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Int J Environ Res Public Health. 2017 Mar 31;14(4). pii: E362. doi: 10.3390/ijerph14040362.

Proximity to Industrial Food Animal Production and Asthma Exacerbations in Pennsylvania, 2005-2012.

Author information

1
Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. srasmus7@jhu.edu.
2
Department of Environmental Science, Policy & Management, University of California, Berkeley, Berkeley, CA 94720, USA. joanacasey@berkeley.edu.
3
Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. kbandee1@jhu.edu.
4
Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. bschwar1@jhu.edu.
5
Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, PA 17822, USA. bschwar1@jhu.edu.
6
Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA. bschwar1@jhu.edu.

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.

KEYWORDS:

asthma; asthma exacerbation; concentrated animal feeding operation (CAFO)

PMID:
28362334
PMCID:
PMC5409563
DOI:
10.3390/ijerph14040362
[Indexed for MEDLINE]
Free PMC Article

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