Interaction of the role of Concentrated Animal Feeding Operations (CAFOs) in Emerging Infectious Diseases (EIDS)

Use of prototype side stream filtration system to control dust levels in a commercial swine farrowing building

Swine meat provides an essential global food source. Due to economies of scale, modern U.S. swine production primarily occurs indoors to maintain an optimal environment across the stages of swine production. Indoor concentrations of dust and contaminant gases in swine production buildings increase in the winter months due to reduced ventilation to optimal building temperature. In this study, an engineering control technology designed to recirculate the air in a swine farrowing room through a mobile air handling unit containing high-efficiency particulate filters was presented. A mobile solution could be easily deployed as an intervention method if an infectious disease outbreak occurs at a swine operation. The performance of this control technology was evaluated following deployment in a production farrowing barn for a period of 6 weeks during the winter in the Midwestern United States. Contaminant concentrations of inhalable dust, respirable dust, and carbon dioxide were measured in the room treated by the prototype system and compared to contaminant concentrations measured in an untreated "control" room. Over 6 weeks, the mean inhalable and respirable dust concentrations observed during the study period for the "treatment" room were 2.61 and 0.14 mg/m3, respectively, compared to 3.51 and 0.25 mg/m3, respectively, for the control room. The mobile recirculating ventilation system, operating at a flow rate of 45 m3/min (5 room air exchanges per hour), reduced the inhalable dust by 25% and respirable dust by 48% as measured with a real-time aerosol monitor, when compared to the control room. In addition, no concentration differences in carbon dioxide and relative humidity between the treatment and the control rooms were observed. Inhalable and respirable concentrations of dust were significantly reduced (p = 0.001), which demonstrates an essential improvement of the air quality that may prove beneficial to reduce the burden of disease among both workers and animals.

Association of Common Zoonotic Pathogens With Concentrated Animal Feeding Operations

Animal farming has intensified significantly in recent decades, with the emergence of concentrated animal feeding operations (CAFOs) in industrialized nations. The congregation of susceptible animals in CAFOs can lead to heavy environmental contamination with pathogens, promoting the emergence of hyper-transmissible, and virulent pathogens. As a result, CAFOs have been associated with emergence of highly pathogenic avian influenza viruses, hepatitis E virus, Escherichia coli O157:H7, Streptococcus suis, livestock-associated methicillin-resistant Staphylococcus aureus, and Cryptosporidium parvum in farm animals. This has led to increased transmission of zoonotic pathogens in humans and changes in disease patterns in general communities. They are exemplified by the common occurrence of outbreaks of illnesses through direct and indirect contact with farm animals, and wide occurrence of similar serotypes or subtypes in both humans and farm animals in industrialized nations. Therefore, control measures should be developed to slow down the dispersal of zoonotic pathogens associated with CAFOs and prevent the emergence of new pathogens of epidemic and pandemic potential.

Spatiotemporal land use change and environmental degradation surrounding CAFOs in Michigan and North Carolina

Concentrated Animal Feeding Operations (CAFOs) have arisen and expanded in the U.S. and globally to address efficiencies in livestock production. CAFOs tend to cluster in space for logistical purposes. Efficient distribution of concentrated manures produced by these operations is often not economically feasible, which may lead to accumulation on land near CAFOs, potentially resulting in local environmental changes. Moreover, as CAFOs are established or expand, they may need more lands to apply their manures, likely driving land use changes even after their establishment. Studies have yet to investigate these spatiotemporal impacts of CAFOs. We investigated whether the presence of regulated liquid waste CAFOs is associated with land use change over time and space as well as degraded environmental conditions surrounding those facilities. We used MODIS (Moderate Resolution Imaging Spectrometer) images from 2000 to 2018 to examine these questions in Michigan and North Carolina- states with varied CAFO establishment histories. We found that cropland extent increased while savanna and forest decreased near CAFOs. Similar observations did not occur outside of areas influenced by CAFOs. We also found evidence of environmental degradation, including decreased evapotranspiration and increased day and nighttime land surface temperatures in North Carolina. This study advances our understanding of environmental impacts surrounding CAFOs. Our findings can support policy changes and highlight the need to better understand these globally increasing entities.

CAFOs, novel influenza, and the need for One Health approaches

Concentrated animal feeding operations (CAFOs) present highly efficient means of meeting food demands. CAFOs create unique conditions that can affect the health and environment of animals and humans within and outside operations, leading to potential epidemiological concerns that scale with operational size. One such arena meriting further investigation is their possible contribution to novel influenzas. CAFOs present opportunities for cross-species transmission of influenza as demonstrated by reports of swine flu and avian influenza outbreaks. Conditions and pathways leading to novel influenza strains are complex and require varied prevention and intervention approaches. Current challenges for prevention of respiratory viruses entering or leaving swine and poultry CAFOs are multifaceted and include adherence of personal safety measures, lack of training and safety provisions for personnel, and incomplete standardized federal, state, and/or county regulation and enforcement coverage across agricultural systems. This report acknowledges that any proposed CAFO-associated influenza intervention should be cross-organizational, and no single intervention should be expected to provide full resolution. Proposed interventions affect multiple components of the One Health triad, and include seasonal human influenza immunization, PPE regulation and adherence, alternative waste management, general biosecurity standardization and an industry best practices incentive program. Due to the complexity of this problem, multiple anticipated communication, enforcement, and logistical challenges may hinder the full implementation of proposed solutions. General and operation-specific (swine and poultry) biosecurity practices may mitigate some of the risks associated with influenza virus reassortment across species. Education and advocacy can help protect workers, communities, veterinarians and consumers from CAFO-associated influenza virus. To achieve this, there must be more complete communication between CAFOs, governing agencies, health services, animal services, researchers, and consumers to better explore the potential health outcomes associated with CAFOs.

Personal protective equipment use during industrial hog operation work activities and acute lung function changes in a prospective worker cohort, North Carolina 2014-2015

INTRODUCTION

Occupational activities related to industrial hog operation (IHO) worker lung function are not well defined. Therefore, we aimed to identify IHO work activities associated with diminished respiratory function and the effectiveness, if any, of personal protective equipment (PPE) use on IHOs.

METHODS

From 2014 to 2015, 103 IHO workers were enrolled and followed for 16 weeks. At each biweekly visit, work activities and PPE use were self-reported via questionnaire and lung function measurements were collected via spirometry. Generalized linear and linear fixed-effects models were fitted to cross-sectional and longitudinal data.

RESULTS

Increasing years worked on an IHO were associated with diminished lung function, but baseline and longitudinal work activities were largely inconsistent in direction and magnitude. Unexpectedly, a -0.3 L (95% confidence interval: -0.6, -0.04) difference in forced expiratory volume in the first second (FEV₁ ) was estimated when workers wore PPE consistently (≥80% of the time at work) versus those weeks they did not. In post-hoc analyses, we found that coveralls and facemasks were worn less consistently when workers experienced worse barn conditions and had more contact with pigs, but coveralls were worn more consistently as cleaning activities increased.

CONCLUSIONS

Similar to past studies, baseline estimates were likely obscured by healthy worker effect bias, but showed decrements in worker lung function as years of work increased. A challenge to disentangling the effect of work activities on lung function was the discovery that IHO workers used PPE differently according to the work task. These data suggest that interventions may be targeted toward improving barn conditions so that workers can consistently utilize IHO-provided PPE.

The use of personal protective equipment during common industrial hog operation work activities and acute lung function changes in a prospective worker cohort, North Carolina, USA

Introduction

As occupational activities related to acute industrial hog operation (IHO) worker lung function are not well defined, we aimed to identify IHO work activities associated with diminished respiratory function and the effectiveness, if any, of personal protective equipment (PPE) on IHOs.

Methods

From 2014-2015, 103 IHO workers were enrolled and followed for 16 weeks. At each bi-weekly visit, lung function measurements were collected via spirometry and work activities and PPE use were self-reported via questionnaire. Generalized linear and linear fixed-effects models were fitted to cross-sectional and longitudinal data.

Results

At baseline, increasing years worked on an IHO were associated with diminished lung function, but other activities were less consistent in direction and magnitude. In longitudinal models, only reports of working in feeding/finisher barns, showed a consistent association. However, a -0.3 L (95% confidence interval: -0.6, -0.04) difference in FEV ₁ was estimated when workers wore PPE consistently versus those weeks they did not. In post-hoc analyses, we found that coveralls and facemasks were worn less consistently when workers experienced worse barn conditions and had more contact with pigs, but coveralls were worn more consistently as cleaning activities increased.

Conclusions

Similar to past studies, baseline estimates were likely obscured by healthy worker bias. Also making it challenging to disentangle the effect of work activities on lung function was the discovery that IHO workers used PPE differently according to work task. These data suggest that interventions may be targeted toward improving barn conditions so that workers can consistently utilize IHO-provided PPE.

KEY MESSAGES

What is already known about this subject?: Working on industrial hog operations may be deleterious to long- and short-term respiratory health due to airborne bacteria, endotoxin, hazardous gases, dust, and dander in barns. In efficacy studies PPE has been shown to be protective, but studies have shown that PPE utilization among hog workers has historically been sub-optimal.What are the new findings?: As barn conditions worsened and contact with pigs increased, workers in this cohort reported wearing coveralls and face masks less often; however, they reported increased PPE use as they conducted more cleaning activities at work. During weeks when workers wore PPE their lung function declined, a possible cause being the improper use of the equipment leading to a false sense of protection or re-exposure to hazardous contaminants.How might this impact on policy or clinical practice in the foreseeable future?: Given COVID-19, the H1N1 "swine flu" pandemic, our knowledge of antimicrobial resistant pathogens, and increasing awareness about how food systems are linked to the spread of emerging infectious diseases, occupational health intervention research and workplace policies may focus on creating barn environments that are more conducive to PPE use which could help protect workers and consequently the community.

COVID-19, other zoonotic diseases and wildlife conservation

Many experts have warned that environmental degradation is increasing the likelihood of future pandemics like COVID-19, as habitat loss and poaching increase close contact between wildlife and people. This fact has been framed as a reason to increase wildlife conservation efforts. We have many good reasons to step up conservation efforts, but arguments for doing so on the basis of pandemic prevention are rhetorically, ethically, and empricially flawed.

Occupational health and safety in agriculture. A systematic review

Introduction: The prevalence of occupational diseases in the agricultural sector is higher than in other industries, since agricultural workers are at higher risk of exposure to different chemicals and pesticides, and are more prone to occupational accidents.Objective: To conduct a review of recent literature on occupational health and risk in agriculture.Materials and methods: A literature search was conducted in PubMed, SciencieDirect and Scopus using the following search strategy: type of articles: original research papers; language: English; publication period: 2006-2016; search terms: "agricultural health", "agrarian health", "risk factors", "epidemiology", "causality" and "occupational", used in different combinations ("AND" and "OR").Results: The search yielded 350 articles, of which 102 met the inclusion criteria. Moreover, 5 articles were found in grey literature sources and included in the final analysis. Most research on this topic has been conducted in the United States, which produced 91% (97/107) of the articles included.Conclusions: Most studies on health and safety in agriculture focused primarily on the harmful effects of occupational exposure to agrochemicals and pesticides, and the consequences of occupational accidents. However, since more than 90% of these studies come from the United States, a more comprehensive approach to health in agriculture is required, since what is reported here may be far from the reality of other regions, especially Latin America.

Self-Reported Occupational Injuries and Perceived Occupational Health Problems among Latino Immigrant Swine Confinement Workers in Missouri

Swine production has changed dramatically, and in the United States production often takes place in concentrated animal feeding operations (CAFOs). Because of the size and density of these types of facilities, workers may be exposed to serious occupational health risks such as noxious gases, agricultural dusts, elevated noise levels, and zoonotic diseases. This descriptive study examines self-reported occupational injuries and perceived occupational health problems among a convenience sample of 40 Latino immigrant swine confinement workers (92.5% male; M age = 36.1 years; SD = 10.0) in Missouri. Results indicated that seventeen workers (42.5%) rated their health as fair or poor, thirteen (32.5%) had experienced an occupational injury, and eleven (28.2%) reported occupational health problems such as burning eyes, muscular pain, headaches, coughing, nausea, nasal congestion, and sneezing. The majority of workers did not perceive their job to be dangerous. Clearly, more must be done to protect workers, especially immigrant workers, who may not have the same access to information, training, or other protections. Health and safety should be a priority for both farmworkers and farm employers. Practical and policy-based implications and recommendations are discussed.

Environmental and human health challenges of industrial livestock and poultry farming in China and their mitigation

Driven by the growing demand for food products of animal origin, industrial livestock and poultry production has become increasingly popular and is on the track of becoming an important source of environmental pollution in China. Although concentrated animal feeding operations (CAFOs) have higher production efficiency and profitability with less resource consumption compared to the traditional family-based and "free range" farming, they bring significant environmental pollution concerns and pose public health risks. Gaseous pollutants and bioaerosols are emitted directly from CAFOs, which have health implications on animal producers and neighboring communities. A range of pollutants are excreted with the animal waste, including nutrients, pathogens, natural and synthetic hormones, veterinary antimicrobials, and heavy metals, which can enter local farmland soils, surface water, and groundwater, during the storage and disposal of animal waste, and pose direct and indirect human health risks. The extensive use of antimicrobials in CAFOs also contributes to the global public health concern of antimicrobial resistance (AMR). Efforts on treating the large volumes of manure generated in CAFOs should be enhanced (e.g., by biogas digesters and integrated farm systems) to minimize their impacts on the environment and human health. Furthermore, the use of veterinary drugs and feed additives in industrial livestock and poultry farming should be controlled, which will not only make the animal food products much safer to the consumers, but also render the manure more benign for treatment and disposal on farmlands. While improving the sustainability of animal farming, China also needs to promote healthy food consumption, which not only improves public health from avoiding high-meat diets, but also slows down the expansion of industrial animal farming, and thus reduces the associated environmental and public health risks.

Assessing the State of Knowledge Regarding the Effectiveness of Interventions to Contain Pandemic Influenza Transmission: A Systematic Review and Narrative Synthesis

BACKGROUND

Influenza pandemics occur when a novel influenza strain, to which humans are immunologically naïve, emerges to cause infection and illness on a global scale. Differences in the viral properties of pandemic strains, relative to seasonal ones, can alter the effectiveness of interventions typically implemented to control seasonal influenza burden. As a result, annual control activities may not be sufficient to contain an influenza pandemic.

PURPOSE

This study seeks to inform pandemic policy and planning initiatives by reviewing the effectiveness of previous interventions to reduce pandemic influenza transmission and infection. Results will inform the planning and design of more focused in-depth systematic reviews for specific types of interventions, thus providing the most comprehensive and current understanding of the potential for alternative interventions to mitigate the burden of pandemic influenza.

METHODS

A systematic review and narrative synthesis of existing systematic reviews and meta-analyses examining intervention effectiveness in containing pandemic influenza transmission was conducted using information collected from five databases (PubMed, Medline, Cochrane, Embase, and Cinahl/EBSCO). Two independent reviewers conducted study screening and quality assessment, extracting data related to intervention impact and effectiveness.

RESULTS AND DISCUSSION

Most included reviews were of moderate to high quality. Although the degree of statistical heterogeneity precluded meta-analysis, the present systematic review examines the wide variety of interventions that can impact influenza transmission in different ways. While it appears that pandemic influenza vaccination provides significant protection against infection, there was insufficient evidence to conclude that antiviral prophylaxis, seasonal influenza cross-protection, or a range of non-pharmaceutical strategies would provide appreciable protection when implemented in isolation. It is likely that an optimal intervention strategy will employ a combination of interventions in a layered approach, though more research is needed to substantiate this proposition.

TRIAL REGISTRATION

PROSPERO 42016039803.