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Zorn J, Simões M, Velders GJM, Gerlofs-Nijland M, Strak M, Jacobs J, Dijkema MBA, Hagenaars TJ, Smit LAM, Vermeulen R, Mughini-Gras L, Hogerwerf L, Klinkenberg D. Effects of long-term exposure to outdoor air pollution on COVID-19 incidence: A population-based cohort study accounting for SARS-CoV-2 exposure levels in the Netherlands. ENVIRONMENTAL RESEARCH 2024; 252:118812. [PMID: 38561121 DOI: 10.1016/j.envres.2024.118812] [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: 02/04/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/04/2024]
Abstract
Several studies have linked air pollution to COVID-19 morbidity and severity. However, these studies do not account for exposure levels to SARS-CoV-2, nor for different sources of air pollution. We analyzed individual-level data for 8.3 million adults in the Netherlands to assess associations between long-term exposure to ambient air pollution and SARS-CoV-2 infection (i.e., positive test) and COVID-19 hospitalisation risks, accounting for spatiotemporal variation in SARS-CoV-2 exposure levels during the first two major epidemic waves (February 2020-February 2021). We estimated average annual concentrations of PM10, PM2.5 and NO2 at residential addresses, overall and by PM source (road traffic, industry, livestock, other agricultural sources, foreign sources, other Dutch sources), at 1 × 1 km resolution, and weekly SARS-CoV-2 exposure at municipal level. Using generalized additive models, we performed interval-censored survival analyses to assess associations between individuals' average exposure to PM10, PM2.5 and NO2 in the three years before the pandemic (2017-2019) and COVID-19-outcomes, adjusting for SARS-CoV-2 exposure, individual and area-specific confounders. In single-pollutant models, per interquartile (IQR) increase in exposure, PM10 was associated with 7% increased infection risk and 16% increased hospitalisation risk, PM2.5 with 8% increased infection risk and 18% increased hospitalisation risk, and NO2 with 3% increased infection risk and 11% increased hospitalisation risk. Bi-pollutant models suggested that effects were mainly driven by PM. Associations for PM were confirmed when stratifying by urbanization degree, epidemic wave and testing policy. All emission sources of PM, except industry, showed adverse effects on both outcomes. Livestock showed the most detrimental effects per unit exposure, whereas road traffic affected severity (hospitalisation) more than infection risk. This study shows that long-term exposure to air pollution increases both SARS-CoV-2 infection and COVID-19 hospitalisation risks, even after controlling for SARS-CoV-2 exposure levels, and that PM may have differential effects on these COVID-19 outcomes depending on the emission source.
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Affiliation(s)
- Jelle Zorn
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Mariana Simões
- Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Guus J M Velders
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Institute for Marine and Atmospheric Research (IMAU), Utrecht University, Utrecht, the Netherlands
| | - Miriam Gerlofs-Nijland
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Maciek Strak
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - José Jacobs
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Marieke B A Dijkema
- Environment and Health in Overijssel and Gelderland, Public Health Services Gelderland-Midden, the Netherlands
| | | | - Lidwien A M Smit
- Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Lapo Mughini-Gras
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.
| | - Lenny Hogerwerf
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Don Klinkenberg
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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Simões M, Zorn J, Hogerwerf L, Velders GJM, Portengen L, Gerlofs-Nijland M, Dijkema M, Strak M, Jacobs J, Wesseling J, de Vries WJ, Mijnen-Visser S, Smit LAM, Vermeulen R, Mughini-Gras L. Outdoor air pollution as a risk factor for testing positive for SARS-CoV-2: A nationwide test-negative case-control study in the Netherlands. Int J Hyg Environ Health 2024; 259:114382. [PMID: 38652943 DOI: 10.1016/j.ijheh.2024.114382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/02/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Abstract
Air pollution is a known risk factor for several diseases, but the extent to which it influences COVID-19 compared to other respiratory diseases remains unclear. We performed a test-negative case-control study among people with COVID-19-compatible symptoms who were tested for SARS-CoV-2 infection, to assess whether their long- and short-term exposure to ambient air pollution (AAP) was associated with testing positive (vs. negative) for SARS-CoV-2. We used individual-level data for all adult residents in the Netherlands who were tested for SARS-CoV-2 between June and November 2020, when only symptomatic people were tested, and modeled ambient concentrations of PM10, PM2.5, NO2 and O3 at geocoded residential addresses. In long-term exposure analysis, we selected individuals who did not change residential address in 2017-2019 (1.7 million tests) and considered the average concentrations of PM10, PM2.5 and NO2 in that period, and different sources of PM (industry, livestock, other agricultural activities, road traffic, other Dutch sources, foreign sources). In short-term exposure analysis, individuals not changing residential address in the two weeks before testing day (2.7 million tests) were included in the analyses, thus considering 1- and 2-week average concentrations of PM10, PM2.5, NO2 and O3 before testing day as exposure. Mixed-effects logistic regression analysis with adjustment for several confounders, including municipality and testing week to account for spatiotemporal variation in viral circulation, was used. Overall, there was no statistically significant effect of long-term exposure to the studied pollutants on the odds of testing positive vs. negative for SARS-CoV-2. However, significant positive associations of long-term exposure to PM10 and PM2.5 from specifically foreign and livestock sources, and to PM10 from other agricultural sources, were observed. Short-term exposure to PM10 (adjusting for NO2) and PM2.5 were also positively associated with increased odds of testing positive for SARS-CoV-2. While these exposures seemed to increase COVID-19 risk relative to other respiratory diseases, the underlying biological mechanisms remain unclear. This study reinforces the need to continue to strive for better air quality to support public health.
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Affiliation(s)
- Mariana Simões
- Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Jelle Zorn
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (CIb), Bilthoven, the Netherlands
| | - Lenny Hogerwerf
- National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (CIb), Bilthoven, the Netherlands
| | - Guus J M Velders
- Institute for Marine and Atmospheric Research Utrecht, Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment (RIVM), Center for Environmental Quality (MIL), Bilthoven, the Netherlands
| | - Lützen Portengen
- Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Miriam Gerlofs-Nijland
- National Institute for Public Health and the Environment (RIVM), Center for Sustainability, Environment and Health (DMG), Bilthoven, the Netherlands
| | - Marieke Dijkema
- Municipal Health Services, Provinces of Overijssel and Gelderland, the Netherlands
| | - Maciek Strak
- National Institute for Public Health and the Environment (RIVM), Center for Sustainability, Environment and Health (DMG), Bilthoven, the Netherlands
| | - José Jacobs
- National Institute for Public Health and the Environment (RIVM), Center for Sustainability, Environment and Health (DMG), Bilthoven, the Netherlands
| | - Joost Wesseling
- National Institute for Public Health and the Environment (RIVM), Center for Environmental Quality (MIL), Bilthoven, the Netherlands
| | - Wilco J de Vries
- National Institute for Public Health and the Environment (RIVM), Center for Environmental Quality (MIL), Bilthoven, the Netherlands
| | - Suzanne Mijnen-Visser
- National Institute for Public Health and the Environment (RIVM), Center for Environmental Quality (MIL), Bilthoven, the Netherlands
| | - Lidwien A M Smit
- Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Lapo Mughini-Gras
- Institute for Risk Assessment Sciences (IRAS), Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control (CIb), Bilthoven, the Netherlands.
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Bittman S, Worth D, Hunt D, Spiegal S, Kleinman P, Nanayakkara S, Vendramini J, Silveira M, Flynn C, Reid K, Martin T, VanderZaag A, Javorek S. Distribution of livestock sectors in Canada: Implications for manureshed management. JOURNAL OF ENVIRONMENTAL QUALITY 2023; 52:596-609. [PMID: 36746193 DOI: 10.1002/jeq2.20457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/12/2023] [Indexed: 05/06/2023]
Abstract
Canada's livestock production and human populations are concentrated in southern regions. Understanding spatial and temporal distributions of animals and excreted nutrients is key to optimizing manure resources and minimizing impact of livestock. Here, we identify manureshed concerns and opportunities by reconciling nitrogen supply and demand on a regional and national scale. Data based on national statistics and farm surveys were allocated to homogeneous soil polygons (Soil Landscapes of Canada [SLC]) to quantify changes in nutrient distribution and ammonia (NH3 ) emissions across Canada (1981-2018). Livestock sectors tied to domestic consumption, dairy and poultry, were stable over time and well dispersed. Export driven beef production has moved west since 1981, whereas pig production was prominent in Manitoba, Quebec, and Ontario. Per ha manure N excretion across livestock sectors in 2018 was generally low with 58% and 6% of the SLCs averaging <25 and >100 kg N ha-1 , respectively. Although only 3% of SLCs had average NH3 emissions reaching 16-200 kg ha-1 , most of these were located near cities and emissions spiked in spring when more people might be exposed. The greatest concentrations of nutrients and livestock occurred around the three largest metropolitan areas: Toronto, Montreal-Quebec City, and Vancouver, posing challenges for nutrient recycling and public health. This study shows that as Canadian cities and livestock agriculture grow in southern Canada, so will challenges around food production, human health, and managing nutrients. Livestock and land use strategies are needed to reconcile changing animal sectors and growing populations.
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Affiliation(s)
- Shabtai Bittman
- Agriculture and Agri-Food Canada, Agassiz Research and Development Centre, Agassiz, British Columbia, Canada
| | - Devon Worth
- Agriculture and Agri-Food Canada, Ottawa Research and Development Centre, Ottawa, Ontario, Canada
| | - Derek Hunt
- Agriculture and Agri-Food Canada, Agassiz Research and Development Centre, Agassiz, British Columbia, Canada
| | - Sheri Spiegal
- USDA-ARS, Jornada Experimental Range, Las Cruces, NM, USA
| | - Peter Kleinman
- USDA-ARS, Soil Management and Sugarbeet Research Unit, Fort Collins, CO, USA
| | - Sama Nanayakkara
- Agriculture and Agri-Food Canada, Ottawa Research and Development Centre, Ottawa, Ontario, Canada
| | - Joao Vendramini
- Range Cattle Research Experiment Station, University of Florida, Ona, FL, USA
| | - Maria Silveira
- Range Cattle Research Experiment Station, University of Florida, Ona, FL, USA
| | - Colton Flynn
- Grassland Soil and Water Research Laboratory, USDA-ARS, Temple, TX, USA
| | - Keith Reid
- Agriculture and Agri-Food Canada, Guelph Research and Development Centre, Guelph, Ontario, Canada
| | - Tim Martin
- Agriculture and Agri-Food Canada, Ottawa Research and Development Centre, Ottawa, Ontario, Canada
| | - Andrew VanderZaag
- Agriculture and Agri-Food Canada, Ottawa Research and Development Centre, Ottawa, Ontario, Canada
| | - Steven Javorek
- Agriculture and Agri-Food Canada, Kentville Research and Development Centre, Kentville, Nova Scotia, Canada
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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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Hogerwerf L, Post PM, Bom B, van der Hoek W, van de Kassteele J, Stemerding AM, de Vries W, Houthuijs D. Proximity to livestock farms and COVID-19 in the Netherlands, 2020-2021. Int J Hyg Environ Health 2022; 245:114022. [PMID: 35987164 PMCID: PMC9376334 DOI: 10.1016/j.ijheh.2022.114022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/12/2022] [Accepted: 08/08/2022] [Indexed: 12/01/2022]
Abstract
Objectives In the Netherlands, during the first phase of the COVID-19 epidemic, the hotspot of COVID-19 overlapped with the country's main livestock area, while in subsequent phases this distinct spatial pattern disappeared. Previous studies show that living near livestock farms influence human respiratory health and immunological responses. This study aimed to explore whether proximity to livestock was associated with SARS-CoV-2 infection. Methods The study population was the population of the Netherlands excluding the very strongly urbanised areas and border areas, on January 1, 2019 (12, 628, 244 individuals). The cases are the individuals reported with a laboratory-confirmed positive SARS-CoV-2 test with onset before January 1, 2022 (2, 223, 692 individuals). For each individual, we calculated distance to nearest livestock farm (cattle, goat, sheep, pig, poultry, horse, rabbit, mink). The associations between residential (6-digit postal-code) distance to the nearest livestock farm and individuals' SARS-CoV-2 status was studied with multilevel logistic regression models. Models were adjusted for individuals' age categories, the social status of the postal code area, particulate matter (PM10)- and nitrogen dioxide (NO2)-concentrations. We analysed data for the entire period and population as well as separately for eight time periods (Jan–Mar, Apr–Jun, Jul–Sep and Oct–Dec in 2020 and 2021), four geographic areas of the Netherlands (north, east, west and south), and for five age categories (0–14, 15–24, 25–44, 45–64 and > 65 years). Results Over the period 2020–2021, individuals' SARS-CoV-2 status was associated with living closer to livestock farms. This association increased from an Odds Ratio (OR) of 1.01 (95% Confidence Interval [CI] 1.01–1.02) for patients living at a distance of 751–1000 m to a farm to an OR of 1.04 (95% CI 1.04–1.04), 1.07 (95% CI 1.06–1.07) and 1.11 (95% CI 1.10–1.12) for patients living in the more proximate 501–750 m, 251–500m and 0–250 m zones around farms, all relative to patients living further than 1000 m around farms. This association was observed in three out of four quarters of the year in both 2020 and 2021, and in all studied geographic areas and age groups. Conclusions In this exploratory study with individual SARS-CoV-2 notification data and high-resolution spatial data associations were found between living near livestock farms and individuals' SARS-CoV-2 status in the Netherlands. Verification of the results in other countries is warranted, as well as investigations into possible underlying exposures and mechanisms.
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Affiliation(s)
- Lenny Hogerwerf
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, the Netherlands.
| | - Pim M Post
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, the Netherlands; Department of Natural Resources, Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, P.O Box 217, Enschede, 7500 AE, the Netherlands.
| | - Ben Bom
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, the Netherlands.
| | - Wim van der Hoek
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, the Netherlands.
| | - Jan van de Kassteele
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, the Netherlands.
| | | | - Wilco de Vries
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, the Netherlands.
| | - Danny Houthuijs
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, the Netherlands.
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Simões M, Janssen N, Heederik DJJ, Smit LAM, Vermeulen R, Huss A. Residential proximity to livestock animals and mortality from respiratory diseases in The Netherlands: A prospective census-based cohort study. ENVIRONMENT INTERNATIONAL 2022; 161:107140. [PMID: 35189407 DOI: 10.1016/j.envint.2022.107140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 01/11/2022] [Accepted: 02/05/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND There is increasing evidence of associations between residential proximity to livestock farms and respiratory morbidity, but less is known about potential effects on respiratory mortality among residents. OBJECTIVES We aimed to assess potential associations between respiratory mortality and residential proximity to (intensive) livestock farming. METHODS In DUELS, a national census-based cohort, we selected all inhabitants from rural and semi-urban areas of the Netherlands, aged ≥30 years and living at the same address for five years up to baseline (2004). We followed these ∼4 million individuals for respiratory mortality (respiratory system diseases, chronic lower respiratory diseases, pneumonia) from 2005 to 2012. We computed the average number of cattle, pigs, chicken, and mink present in 500 m, 1000 m, 1500 m and 2000 m of each individual's residence in the period 1999-2003. Analyses were conducted using Cox proportional hazards regression, adjusting for potential confounders at individual and neighbourhood level. RESULTS We found evidence that living up to 2000 m of pig farms was associated with respiratory mortality, namely from chronic lower respiratory diseases, with Hazard Ratios ranging from 1.06 (1.02, 1.10) in people living close to low numbers (<median number of animals) of pigs in 1000 m and 1.18 (1.13, 1.24) in those living near high numbers (≥median) of pigs in 2000 m. We also found indications of higher pneumonia mortality in people living near mink farms. CONCLUSION Our results are in line with previous findings of adverse respiratory effects in people living near livestock farms. Little is known about the physical, chemical, and biological exposures leading to respiratory morbidity and mortality warranting further explorations of air contaminants in the vicinity of livestock farms.
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Affiliation(s)
- Mariana Simões
- Department Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands.
| | - Nicole Janssen
- Centre for Sustainability, Environment and Health (DMG), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Dick J J Heederik
- Department Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Lidwien A M Smit
- Department Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Roel Vermeulen
- Department Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anke Huss
- Department Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
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Roof I, van der Hoek W, Oude Boerrigter L, Wielders CCH, Smit LAM. Use of Antibiotics among Residents Living Close to Poultry or Goat Farms: A Nationwide Analysis in The Netherlands. Antibiotics (Basel) 2021; 10:1346. [PMID: 34827284 PMCID: PMC8614970 DOI: 10.3390/antibiotics10111346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 01/21/2023] Open
Abstract
Prior regional studies found a high risk of pneumonia for people living close to poultry and goat farms. This epidemiological study in the Netherlands used nationwide antibiotic prescription data as a proxy for pneumonia incidence to investigate whether residents of areas with poultry and goat farms use relatively more antibiotics compared to areas without such farms. We used prescription data on antibiotics most commonly prescribed to treat pneumonia in adults and livestock farming data, both with nationwide coverage. Antibiotic use was expressed as defined daily doses per (4-digit Postal Code (PC4) area)-(age group)-(gender)-(month) combination for the year 2015. We assessed the associations between antibiotic use and farm exposure using negative binomial regression. The amoxicillin, doxycycline, and co-amoxiclav use was significantly higher (5-10% difference in use) in PC4 areas with poultry farms present compared to areas without, even after adjusting for age, gender, smoking, socio-economic status, and goat farm presence. The adjusted models showed no associations between antibiotic use and goat farm presence. The variables included in this study could only partly explain the observed regional differences in antibiotic use. This was an ecological study that precludes inference about causal relations. Further research using individual-level data is recommended.
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Affiliation(s)
- Inge Roof
- National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands; (W.v.d.H.); (L.O.B.); (C.C.H.W.)
| | - Wim van der Hoek
- National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands; (W.v.d.H.); (L.O.B.); (C.C.H.W.)
| | - Lisette Oude Boerrigter
- National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands; (W.v.d.H.); (L.O.B.); (C.C.H.W.)
| | - Cornelia C. H. Wielders
- National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands; (W.v.d.H.); (L.O.B.); (C.C.H.W.)
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands;
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