[Source: PLoS One, full page: (LINK). Abstract, edited.]
OPEN ACCESS / PEER-REVIEWED / RESEARCH ARTICLE
Risk of pneumonia among residents living near goat and poultry farms during 2014-2016
Pim M. Post , Lenny Hogerwerf, Anke Huss, Ronald Petie, Gert Jan Boender, Christos Baliatsas, Erik Lebret, Dick Heederik, Thomas J. Hagenaars, C. Joris IJzermans, Lidwien A. M. Smit
Published: October 14, 2019 / DOI: https://doi.org/10.1371/journal.pone.0223601
In the Netherlands, an association was found between the prevalence of pneumonia and living near goat and poultry farms in 2007–2013. This association then led to regulatory decisions to restrict the building of new goat farms and to reduce emissions of poultry farms. Confirmation of these results, however, is required because the period of previous analyses overlapped a Q-fever epidemic in 2007–2010. To confirm the association, we performed a population-based study during 2014–2016 based on general practitioner (GP) data. Electronic medical records of 90,183 persons were used to analyze the association between pneumonia and the population living in the proximity (within 500–2000 m distance) of goat and poultry farms. Data were analyzed with three types of logistic regression (with and without GP practice as a random intercept and with stratified analyses per GP practice) and a kernel model to discern the influence of different statistical methods on the outcomes. In all regression analyses involving adults, a statistically significant association between pneumonia and residence within 500 meters of goat farms was found (odds ratio [OR] range over all analyses types: 1.33–1.60), with a decreasing OR for increasing distances. In kernel analyses (including all ages), a population-attributable risk between 6.0 and 7.8% was found for a distance of 2000 meters in 2014–2016. The associations were consistent across all years and robust for mutual adjustment for proximity to other animals and for several other sensitivity analyses. However, associations with proximity to poultry farms are not supported by the present study. As the causes of the elevated pneumonia incidence in persons living close to goat farms remain unknown, further research into potential mechanisms is required for adequate prevention.
Citation: Post PM, Hogerwerf L, Huss A, Petie R, Boender GJ, Baliatsas C, et al. (2019) Risk of pneumonia among residents living near goat and poultry farms during 2014-2016. PLoS ONE 14(10): e0223601. https://doi.org/10.1371/journal.pone.0223601
Editor: Eric HY Lau, The University of Hong Kong, CHINA
Received: May 22, 2019; Accepted: September 24, 2019; Published: October 14, 2019
Copyright: © 2019 Post et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: In consultation with the Medical Ethical Committee of the University Medical Centre of Utrecht that approved the study protocol (number 13/533), data are not publicly available due to privacy protection of participants. Sharing an anonymized and de-identified dataset is not possible as it would still contain Electronic Health Records and address data of GP patients, which could potentially lead to the identification of subjects. The data for this study are derived from the NIVEL Primary Care Database. More information about the NIVEL Primary Care Database can be found at https://www.nivel.nl/en/nivel-primary-care-database. Requests for data can be sent to firstname.lastname@example.org. Because of the granularity of the data and the requirements for data protection according to the Dutch Data Protection Act and the General Data Protection Regulation, access to the data is limited. The governance structure (data access committee) of the NIVEL Primary Care Database assesses data requests on data protection, scientific soundness of the request and public interest. Part of the governance structure is the privacy committee of the NIVEL Primary Care Database. For questions on data access, R. Coppen, member of this privacy committee and Data Protection Officer of NIVEL, may be contacted. He is registered as Data Protection Officer at the Dutch Data Protection Authority, see https://autoriteitpersoonsgegevens.nl/nl/onderwerpen/algemene-informatie-avg/functionaris-gegevensbescherming-fg
Funding: The work in this paper was commissioned to the Netherlands Institute for Health Services Research (NIVEL), in collaboration with the Institute for Risk Assessment Sciences (IRAS), Utrecht University, and Wageningen University and Research, The Netherlands. It was funded by the Ministry of Health, Welfare and Sport and the Ministry of Agriculture, Nature and Food Quality of The Netherlands [through grant number BO-43-013.01-007]. PMP analyzed the data as part of his PhD-project, which is supervised by Lenny Hogerwerf and funded by the Strategic Programme (SPR) of the National Institute for Public Health and the Environment (RIVM), The Netherlands. The funding sources had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
Competing interests: The authors have declared that no competing interests exist.
Keywords: Goat; Poultry; Pneumonia; Human; Netherlands.