title: The association between proximity to animal-feeding operations and community health: a protocol for updating a systematic review.
abstract: BACKGROUND
  Livestock and poultry operations that feed large numbers of animals are common. Facility capacity varies, but it is not uncommon for facilities to house 1,000 swine with multiple barns at a single site, feedlots to house 50,000 cattle, and poultry houses to house 250,000 hens. There is primary research that suggests livestock facilities that confine animals indoors for feeding can represent a health hazard for surrounding communities. In this protocol, we describe a review about the association between proximity to animal-feeding operations (AFOs) and the health of individuals in nearby communities. A systematic review of the topic was published by some members of our group in 2010. The purpose of this review is to update that review.
  
  
  METHODS
  The populations of interest are people living in communities near livestock production facilities. Outcomes of interest are any health outcome measured in humans such as respiratory disease, gastrointestinal disease, and mental health. Measures of antibiotic resistance in people from the communities compared to measures of resistance found in animals and the environment on animal-feeding operations will also be summarized. The exposure of interest will be exposure to livestock production using a variety of metrics such as distance from facilities, endotoxin levels, and measures of odor. Electronic searches will be conducted using MEDLINE and MEDLINE In-Process (via OvidSP), CAB Abstracts (via Web of Knowledge), and Science Citation Index (via Web of Knowledge). No language or date restriction will be applied. We will access the risk of bias using a pilot version of a tool developed by the Methods Groups of the Cochrane Collaboration for non-randomized interventions.We propose to conduct a meta-analysis for each health metric (e.g., combining all respiratory disease outcomes, combining all gastrointestinal outcomes). A planned subgroup analysis will be based on the domains of the risk of bias.
  
  
  CONCLUSIONS
  This systematic review will provide synthesis of current evidence reporting the association between living near an animal-feeding operation and human health.
  
  
  BACKGROUND
  PROSPERO CRD42014010521.
authors.affiliation: College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA. oconnor@iastate.edu.
authors.forename: Annette M
authors.initials: AM
authors.lastname: O'Connor
authors.forename: Brent W
authors.initials: BW
authors.lastname: Auvermann
authors.forename: Julian P T
authors.initials: JP
authors.lastname: Higgins
authors.forename: Shelley P
authors.initials: SP
authors.lastname: Kirychuk
authors.forename: Jan M
authors.initials: JM
authors.lastname: Sargeant
authors.forename: Susanna G
authors.initials: SG
authors.lastname: Von Essen
authors.forename: Julie M
authors.initials: JM
authors.lastname: Glanville
authors.forename: Hannah
authors.initials: H
authors.lastname: Wood
mesh_terms: D000821:Animal Feed; D000822:Animal Husbandry / Q000379:methods; D000818:Animals; D024881:Drug Resistance, Bacterial; D004781:Environmental Exposure / Q000009:adverse effects*; D006304:Health Status; D006801:Humans; D058751:Livestock; D008603:Mental Health; D011200:Poultry; D012107:Research Design; D012111:Residence Characteristics; D000078202:Systematic Reviews as Topic