Source: International Congress 2014 – Chronic and acute environmental exposure effect during childhood and in the elderly

Abstract

Living in the neighbourhood of a high density of livestock farms has been associated with adverse respiratory health effects. Little is known about the effects of livestock farming on health care utilisation. Our aim was to investigate associations between proximity to livestock farms and contacts for respiratory disorders in general practice. Electronic medical records of 54,777 patients of 16 general practices in an area with a high density of livestock farms in the Netherlands were analysed. Outcomes were the total number of contacts in general practice, respiratory contacts, and contacts related to acute respiratory infections. Livestock-related exposures at the home address were defined as i) distance to livestock farms and ii) particulate matter (PM)10 emissions from farms within 500 m. Associations between the number of contacts and livestock-related exposures were evaluated using Poisson multilevel regression analyses adjusted for age, gender, chronic diseases and distance to the general practice. Patients living closer to livestock farms and/or with higher PM10 emissions levels had fewer contacts with their general practitioner. Similar results were found for respiratory contacts and contacts related to acute respiratory infections. Patients living further away from their general practitioner had fewer contacts, but did not confound the association with livestock exposures. We conclude that people living in the proximity of livestock farming less often see their general practitioner. This may reflect a different health care seeking behaviour of these patients, and has important implications for epidemiological studies on proximity to farms and health care utilisation for respiratory problems.

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C. van Dijk, L. Smit, J. P. Zoch, M. Hooiveld, I. Wouters, D. Heederik, J. Yzermans (Utrecht, Netherlands). People living close to livestock farms less often see their general practitioner. Eur Respir J 2014; 44: Suppl. 58, 4965

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