Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands; Institute for Risk Assessment Sciences, Division Environmental Epidemiology and Veterinary Public Health, Utrecht University, The Netherlands.
Institute for Risk Assessment Sciences, Division Environmental Epidemiology and Veterinary Public Health, Utrecht University, The Netherlands.
Environ Int. 2018 Jun;115:150-160. doi: 10.1016/j.envint.2018.03.020. Epub 2018 Mar 28.
We previously observed an increased incidence of pneumonia in persons living near goat and poultry farms, using animal presence around the home to define exposure. However, it is unclear to what extent individual mobility and time spent outdoors close to home contributes to this increased risk. Therefore, the aim of the current study was to investigate the role of mobility patterns and time spent outdoors in the vicinity of goat or poultry farms in relation to pneumonia risk. In a rural Dutch cohort, 941 members logged their mobility using GPS trackers for 7 days. Pneumonia was diagnosed in 83 subjects (participants reported that pneumonia had been diagnosed by a medical doctor, or recorded in EMR from general practitioners, 2011-2014). We used logistic regression to evaluate pneumonia-risk by presence of goat farms within 500 and 1000 m around the home and around GPS-tracks (only non-motorised mobility), also we evaluated whether more time spent outdoors increased pneumonia-risks. We observed a clearly increased risk of pneumonia among people living in close proximity to goat farms, ORs increased with closer distances of homes to farms (500 m: 6.2 (95% CI 2.2-16.5) 1000 m: 2.5 (1.4-4.3)) The risk increased for individuals who spent more time outdoors close to home, but only if homes were close to goat farms (within 500 m and often outdoors: 12.7 (3.6-45.4) less often: 2.0 (0.3-9.2), no goat farms and often outdoors: 1.0 (0.6-1.6)). For poultry we found no increased risks. Pneumonia-risks increased when people lived near goat farms, especially when they spent more time outdoors, mobility does not seem to add to these risks.
我们之前观察到,居住在靠近山羊和家禽养殖场附近的人患肺炎的发病率增加,使用家庭周围动物的存在来定义暴露。然而,目前尚不清楚个人的活动范围和在家附近户外逗留的时间在多大程度上导致了这种风险的增加。因此,本研究旨在调查与肺炎风险相关的山羊或家禽养殖场附近的活动模式和户外时间的作用。在一个荷兰农村队列中,941 名成员使用 GPS 追踪器记录了他们的活动范围,时长为 7 天。在 83 名研究对象中诊断出肺炎(参与者报告肺炎是由医生诊断的,或者在 2011-2014 年从全科医生的电子病历中记录的)。我们使用逻辑回归评估了家庭周围 500 和 1000 米范围内以及 GPS 轨迹周围(仅非机动活动)存在山羊养殖场与肺炎风险之间的关系,还评估了在户外逗留的时间是否会增加肺炎风险。我们发现,居住在离山羊养殖场较近的人患肺炎的风险明显增加,OR 随着家庭与农场的距离越来越近而增加(距离 500 米:6.2(95%CI 2.2-16.5),距离 1000 米:2.5(1.4-4.3))。对于那些在家附近户外逗留时间较长的人来说,风险也会增加,但前提是他们的家靠近山羊养殖场(距离 500 米且经常在户外:12.7(3.6-45.4),不太经常:2.0(0.3-9.2),没有山羊养殖场且经常在户外:1.0(0.6-1.6))。对于家禽,我们没有发现风险增加。当人们住在山羊养殖场附近时,肺炎的风险会增加,尤其是当他们在户外逗留的时间更多时,活动范围似乎不会增加这些风险。