
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Affiliation(s)
- Virginia T Guidry
- Department of Epidemiology, University of North Carolina at Chapel Hill
| | - Amy Lowman
- Department of Epidemiology, University of North Carolina at Chapel Hill
| | - Devon Hall
- Rural Empowerment Association for Community Help (REACH), Warsaw, NC
| | - Dothula Baron
- Epidemiology Department at UNC-Chapel Hill, Rural Empowerment Association for Community Help (REACH)
| | - Steve Wing
- University of North Carolina at Chapel Hill
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45
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Data quality from a longitudinal study of adolescent health at schools near industrial livestock facilities. Ann Epidemiol 2015; 25:532-8.e1. [PMID: 25935712 DOI: 10.1016/j.annepidem.2015.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 02/03/2015] [Accepted: 03/04/2015] [Indexed: 11/22/2022]
Abstract
PURPOSE Longitudinal designs enable examination of temporal relationships between exposures and health outcomes, but extended participation can cause study fatigue. We present an approach for analyzing data quality and study fatigue in a participatory, longitudinal study of adolescents. METHODS Participants (n = 340) in the Rural Air Pollutants and Children's Health study completed daily diaries for 3 to 5 weeks in 2009 while we monitored outdoor pollutant concentrations. We used regression models to examine established associations between disease, symptoms, anthropometrics, and lung function as indicators of internal consistency and external validity. We modeled temporal trends in data completeness, lung function, environmental odors, and symptoms to assess study fatigue. RESULTS Of 5728 records, 94.2% were complete. Asthma and allergy status were associated with asthma-related symptoms at baseline and during follow-up, for example, prevalence ratio = 8.77 (95% confidence interval: 4.33-17.80) for awakening with wheeze among diagnosed asthmatics versus nonasthmatics. Sex, height, and age predicted mean lung function. Plots depicting outcome reporting over time and associated linear trends showed time-dependent declines for most outcomes. CONCLUSIONS We achieved data completeness, internal consistency, and external validity, yet still observed study fatigue, despite efforts to maintain participant engagement. Future investigators should model time trends in reporting to monitor longitudinal data quality.
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46
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Wing S, Lowman A, Keil A, Marshall SW. Odors from sewage sludge and livestock: associations with self-reported health. Public Health Rep 2015; 129:505-15. [PMID: 25364052 DOI: 10.1177/003335491412900609] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Class B treated sewage sludge (TSS) contains microbes and toxicants and is applied to land in areas where livestock wastes may be present. We evaluated relationships of reports of TSS and livestock odors with acute symptoms and excessive flies. METHODS A total of 158 adults living near liquid TSS application sites, 85 living near cake TSS application sites, and 188 living in comparison areas responded to a household survey regarding odors, health, and demographics. We identified symptom groups using factor analysis. We used generalized estimating equations to fit linear models for associations between factor scores and odors, and Poisson models for associations with specific symptoms. RESULTS Most factor scores were similar between exposure groups. Covariate-adjusted z-scores for lower respiratory symptoms were 0.28 (95% confidence interval [CI] -0.10, 0.65) higher among residents who reported moderate to very strong liquid TSS odor than among residents in comparison areas, and 0.28 (95% CI 0.05, 0.50) higher among residents who reported moderate to very strong livestock odor compared with residents reporting no or faint livestock odor. The factor score for dermatologic conditions was higher among residents who reported higher liquid sludge odor (0.27, 95% CI -0.13, 0.68), primarily due to skin rash (prevalence ratio = 2.21, 95% CI 1.13, 4.32). Excessive flies were reported twice as commonly among respondents who reported moderate to very strong TSS odor than among other residents. CONCLUSIONS Reported odors from TSS and livestock were associated with some acute symptoms. Health departments should monitor land applications of human and animal wastes and conduct surveillance of health problems reported by neighbors.
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Affiliation(s)
- Steve Wing
- University of North Carolina, Department of Epidemiology, Chapel Hill, NC
| | - Amy Lowman
- University of North Carolina, Department of Epidemiology, Chapel Hill, NC
| | - Alex Keil
- University of North Carolina, Department of Epidemiology, Chapel Hill, NC
| | - Stephen W Marshall
- University of North Carolina, Department of Epidemiology, Chapel Hill, NC
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Kumari P, Choi HL. Seasonal variability in airborne biotic contaminants in swine confinement buildings. PLoS One 2014; 9:e112897. [PMID: 25393011 PMCID: PMC4231085 DOI: 10.1371/journal.pone.0112897] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 10/16/2014] [Indexed: 12/17/2022] Open
Abstract
Little is known about the seasonal dynamics of biotic contaminants in swine confinement buildings (SCBs). The biotic contaminants of seven SCBs were monitored during one visit in the winter and one during the summer. Paired-end Illumina sequencing of the 16S rRNA gene, V3 region, was used to examine seasonal shifts in bacterial community composition and diversity. The abundances of 16S rRNA genes and six tetracycline resistance genes (tetB, tetH, tetZ, tetO, tetQ, and tetW) were also quantified using real-time PCR. Bacterial abundances, community composition and diversity all showed strong seasonal patterns defined by winter peaks in abundance and diversity. Microclimatic variables of SCBs, particularly air speed, PM2.5 and total suspended particles (TSP) were found significantly correlated to abundances, community composition, and diversity of bacterial bioaerosols. Seasonal fluctuations were also observed for four tetracycline resistance genes, tetH, tetO, tetQ, and tetW. The frequency of occurrences of these resistance genes were significantly higher in samples collected during winter and was also significantly correlated with air speed, PM2.5 and TSP. Overall, our results indicate that biotic contaminants in SCBs exhibit seasonal trends, and these could be associated with the microclimatic variables of SCBs. The correlations established in the current study could be helpful in establishing better management strategies to minimize the potential health impacts on both livestock and humans working in this environment.
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Affiliation(s)
- Priyanka Kumari
- Department of Agricultural Biotechnology, Research Institute for Agriculture and Life Science, Seoul National University, Gwanak, Seoul, Republic of Korea
| | - Hong L. Choi
- Department of Agricultural Biotechnology, Research Institute for Agriculture and Life Science, Seoul National University, Gwanak, Seoul, Republic of Korea
- * E-mail:
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Wells AD, Poole JA, Romberger DJ. Influence of farming exposure on the development of asthma and asthma-like symptoms. Int Immunopharmacol 2014; 23:356-63. [PMID: 25086344 DOI: 10.1016/j.intimp.2014.07.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 07/09/2014] [Accepted: 07/11/2014] [Indexed: 12/24/2022]
Abstract
Based upon age and type of farming exposures, a wide range of studies demonstrate either protective or deleterious effects of the farming environment on asthma. In this review, we highlight key studies supporting the concept that farming exposure protects children from asthma and atopy based on studies performed largely in European pediatric cohorts. Various types of farming in certain regions appear to have a greater effect on asthma protection, as does the consumption of unpasteurized milk. In the United State, where concentrated animal feeding operations (CAFOs) are more common, asthma is increased in children exposed especially to swine CAFOs; whereas, rates of atopy and allergy are lower in these children. We also review studies evaluating the role of farming exposures both as a child and/or as an adult on asthma seen in adults. The importance of microbes in farming environments and the contribution of various components of the innate immune system including toll-like receptors to the underlying mechanisms of asthma related to farming exposures are also reviewed.
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Affiliation(s)
- Adam D Wells
- Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198-5990, USA
| | - Jill A Poole
- Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198-5990, USA
| | - Debra J Romberger
- VA Nebraska-Western Iowa Health Care System, Research Service, Omaha, NE 68105, USA; Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198-5990, USA
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Fry JP, Laestadius LI, Grechis C, Nachman KE, Neff RA. Investigating the role of state permitting and agriculture agencies in addressing public health concerns related to industrial food animal production. PLoS One 2014; 9:e89870. [PMID: 24587087 PMCID: PMC3933695 DOI: 10.1371/journal.pone.0089870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 01/24/2014] [Indexed: 12/26/2022] Open
Abstract
Objectives Industrial food animal production (IFAP) operations adversely impact environmental public health through air, water, and soil contamination. We sought to determine how state permitting and agriculture agencies respond to these public health concerns. Methods We conducted semi-structured qualitative interviews with staff at 12 state agencies in seven states, which were chosen based on high numbers or rapid increase of IFAP operations. The interviews served to gather information regarding agency involvement in regulating IFAP operations, the frequency and type of contacts received about public health concerns, how the agency responds to such contacts, and barriers to additional involvement. Results Permitting and agriculture agencies’ responses to health-based IFAP concerns are constrained by significant barriers including narrow regulations, a lack of public health expertise within the agencies, and limited resources. Conclusions State agencies with jurisdiction over IFAP operations are unable to adequately address relevant public health concerns due to multiple factors. Combining these results with previously published findings on barriers facing local and state health departments in the same states reveals significant gaps between these agencies regarding public health and IFAP. There is a clear need for regulations to protect public health and for public health professionals to provide complementary expertise to agencies responsible for regulating IFAP operations.
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Affiliation(s)
- Jillian P. Fry
- Center for a Livable Future, Johns Hopkins University, Baltimore, Maryland, United States of America
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- * E-mail:
| | - Linnea I. Laestadius
- Center for a Livable Future, Johns Hopkins University, Baltimore, Maryland, United States of America
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States of America
| | - Clare Grechis
- Center for a Livable Future, Johns Hopkins University, Baltimore, Maryland, United States of America
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Keeve E. Nachman
- Center for a Livable Future, Johns Hopkins University, Baltimore, Maryland, United States of America
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Roni A. Neff
- Center for a Livable Future, Johns Hopkins University, Baltimore, Maryland, United States of America
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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50
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Radon K. To live or not to live near a farm? Occup Environ Med 2013; 71:79. [PMID: 24213565 DOI: 10.1136/oemed-2013-101790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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