• Air Pollution from Livestock Farms Is Associated with Airway Obstruction in Neighboring Residents.

      Borlée, Floor; Yzermans, C Joris; Aalders, Bernadette; Rooijackers, Jos; Krop, Esmeralda; Maassen, Catharina B M; Schellevis, François; Brunekreef, Bert; Heederik, Dick; Smit, Lidwien A M (2017-11-01)
      Livestock farm emissions may not only affect respiratory health of farmers but also of neighboring residents.
    • Livestock-associated risk factors for pneumonia in an area of intensive animal farming in the Netherlands.

      Freidl, Gudrun S; Spruijt, Ineke T; Borlée, Floor; Smit, Lidwien A M; van Gageldonk-Lafeber, Arianne B; Heederik, Dick J J; Yzermans, Joris; van Dijk, Christel E; Maassen, Catharina B M; van der Hoek, Wim (2017)
      Previous research conducted in 2009 found a significant positive association between pneumonia in humans and living close to goat and poultry farms. However, as this result might have been affected by a large goat-related Q fever epidemic, the aim of the current study was to re-evaluate this association, now that the Q-fever epidemic had ended. In 2014/15, 2,494 adults (aged 20-72 years) living in a livestock-dense area in the Netherlands participated in a medical examination and completed a questionnaire on respiratory health, lifestyle and other items. We retrieved additional information for 2,426/2,494 (97%) participants from electronic medical records (EMR) from general practitioners. The outcome was self-reported, physician-diagnosed pneumonia or pneumonia recorded in the EMR in the previous three years. Livestock license data was used to determine exposure to livestock. We quantified associations between livestock exposures and pneumonia using odds ratios adjusted for participant characteristics and comorbidities (aOR). The three-year cumulative frequency of pneumonia was 186/2,426 (7.7%). Residents within 2,000m of a farm with at least 50 goats had an increased risk of pneumonia, which increased the closer they lived to the farm (2,000m aOR 1.9, 95% CI 1.4-2.6; 500m aOR 4.4, 95% CI 2.0-9.8). We found no significant associations between exposure to other farm animals and pneumonia. However, when conducting sensitivity analyses using pneumonia outcome based on EMR only, we found a weak but statistically significant association with presence of a poultry farm within 1,000m (aOR: 1.7, 95% CI 1.1-2.7). Living close to goat and poultry farms still constitute risk factors for pneumonia. Individuals with pneumonia were not more often seropositive for Coxiella burnetii, indicating that results are not explained by Q fever. We strongly recommend identification of pneumonia causes by the use of molecular diagnostics and investigating the role of non-infectious agents such as particulate matter or endotoxins.
    • Prevalence and risk factors for colonization of Clostridium difficile among adults living near livestock farms in the Netherlands.

      Zomer, T P; VAN Duijkeren, E; Wielders, C C H; Veenman, C; Hengeveld, P; VAN DER Hoek, W; DE Greeff, S C; Smit, L A M; Heederik, D J; Yzermans, C J; et al. (2017)
      A cross-sectional study was performed among 2494 adults not living or working on a farm to assess prevalence of Clostridium difficile (CD) colonization and risk factors in a livestock dense area. CD prevalence was 1·2%. Twenty-one persons were colonized with a toxigenic strain and nine with a non-toxigenic strain. CD-positive persons did not live closer to livestock farms than individuals negative for CD. Antibiotic exposure in the preceding 3 months was a risk factor for CD colonization (odds ratio 3·70; 95% confidence interval 1·25-10·95).
    • Remarkable spatial variation in the seroprevalence of Coxiella burnetii after a large Q fever epidemic.

      Pijnacker, Roan; Reimerink, Johan; Smit, Lidwien A M; van Gageldonk-Lafeber, Arianne B; Zock, Jan-Paul; Borlée, Floor; Yzermans, Joris; Heederik, Dick J J; Maassen, Catharina B M; van der Hoek, Wim (2017)
      Prior to the 2007-2010 Q fever epidemic in the Netherlands, the seroprevalence of antibodies against Coxiella burnetii in the general population was 1.5%, which is low compared to other countries. We aimed to determine the seroprevalence after the Q fever epidemic among people living in the affected area, compare the seroprevalence with the incidence of Q fever notifications during the 2007-2010 Q fever epidemic, and to identify farm exposures associated with having antibodies against C. burnetii.