Limits...
Q fever and pneumonia in an area with a high livestock density: a large population-based study.

Smit LA, van der Sman-de Beer F, Opstal-van Winden AW, Hooiveld M, Beekhuizen J, Wouters IM, Yzermans J, Heederik D - PLoS ONE (2012)

Bottom Line: The association with 'other infectious disease' was particularly strong, with an OR [95%CI] of 12.03 [8.79-16.46] for the fourth quartile (>17,190 goats) compared with the first quartile (<2,251 goats).The presence of poultry within 1 km was associated with an increased incidence of pneumonia among adults (OR [95%CI] 1.25 [1.06-1.47]).A high density of goats in a densely populated region was associated with human Q fever.The use of GP records combined with individual exposure estimates using a Geographic Information System is a powerful approach to assess environmental health risks.

View Article: PubMed Central - PubMed

Affiliation: Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. L.A.Smit@uu.nl

ABSTRACT
Concerns about public health risks of intensive animal production in The Netherlands continue to rise, in particular related to outbreaks of infectious diseases. The aim was to investigate associations between the presence of farm animals around the home address and Q fever and pneumonia.Electronic medical record data for the year 2009 of all patients of 27 general practitioners (GPs) in a region with a high density of animal farms were used. Density of farm animals around the home address was calculated using a Geographic Information System. During the study period, a large Q fever outbreak occurred in this region. Associations between farm exposure variables and pneumonia or 'other infectious disease', the diagnosis code used by GPs for registration of Q fever, were analyzed in 22,406 children (0-17 y) and 70,142 adults (18-70 y), and adjusted for age and sex. In adults, clear exposure-response relationships between the number of goats within 5 km of the home address and pneumonia and 'other infectious disease' were observed. The association with 'other infectious disease' was particularly strong, with an OR [95%CI] of 12.03 [8.79-16.46] for the fourth quartile (>17,190 goats) compared with the first quartile (<2,251 goats). The presence of poultry within 1 km was associated with an increased incidence of pneumonia among adults (OR [95%CI] 1.25 [1.06-1.47]).A high density of goats in a densely populated region was associated with human Q fever. The use of GP records combined with individual exposure estimates using a Geographic Information System is a powerful approach to assess environmental health risks.

Show MeSH

Related in: MedlinePlus

Smoothed plots with 95% confidence bands representing associations of the number of goats within 5 km around the home address with pneumonia (A; P = 0.001) and ‘other infectious disease’ (C; P<0.0001), and associations of distance to nearest goat farm with pneumonia (B; P = 0.0002) and ‘other infectious disease’ (D; P<0.0001) among 70,142 adults.Associations were adjusted for age and sex.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3369851&req=5

pone-0038843-g002: Smoothed plots with 95% confidence bands representing associations of the number of goats within 5 km around the home address with pneumonia (A; P = 0.001) and ‘other infectious disease’ (C; P<0.0001), and associations of distance to nearest goat farm with pneumonia (B; P = 0.0002) and ‘other infectious disease’ (D; P<0.0001) among 70,142 adults.Associations were adjusted for age and sex.

Mentions: The shape of the associations between distance to the nearest goat farm and number of goats around the home address and the Q fever-related outcomes in adults are shown as smoothed plots (Figure 2). Clear trends between a smaller distance to the nearest goat farm, a higher number of goats around the home address, and a higher disease incidence were observed, and all associations were statistically significant (linear component P≤0.001). A steep, non-linear increase of ‘other infectious disease’ with an increasing number of goats around the home address was found, showing a predicted incidence of 0.1% in adults with 100 goats within 5 km, 0.9% in adults with 10,000 goats within 5 km, and 2.2% in adults with 20,000 goats within 5 km of the home address (Figure 2C). The predicted incidence of ‘other infectious disease’ was 0.1% in those living at 10 km from the nearest goat farm, 1.1% in adults living at 1000 m, and 3.4% among adults living at 50 m from a goat farm (Figure 2D). When these two goat exposures were included as determinants in one model, only the number of goats remained a statistically significant risk factor (P<0.0001), whereas the distance to the nearest goat farm was no independent determinant (P = 0.40).


Q fever and pneumonia in an area with a high livestock density: a large population-based study.

Smit LA, van der Sman-de Beer F, Opstal-van Winden AW, Hooiveld M, Beekhuizen J, Wouters IM, Yzermans J, Heederik D - PLoS ONE (2012)

Smoothed plots with 95% confidence bands representing associations of the number of goats within 5 km around the home address with pneumonia (A; P = 0.001) and ‘other infectious disease’ (C; P<0.0001), and associations of distance to nearest goat farm with pneumonia (B; P = 0.0002) and ‘other infectious disease’ (D; P<0.0001) among 70,142 adults.Associations were adjusted for age and sex.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3369851&req=5

pone-0038843-g002: Smoothed plots with 95% confidence bands representing associations of the number of goats within 5 km around the home address with pneumonia (A; P = 0.001) and ‘other infectious disease’ (C; P<0.0001), and associations of distance to nearest goat farm with pneumonia (B; P = 0.0002) and ‘other infectious disease’ (D; P<0.0001) among 70,142 adults.Associations were adjusted for age and sex.
Mentions: The shape of the associations between distance to the nearest goat farm and number of goats around the home address and the Q fever-related outcomes in adults are shown as smoothed plots (Figure 2). Clear trends between a smaller distance to the nearest goat farm, a higher number of goats around the home address, and a higher disease incidence were observed, and all associations were statistically significant (linear component P≤0.001). A steep, non-linear increase of ‘other infectious disease’ with an increasing number of goats around the home address was found, showing a predicted incidence of 0.1% in adults with 100 goats within 5 km, 0.9% in adults with 10,000 goats within 5 km, and 2.2% in adults with 20,000 goats within 5 km of the home address (Figure 2C). The predicted incidence of ‘other infectious disease’ was 0.1% in those living at 10 km from the nearest goat farm, 1.1% in adults living at 1000 m, and 3.4% among adults living at 50 m from a goat farm (Figure 2D). When these two goat exposures were included as determinants in one model, only the number of goats remained a statistically significant risk factor (P<0.0001), whereas the distance to the nearest goat farm was no independent determinant (P = 0.40).

Bottom Line: The association with 'other infectious disease' was particularly strong, with an OR [95%CI] of 12.03 [8.79-16.46] for the fourth quartile (>17,190 goats) compared with the first quartile (<2,251 goats).The presence of poultry within 1 km was associated with an increased incidence of pneumonia among adults (OR [95%CI] 1.25 [1.06-1.47]).A high density of goats in a densely populated region was associated with human Q fever.The use of GP records combined with individual exposure estimates using a Geographic Information System is a powerful approach to assess environmental health risks.

View Article: PubMed Central - PubMed

Affiliation: Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. L.A.Smit@uu.nl

ABSTRACT
Concerns about public health risks of intensive animal production in The Netherlands continue to rise, in particular related to outbreaks of infectious diseases. The aim was to investigate associations between the presence of farm animals around the home address and Q fever and pneumonia.Electronic medical record data for the year 2009 of all patients of 27 general practitioners (GPs) in a region with a high density of animal farms were used. Density of farm animals around the home address was calculated using a Geographic Information System. During the study period, a large Q fever outbreak occurred in this region. Associations between farm exposure variables and pneumonia or 'other infectious disease', the diagnosis code used by GPs for registration of Q fever, were analyzed in 22,406 children (0-17 y) and 70,142 adults (18-70 y), and adjusted for age and sex. In adults, clear exposure-response relationships between the number of goats within 5 km of the home address and pneumonia and 'other infectious disease' were observed. The association with 'other infectious disease' was particularly strong, with an OR [95%CI] of 12.03 [8.79-16.46] for the fourth quartile (>17,190 goats) compared with the first quartile (<2,251 goats). The presence of poultry within 1 km was associated with an increased incidence of pneumonia among adults (OR [95%CI] 1.25 [1.06-1.47]).A high density of goats in a densely populated region was associated with human Q fever. The use of GP records combined with individual exposure estimates using a Geographic Information System is a powerful approach to assess environmental health risks.

Show MeSH
Related in: MedlinePlus