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dc.contributor.authorFreidl, Gudrun S
dc.contributor.authorSpruijt, Ineke T
dc.contributor.authorBorlée, Floor
dc.contributor.authorSmit, Lidwien A M
dc.contributor.authorvan Gageldonk-Lafeber, Arianne B
dc.contributor.authorHeederik, Dick J J
dc.contributor.authorYzermans, Joris
dc.contributor.authorvan Dijk, Christel E
dc.contributor.authorMaassen, Catharina B M
dc.contributor.authorvan der Hoek, Wim
dc.date.accessioned2018-02-07T08:06:17Z
dc.date.available2018-02-07T08:06:17Z
dc.date.issued2017
dc.identifier.citationLivestock-associated risk factors for pneumonia in an area of intensive animal farming in the Netherlands. 2017, 12 (3):e0174796 PLoS ONEen
dc.identifier.issn1932-6203
dc.identifier.pmid28362816
dc.identifier.doi10.1371/journal.pone.0174796
dc.identifier.urihttp://hdl.handle.net/10029/621345
dc.description.abstractPrevious 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.
dc.language.isoenen
dc.rightsArchived with thanks to PloS oneen
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAnimal Husbandry
dc.subject.meshAnimals
dc.subject.meshAnimals, Domestic
dc.subject.meshCoxiella burnetii
dc.subject.meshElectronic Health Records
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshLivestock
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshNetherlands
dc.subject.meshPneumonia
dc.subject.meshQ Fever
dc.subject.meshRisk Factors
dc.subject.meshYoung Adult
dc.titleLivestock-associated risk factors for pneumonia in an area of intensive animal farming in the Netherlands.en
dc.typeArticleen
dc.identifier.journalPlos One 2017; 12(3)e0174796en
html.description.abstractPrevious 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.


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