title: Health conditions in rural areas with high livestock density: Analysis of seven consecutive years.
abstract: Previous studies investigating health conditions of individuals living near livestock farms generally assessed short time windows. We aimed to take time-specific differences into account and to compare the prevalence of various health conditions over seven consecutive years. The sample consisted of 156,690 individuals registered in 33 general practices in a (rural) area with a high livestock density and 101,015 patients from 23 practices in other (control) areas in the Netherlands. Prevalence of health conditions were assessed using 2007-2013 electronic health record (EHR) data. Two methods were employed to assess exposure: 1) Comparisons between the study and control areas in relation to health problems, 2) Use of individual estimates of livestock exposure (in the study area) based on Geographic Information System (GIS) data. A higher prevalence of chronic bronchitis/bronchiectasis, lower respiratory tract infections and vertiginous syndrome and lower prevalence of respiratory symptoms and emphysema/COPD was found in the study area compared with the control area. A shorter distance to the nearest farm was associated with a lower prevalence of upper respiratory tract infections, respiratory symptoms, asthma, COPD/emphysema, allergic rhinitis, depression, eczema, vertiginous syndrome, dizziness and gastrointestinal infections. Especially exposure to cattle was associated with less health conditions. Living within 500m of mink farms was associated with increased chronic enteritis/ulcerative colitis. Livestock-related exposures did not seem to be an environmental risk factor for the occurrence of health conditions. Nevertheless, lower respiratory tract infections, chronic bronchitis and vertiginous syndrome were more common in the area with a high livestock density. The association between exposure to minks and chronic enteritis/ulcerative colitis remains to be elucidated.
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513 CR Utrecht, The Netherlands.
authors.forename: Christel E
authors.initials: CE
authors.lastname: van Dijk
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513 CR Utrecht, The Netherlands; ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Dr. Aiguader 88, E-08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè 10, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta, 0 28029 Madrid, Spain.
authors.forename: Jan-Paul
authors.initials: JP
authors.lastname: Zock
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513 CR Utrecht, The Netherlands.
authors.forename: Christos
authors.initials: C
authors.lastname: Baliatsas
authors.affiliation: Utrecht University, Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Yalelaan 2, 2584 CM Utrecht, The Netherlands.
authors.forename: Lidwien A M
authors.initials: LAM
authors.lastname: Smit
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513 CR Utrecht, The Netherlands; Utrecht University, Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Yalelaan 2, 2584 CM Utrecht, The Netherlands.
authors.forename: Floor
authors.initials: F
authors.lastname: Borlée
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513 CR Utrecht, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Spreeuwenberg
authors.affiliation: Utrecht University, Institute for Risk Assessment Sciences (IRAS), Division Environmental Epidemiology, Yalelaan 2, 2584 CM Utrecht, The Netherlands.
authors.forename: Dick
authors.initials: D
authors.lastname: Heederik
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Otterstraat 118-124, 3513 CR Utrecht, The Netherlands. Electronic address: j.yzermans@nivel.nl.
authors.forename: C Joris
authors.initials: CJ
authors.lastname: Yzermans
mesh_terms: D000328:Adult; D000818:Animals; D016022:Case-Control Studies; D005260:Female; D062306:Geography, Medical / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D058751:Livestock; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D015995:Prevalence; D012423:Rural Health / Q000706:statistics & numerical data* / Q000639:trends; D012424:Rural Population / Q000706:statistics & numerical data* / Q000639:trends
keywords: Environmental exposure; Epidemiology; General practice; Livestock; Respiratory health