Borlée Floor, Yzermans C Joris, Oostwegel Floor S M, Schellevis François, Heederik Dick, Smit Lidwien A M
Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
Netherlands Institute for Health Services Research, NIVEL, Utrecht, The Netherlands.
Environ Epidemiol. 2019 Apr 12;3(2):e041. doi: 10.1097/EE9.0000000000000041. eCollection 2019 Apr.
Attitudes toward environmental risks may be a source of bias in environmental health studies because concerns about environmental hazards may influence self-reported outcomes.
The main aim was to assess whether earlier observed associations between proximity to goat farms and self-reported pneumonia were biased by participants' attitude toward farming.
We developed an attitude-score for 2,457 participants of the Dutch Livestock Farming and Neighbouring Residents' Health Study (veehouderij en gezondheid omwonenden) by factor analysis of 13 questionnaire items related to attitude toward livestock farming. Linear regression analysis was used to assess associations between attitude and potential determinants. The effect of attitude on the association between goat farm proximity and pneumonia was analyzed by evaluating (1) misclassification of the outcome, (2) effect modification by attitude, and (3) exclusion of participants reporting health problems due to farms in their environment.
In general, the study population had a positive attitude toward farming, especially if participants were more familiar with farming. Older participants, females, ex-smokers, and higher-educated individuals had a more negative attitude. Both self-reported respiratory symptoms and exposure to livestock farms were associated with a more negative attitude. Misclassification of self-reported pneumonia was nondifferential with regard to participants' attitude. Furthermore, no indication was found that the association between proximity to goat farms and pneumonia was modified by attitude. Excluding subjects who attributed their health symptoms to livestock farms did also not change the association.
The association between goat farm proximity and pneumonia was not substantially biased by study participants' attitude toward livestock farming.
对环境风险的态度可能是环境卫生研究中偏差的一个来源，因为对环境危害的担忧可能会影响自我报告的结果。
主要目的是评估早期观察到的靠近山羊养殖场与自我报告的肺炎之间的关联是否因参与者对养殖的态度而产生偏差。
我们通过对与对畜牧业态度相关的13个问卷项目进行因子分析，为荷兰畜牧业与周边居民健康研究（veehouderij en gezondheid omwonenden）的2457名参与者制定了一个态度得分。线性回归分析用于评估态度与潜在决定因素之间的关联。通过评估（1）结果的错误分类、（2）态度的效应修正以及（3）排除报告因周围农场导致健康问题的参与者，分析态度对靠近山羊养殖场与肺炎之间关联的影响。
总体而言，研究人群对养殖持积极态度，尤其是那些对养殖更熟悉的参与者。年龄较大的参与者、女性、曾经吸烟者和受过高等教育的人态度更为消极。自我报告的呼吸道症状和接触畜牧场都与更消极的态度相关。自我报告肺炎的错误分类在参与者态度方面无差异。此外，没有迹象表明靠近山羊养殖场与肺炎之间的关联因态度而改变。排除将健康症状归因于畜牧场的受试者也没有改变这种关联。
靠近山羊养殖场与肺炎之间的关联并未因研究参与者对畜牧业的态度而产生实质性偏差。
