van Dijk Christel E, Zock Jan-Paul, Baliatsas Christos, Smit Lidwien A M, Borlée Floor, Spreeuwenberg Peter, Heederik Dick, Yzermans C Joris
NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513 CR Utrecht, The Netherlands.
NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513 CR Utrecht, The Netherlands; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Dr. Aiguader 88, E-08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta, 0 28029 Madrid, Spain.
Environ Pollut. 2017 Mar;222:374-382. doi: 10.1016/j.envpol.2016.12.023. Epub 2016 Dec 30.
Previous studies investigating health conditions of individuals living near livestock farms generally assessed short time windows. We aimed to take time-specific differences into account and to compare the prevalence of various health conditions over seven consecutive years. The sample consisted of 156,690 individuals registered in 33 general practices in a (rural) area with a high livestock density and 101,015 patients from 23 practices in other (control) areas in the Netherlands. Prevalence of health conditions were assessed using 2007-2013 electronic health record (EHR) data. Two methods were employed to assess exposure: 1) Comparisons between the study and control areas in relation to health problems, 2) Use of individual estimates of livestock exposure (in the study area) based on Geographic Information System (GIS) data. A higher prevalence of chronic bronchitis/bronchiectasis, lower respiratory tract infections and vertiginous syndrome and lower prevalence of respiratory symptoms and emphysema/COPD was found in the study area compared with the control area. A shorter distance to the nearest farm was associated with a lower prevalence of upper respiratory tract infections, respiratory symptoms, asthma, COPD/emphysema, allergic rhinitis, depression, eczema, vertiginous syndrome, dizziness and gastrointestinal infections. Especially exposure to cattle was associated with less health conditions. Living within 500m of mink farms was associated with increased chronic enteritis/ulcerative colitis. Livestock-related exposures did not seem to be an environmental risk factor for the occurrence of health conditions. Nevertheless, lower respiratory tract infections, chronic bronchitis and vertiginous syndrome were more common in the area with a high livestock density. The association between exposure to minks and chronic enteritis/ulcerative colitis remains to be elucidated.
以往调查畜牧场附近居民健康状况的研究通常评估的是较短的时间窗。我们旨在考虑特定时间的差异,并比较连续七年中各种健康状况的患病率。样本包括荷兰一个畜牧密度高的(农村)地区33家普通诊所登记的156,690人,以及其他(对照)地区23家诊所的101,015名患者。使用2007 - 2013年电子健康记录(EHR)数据评估健康状况的患病率。采用两种方法评估暴露情况:1)研究区域与对照区域在健康问题方面的比较;2)基于地理信息系统(GIS)数据对(研究区域内)个体的畜牧暴露进行估计。与对照区域相比,研究区域慢性支气管炎/支气管扩张、下呼吸道感染和眩晕综合征的患病率较高,而呼吸道症状以及肺气肿/慢性阻塞性肺疾病(COPD)的患病率较低。与最近农场的距离越短,上呼吸道感染、呼吸道症状、哮喘、COPD/肺气肿、过敏性鼻炎、抑郁症、湿疹、眩晕综合征、头晕和胃肠道感染的患病率越低。特别是接触牛与较少的健康问题相关。居住在水貂养殖场500米范围内与慢性肠炎/溃疡性结肠炎患病率增加有关。与畜牧相关的暴露似乎并不是健康状况发生的环境风险因素。然而,在畜牧密度高的地区,下呼吸道感染、慢性支气管炎和眩晕综合征更为常见。水貂暴露与慢性肠炎/溃疡性结肠炎之间的关联仍有待阐明。