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Int. J. Environ. Res. Public Health 2017, 14(4), 362; doi:10.3390/ijerph14040362

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

1
Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
2
Department of Environmental Science, Policy & Management, University of California, Berkeley, Berkeley, CA 94720, USA
3
Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
4
Department of Epidemiology and Health Services Research, Geisinger Health System, Danville, PA 17822, USA
5
Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 10 March 2017 / Revised: 28 March 2017 / Accepted: 30 March 2017 / Published: 31 March 2017
(This article belongs to the Section Environmental Health)
View Full-Text   |   Download PDF [871 KB, uploaded 31 March 2017]   |  

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. View Full-Text
Keywords: asthma; asthma exacerbation; concentrated animal feeding operation (CAFO) asthma; asthma exacerbation; concentrated animal feeding operation (CAFO)
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MDPI and ACS Style

Rasmussen, S.G.; Casey, J.A.; Bandeen-Roche, K.; Schwartz, B.S. Proximity to Industrial Food Animal Production and Asthma Exacerbations in Pennsylvania, 2005–2012. Int. J. Environ. Res. Public Health 2017, 14, 362.

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