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. 2017 Mar 31;12(3):e0174796.
doi: 10.1371/journal.pone.0174796. eCollection 2017.

Livestock-associated risk factors for pneumonia in an area of intensive animal farming in the Netherlands

Gudrun S Freidl  1   2 , Ineke T Spruijt  1 , Floor Borlée  3   4 , Lidwien A M Smit  3 , Arianne B van Gageldonk-Lafeber  1 , Dick J J Heederik  3 , Joris Yzermans  4 , Christel E van Dijk  4 , Catharina B M Maassen  1 , Wim van der Hoek  1
Affiliations

Livestock-associated risk factors for pneumonia in an area of intensive animal farming in the Netherlands

Gudrun S Freidl et al. PLoS One. .

Abstract

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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Construction of outcome variable ‘Having had pneumonia in the past three years’ based on information from questionnaires and electronic medical records (EMR).
See this image and copyright information in PMC

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References

    1. Van Os J and Gies T, Grootschalige veehouderij in Nederland—Aantal bedrijven, locaties en milieuvergunningen, in Alterra-rapport. 2011: Wageningen.
    1. Roest H, Tilburg J, Van der Hoek W, Vellema P, van Zijderveld F, Klaassen C, et al., The Q fever epidemic in The Netherlands: history, onset, response and reflection. Epidemiol Infect, 2011. 139(1): p. 1–12. 10.1017/S0950268810002268 - DOI - PubMed
    1. Van der Hoek W, Morroy G, Renders NH, Wever PC, Hermans MH, Leenders AC, et al., Epidemic Q fever in humans in the Netherlands. Adv Exp Med Biol, 2012. 984: p. 329–64. 10.1007/978-94-007-4315-1_17 - DOI - PubMed
    1. Dijkstra F, van der Hoek W, Wijers N, Schimmer B, Rietveld A, Wijkmans CJ, et al., The 2007–2010 Q fever epidemic in The Netherlands: characteristics of notified acute Q fever patients and the association with dairy goat farming. FEMS Immunol Med Microbiol, 2012. 64(1): p. 3–12. 10.1111/j.1574-695X.2011.00876.x - DOI - PubMed
    1. Slok EN, Dijkstra F, de Vries E, Rietveld A, Wong A, Notermans DW, et al., Estimation of acute and chronic Q fever incidence in children during a three-year outbreak in the Netherlands and a comparison with international literature. BMC Res Notes, 2015. 8: p. 456 10.1186/s13104-015-1389-0 - DOI - PMC - PubMed

Grants and funding

The Livestock Farming and Neighbouring Residents’ Health (VGO) study was funded by the Ministry of Health, Welfare and Sports and the Ministry of Economic Affairs of The Netherlands, and supported by a grant from the Lung Foundation Netherlands (Grant number: 3.2.11.022). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.