Livestock Farming and Neighbouring residents* health: The VGO-study

There is an ongoing debate regarding environmental health risks of livestock
farming in the Netherlands. Emerging outbreaks of zoonotic diseases such as
Q-fever and avian influenza have called attention to various human health risks
that may result from building larger and more concentrated types of farms near
residential areas, including current farm locations. Residents of many (new)
urban areas, located less than a few hundreds meters to a few kilometers from
commercial farming activities, may be exposed to harmful infectious and
resistant microorganisms, gases, and dust particles containing toxins. So far,
little is known about health effects of farm-related exposures to dust and
microbial agents among residents.
Between 2009 and 2011, a Dutch study was conducted *Intensieve veehouderij en
Gezondheid* (IVG). This multidisciplinary study explored exposure to PM10 (fine
dust), microbial agents in PM10 and health effects using General Practitioners
(GP) consultation data. In this study, proximity to farms was inversely
associated with asthma, COPD, upper respiratory tracts infection and hay fever
while proximity of a goat or poultry farm was positively associated with
pneumonia. There is little information in literature about health risks for
people living near farms, but the available literature suggests several
potential community health risks, like zoonoses, and respiratory health
effects.

The objective is to investigate whether environmental exposure to livestock
farm emissions in the Netherlands poses a health risk among neighbouring
residents.

Observational cross-sectional study with a longitudinal follow-up of a subgroup
of participants, a longitudinal panel study and a potential outbreak-study.

Participants in the cross-sectional study will be asked to visit a research
center. The use of temporary research centers sets the maximum travel distance
for each participant to 10 km. During the visit to the research center, a
standard forced exhalatory spirometric lung function test will be conducted,
blood (2 * 10 mL and 1 * 5 mL) will be collected via venapuncture, a nasal swab
and a nasal and buccal brush will be taken. Sampling instructions for a faecal
sample will be sent to the participant prior to the survey visit. Faecal
samples will be taken by the participants at home and sent to the laboratory by
mail. The visit (excluding travel time) will take around 45 minutes of time.
For participants who are not able to visit the research center (for instance
physical disabled participants), a nurse practitioner will visit them at their
home address for the lung function test, blood sampling, nasal swab, and nasal
and buccal brush.
In total 25 ESBL positive participants and 25 ESBL negative participants will
be selected from the cross-sectional study and included in the ESBL
longitudinal follow-up study. In total five rectal swabs will be asked from the
participants with an interval of one month. Rectal swabs will be taken by the
participants at home and sent to the laboratory by mail.
For the longitudinal panel study, participants will be asked to register peak
expiratory flow at three moments of the day for up to four periods of two
weeks, in an overall period of 4 months. At the same time presence and severity
of respiratory symptoms, use of medication for respiratory symptoms, and
self-reports of odours will be recorded.
In case of a zoonotic outbreak, participants who give consent will be asked to
fill out a targeted short questionnaire regarding animal contact and other
possible sources of the infection and provide an adequate biological sample(s).