title: Odour annoyance in the neighbourhood of livestock farming - perceived health and health care seeking behaviour.
abstract: OBJECTIVE
  Odour annoyance forms the main source of environmental stress in residents living in the proximity of animal feeding operations (AFOs) and it has been associated with reduced health. This study aims to gain more insight into the association between AFOs in the neighbourhood, odour annoyance, other environmental stressors, and health, and incorporates health care seeking behaviour for reported symptoms.
  
  
  METHODS
  Cross-sectional data from 753 people living in an area in the Netherlands with a high density of AFOs was evaluated. Odour and other environmental annoyances in the neighbourhood, general health and symptom reporting were obtained by questionnaire. Health care utilisation was obtained from electronic medical records of general practices. The number of pigs, poultry and cattle within a 500 m radius from homes was computed using Geographic Information System data. Mutually adjusted multiple Poisson and (ordinal) logistic regression analyses were performed.
  
  
  RESULTS
  The number of pigs, poultry and cattle was equally associated with odour annoyance. This annoyance was associated with reduced general health and increased reporting of respiratory, gastrointestinal, neurological and stress-related symptoms. Participants rarely consulted their general practitioner for reported symptoms. Environmental stressors were weakly associated.
  
  
  CONCLUSIONS
  The number of animals around the homes was associated with odour annoyance. Odour annoyance was associated with reduced health, which could be a reason for caution with the construction of new AFOs.
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands.
authors.forename: Mariette
authors.initials: M
authors.lastname: Hooiveld
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands.
authors.forename: Christel
authors.initials: C
authors.lastname: van Dijk
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands.
authors.forename: Femke
authors.initials: F
authors.lastname: van der Sman-de Beer
authors.affiliation: Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, the Netherlands.
authors.forename: Lidwien A M
authors.initials: LA
authors.lastname: Smit
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands.
authors.forename: Maartje
authors.initials: M
authors.lastname: Vogelaar
authors.affiliation: Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, the Netherlands.
authors.forename: Inge M
authors.initials: IM
authors.lastname: Wouters
authors.affiliation: Institute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, the Netherlands.
authors.forename: Dick J
authors.initials: DJ
authors.lastname: Heederik
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands.
authors.forename: C Joris
authors.initials: CJ
authors.lastname: Yzermans
mesh_terms: D000293:Adolescent; D000328:Adult; D000397:Air Pollution / Q000032:analysis*; D000822:Animal Husbandry; D000818:Animals; D002417:Cattle; D003430:Cross-Sectional Studies; D004781:Environmental Exposure; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009812:Odorants / Q000032:analysis*; D010342:Patient Acceptance of Health Care; D011200:Poultry; D011795:Surveys and Questionnaires; D034421:Sus scrofa; D055815:Young Adult