Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Proximity to Industrial Food Animal Production and Asthma Exacerbations in Pennsylvania, 2005-2012

TitleProximity to Industrial Food Animal Production and Asthma Exacerbations in Pennsylvania, 2005-2012
Publication TypeJournal Article
Year of Publication2017
AuthorsRasmussen, SG, Casey, JA, Bandeen-Roche, K, Schwartz, BS
JournalInt J Environ Res Public Health
Date PublishedMar 31
ISBN Number1660-4601
Accession Number28362334
Keywordsasthma, asthma exacerbation, concentrated animal feeding operation (CAFO)

The research on industrial food animal production (IFAP) and asthma exacerbations in the United States has relied on small sample sizes and/or self-reported outcomes. We assessed associations of proximity to large-scale and densely stocked swine and dairy/veal IFAP with three types of asthma exacerbations: hospitalizations, emergency encounters, and oral corticosteroid (OCS) medication orders from Geisinger Clinic in Pennsylvania. We used a diagnosis code (International Classification of Diseases, 9th Revision, Clinical Modification code 493.x) and medication orders from electronic health records to identify these exacerbations among asthma patients (n = 35,269) from 2005-2012. We compared residential proximity to swine or dairy/veal IFAP (dichotomized as <3 miles (4.8 km) or >/=3 miles) among asthma patients with and without exacerbations and estimated odds ratios using multilevel logistic regression. In adjusted models, proximity to IFAP was associated (odds ratio (95% confidence interval)) with OCS orders (1.11 (1.04-1.19)) and hospitalizations (1.29 (1.15-1.46)), but not emergency encounters (1.12 (0.91-1.37)). This study contributes to growing evidence that IFAP may impact health, in this case clinically-documented asthma exacerbations. No prior study has evaluated the association of IFAP and clinically-documented asthma exacerbations in the United States.