Proximity to Industrial Food Animal Production and Asthma Exacerbations in Pennsylvania, 2005–2012
Abstract
:1. Introduction
2. Materials and Methods
2.1. IFAP Data and Study Population
2.2. Comparison Subjects and Matching
2.3. Statistical Analysis
2.4. Sensitivity Analyses
3. Results
3.1. Description of Study Population
3.2. Association of IFAP and Asthma Exacerbations
3.3. Results of Sensitivity Analyses
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Variable, n (% a), Unless Specified | Hospitalization | Emergency Visit | OCS b | |||
---|---|---|---|---|---|---|
Case n = 3552 | Comparison Subject n = 10,640 | Case n = 1445 | Comparison Subject n = 7225 | Case n = 13,137 | Comparison Subject n = 13,044 | |
Race/ethnicity | ||||||
White non-Hispanic | 3297 (92.8) | 10,065 (94.6) | 1218 (84.3) | 6720 (93) | 12,126 (92.3) | 11,998 (92) |
Black non-Hispanic | 107 (3) | 257 (2.4) | 124 (8.6) | 221 (3.1) | 428 (3.3) | 468 (3.6) |
Hispanic/other/missing | 148 (4.1) | 318 (3.0) | 103 (7.1) | 284 (3.9) | 583 (4.5) | 578 (4.5) |
p c < 0.01 | p < 0.01 | p = 0.43 | ||||
Family history of asthma | 404 (11.4) | 999 (9.4) | 265 (18.3) | 871 (12.1) | 1668 (12.7) | 1354 (10.4) |
p < 0.01 | p < 0.01 | p < 0.01 | ||||
Smoking status | ||||||
Never | 1529 (43) | 5567 (52.3) | 656 (45.4) | 4148 (57.4) | 7424 (56.5) | 7975 (61.1) |
Current | 895 (25.2) | 1913 (18) | 276 (19.1) | 1100 (15.2) | 2219 (16.9) | 1777 (13.6) |
Former/missing | 1128 (31.8) | 3160 (29.7) | 513 (35.5) | 1977 (27.4) | 3494 (26.6) | 3292 (25.2) |
p < 0.01 | p < 0.01 | p < 0.01 | ||||
Medical Assistance | 1094 (30.8) | 2024 (19) | 542 (37.5) | 1991 (27.6) | 3683 (28.0) | 3369 (25.8) |
p < 0.01 | p < 0.01 | p < 0.01 | ||||
Body mass index | ||||||
Normal/underweight | 794 (22.4) | 2873 (27) | 445 (30.8) | 2574 (35.6) | 3887 (29.6) | 4693 (36) |
Overweight | 786 (22.1) | 2758 (25.9) | 304 (21) | 1708 (23.6) | 3103 (23.6) | 3164 (24.3) |
Obese | 1972 (55.5) | 5009 (47.1) | 696 (48.2) | 2943 (40.7) | 6147 (46.8) | 5187 (39.8) |
p < 0.01 | p < 0.01 | p < 0.01 | ||||
Type 2 diabetes | 558 (15.7) | 1033 (9.7) | 114 (7.9) | 405 (5.6) | 1051 (8.0) | 1010 (7.7) |
p < 0.01 | p < 0.01 | p = 0.44 | ||||
Age d (years) | ||||||
5–12 | 301 (8.5) | 903 (8.5) | 376 (26) | 1880 (26) | 2975 (22.6) | 2975 (22.8) |
13–18 | 222 (6.3) | 666 (6.3) | 156 (10.8) | 780 (10.8) | 1325 (10.1) | 1298 (10) |
19–44 | 1347 (37.9) | 4041 (38) | 576 (39.9) | 2880 (39.9) | 4065 (30.9) | 4065 (31.2) |
45–61 | 946 (26.6) | 2838 (26.7) | 234 (16.2) | 1170 (16.2) | 3177 (24.2) | 3110 (23.8) |
62–74 | 470 (13.2) | 1410 (13.3) | 70 (4.8) | 350 (4.8) | 1146 (8.7) | 1146 (8.8) |
75+ | 266 (7.5) | 782 (7.3) | 33 (2.3) | 165 (2.3) | 449 (3.4) | 450 (3.4) |
Female | 2502 (70.4) | 7506 (70.5) | 868 (60.1) | 4340 (60.1) | 8133 (61.9) | 8040 (61.6) |
Year | ||||||
2005 | 527 (14.8) | 1581 (14.9) | 166 (11.5) | 830 (11.5) | ||
2006 | 504 (14.2) | 1512 (14.2) | 147 (10.2) | 735 (10.2) | ||
2007 | 436 (12.3) | 1308 (12.3) | 195 (13.5) | 975 (13.5) | ||
2008 | 378 (10.6) | 1134 (10.7) | 179 (12.4) | 895 (12.4) | 3356 (25.5) | 3356 (25.7) |
2009 | 431 (12.1) | 1293 (12.2) | 206 (14.3) | 1030 (14.3) | 2986 (22.7) | 2986 (22.9) |
2010 | 398 (11.2) | 1194 (11.2) | 182 (12.6) | 910 (12.6) | 2405 (18.3) | 2378 (18.2) |
2011 | 422 (11.9) | 1266 (11.9) | 174 (12.0) | 870 (12.0) | 2342 (17.8) | 2342 (18.0) |
2012 | 456 (12.8) | 1352 (12.7) | 196 (13.6) | 980 (13.6) | 2048 (15.6) | 1982 (15.2) |
Variable, n (% a), Unless Specified | Hospitalization | Emergency Visit | OCS b | |||
---|---|---|---|---|---|---|
Case n = 3552 | Comparison Subject n = 10,640 | Case n = 1445 | Comparison Subject n = 7225 | Case n = 13,137 | Comparison Subject n = 13,044 | |
IFAP c within 3 miles of home address | 832 (23.4) | 2706 (25.4) | 214 (14.8) | 1849 (25.6) | 3350 (25.5) | 3042 (23.3) |
p d = 0.02 | p < 0.01 | p < 0.01 | ||||
Community socioeconomic deprivation, quartiles | ||||||
1 | 870 (24.5) | 2839 (26.7) | 289 (20) | 1935 (26.8) | 3424 (26.1) | 3536 (27.1) |
2 | 815 (22.9) | 2573 (24.2) | 298 (20.6) | 1728 (23.9) | 3093 (23.5) | 3129 (24.0) |
3 | 855 (24.1) | 2694 (25.3) | 345 (23.9) | 1811 (25.1) | 3389 (25.8) | 3203 (24.6) |
4 | 1012 (28.5) | 2534 (23.8) | 513 (35.5) | 1751 (24.2) | 3231 (24.6) | 3176 (24.3) |
p < 0.01 | p < 0.01 | p = 0.06 | ||||
Distance to nearest major road, miles (mean) | 1.59 | 1.66 | 1.35 | 1.73 | 1.69 | 1.69 |
p = 0.16 | p < 0.01 | p = 0.91 | ||||
Distance to nearest minor road, miles (mean) | 0.92 | 1.09 | 0.62 | 1.12 | 1.09 | 1.09 |
p < 0.01 | p < 0.01 | p = 0.87 | ||||
Distance to hospital, miles (mean) | 19.4 | 32.4 | 10.3 | 32.9 | 32.5 | 30.8 |
p < 0.01 | p < 0.01 | p < 0.01 |
Variable (95% CI a) | Outcome | ||
---|---|---|---|
Asthma Hospitalizations b | Asthma Emergency Department Visits b | New Asthma OCS c Orders d | |
Proximity to industrial food animal production e | 1.29 (1.15–1.46) | 1.12 (0.91–1.37) | 1.11 (1.04–1.19) |
Race/ethnicity (ref: white non-Hispanic) | |||
Black non-Hispanic | 1.05 (0.81–1.36) | 1.86 (1.4–2.46) | 0.84 (0.73–0.97) |
Hispanic | 1.23 (0.99–1.54) | 1.47 (1.11–1.93) | 0.95 (0.84–1.08) |
Family history of asthma (ref: no) | 1.27 (1.11–1.45) | 1.68 (1.4–2.01) | 1.27 (1.17–1.37) |
Smoking status (ref: never) | |||
Current | 1.45 (1.3–1.62) | 1.35 (1.12–1.63) | 1.39 (1.29–1.5) |
Former | 1.18 (1.08–1.3) | 1.45 (1.25–1.68) | 1.15 (1.08–1.22) |
Medical Assistance (ref: no) | 1.87 (1.69–2.07) | 1.32 (1.13–1.54) | 1.06 (0.998–1.13) |
Body mass index (ref: normal/underweight) | |||
Overweight | 1.07 (0.95–1.21) | 1.07 (0.89–1.28) | 1.24 (1.16–1.33) |
Obese | 1.36 (1.22–1.51) | 1.3 (1.11–1.52) | 1.53 (1.43–1.62) |
Type 2 diabetes (ref: no) | 1.63 (1.43–1.85) | 1.29 (0.99–1.69) | 0.93 (0.84–1.03) |
Community socioeconomic deprivation (ref: quartile 1) | |||
Quartile 2 | 0.97 (0.83–1.13) | 1.28 (1.01–1.63) | 0.99 (0.91–1.08) |
Quartile 3 | 0.97 (0.83–1.14) | 1.41 (1.10–1.82) | 1.01 (0.93–1.11) |
Quartile 4 | 0.94 (0.79–1.12) | 1.41 (1.10–1.82) | 0.98 (0.89–1.08) |
Distance to nearest major arterial road, z-transformed | |||
z-transformed | 0.94 (0.84–1.04) | 1.10 (0.93–1.31) | 0.97 (0.91–1.03) |
squared | 1.07 (1.02–1.12) | 1.04 (0.97–1.12) | 1.02 (0.99–1.05) |
Distance to nearest minor arterial road | |||
z-transformed | 1.08 (0.97–1.19) | 1.03 (0.87–1.22) | 0.98 (0.92–1.04) |
squared | 0.998 (0.95–1.05) | 0.89 (0.79–1.003) | 1.003 (0.98–1.03) |
Distance to nearest Geisinger hospital | |||
z-transformed | 0.46 (0.42–0.51) | 0.10 (0.08–0.13) | |
squared | 1.14 (1.07–1.21) | 1.35 (1.09–1.66) | f |
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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. https://doi.org/10.3390/ijerph14040362
Rasmussen SG, Casey JA, Bandeen-Roche K, Schwartz BS. Proximity to Industrial Food Animal Production and Asthma Exacerbations in Pennsylvania, 2005–2012. International Journal of Environmental Research and Public Health. 2017; 14(4):362. https://doi.org/10.3390/ijerph14040362
Chicago/Turabian StyleRasmussen, Sara G., Joan A. Casey, Karen Bandeen-Roche, and Brian S. Schwartz. 2017. "Proximity to Industrial Food Animal Production and Asthma Exacerbations in Pennsylvania, 2005–2012" International Journal of Environmental Research and Public Health 14, no. 4: 362. https://doi.org/10.3390/ijerph14040362