TY - JOUR
T1 - Proximity to industrial food animal production and asthma exacerbations in Pennsylvania, 2005–2012
AU - Rasmussen, Sara G.
AU - Casey, Joan A.
AU - Bandeen-Roche, Karen
AU - Schwartz, Brian S.
N1 - Funding Information:
This study was funded by the National Institute of Environmental Health Sciences grant ES023675-01 (PI: Brian S. Schwartz) and training grant ES07141 (Sara G. Rasmussen). Additional support was provided by the National Science Foundation Integrative Graduate Education and Research Traineeship (Sara G. Rasmussen). No funders had input into the study design, conduct, data collection or analysis, or manuscript preparation. We declare that we have no conflicts of interest.
Publisher Copyright:
© 2017 by the authors.
PY - 2017/4
Y1 - 2017/4
N2 - 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.
AB - 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.
KW - Asthma
KW - Asthma exacerbation
KW - Concentrated animal feeding operation (CAFO)
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U2 - 10.3390/ijerph14040362
DO - 10.3390/ijerph14040362
M3 - Article
C2 - 28362334
AN - SCOPUS:85017009617
VL - 14
JO - International Journal of Environmental Research and Public Health
JF - International Journal of Environmental Research and Public Health
SN - 1661-7827
IS - 4
M1 - 362
ER -