Community and environmental health effects of concentrated animal feeding operations.

High-density concentrated animal feeding operations (CAFOs) have become an increasing source of concern with respect to their impact on health, the environment, and quality of life in the communities in which they are located. A growing body of literature has identified a number of potential adverse effects, including the development of antimicrobial resistance patterns, groundwater contamination, and occupational respiratory disease. The odor associated with CAFOs has had a detrimental effect on the quality of life of rural residents, and there may also be associated adverse health effects. Physicians in rural areas may be asked to assess patients with concerns related to neighboring CAFOs and may be drawn into a political battle regarding the authorization of the development of additional CAFOs. This article reviews current research on the community, environmental, and occupational health effects associated with high-density animal production facilities. It also discusses recommendations for evaluating patients affected by CAFO odors and steps to decrease occupational and community exposure.