Risk of respiratory hospital admission associated with modelled concentrations of Aspergillus fumigatus from composting facilities in England
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Supporting information
Published version
Author(s)
Type
Journal Article
Abstract
Bioaerosols have been associated with adverse respiratory-related health effects and are emitted in elevated concentrations from composting facilities. We usedmodelledAspergillus fumigatusconcentrations, a good indicator for bioaerosol emissions,to assess associations with respiratory-related hospital admissions. Mean dailyAspergillus fumigatusconcentrationswere estimated for each composting site for first full year of permit issuefrom2005 onwardsto 2014 for Census Output Areas (COAs) within 4km of 76 composting facilities in England, as previously described (Williams et al. 2019). We fitted ahierarchicalgeneralized mixed modelto examine therisk of hospital admission witha primary diagnosis of(i) any respiratory condition,(ii) respiratory infections,(iii) asthma,(iv) COPD,(v)diseases due to organic dust,and (vi)Cystic Fibrosis,inrelation to quartilesof Aspergillus fumigatusconcentrations. Models included a random intercept for each COAto account for over-dispersion,nested within composting facility, on whicha random intercept was fitted to account for clusteringof the data, with adjustmentsfor age, sex, ethnicity, deprivation, tobacco sales (smoking proxy) and traffic load (as a proxy for traffic-related air pollution). Weincluded 249,748 respiratory-related and 3,163 Cystic Fibrosis hospital admissions in 9,606 COAswith a population-weighted centroid within 4 km of the 76 included composting facilities. After adjustment for confounders, no statistically significant effect was observed for any respiratory-related (Relative Risk (RR)=0.99; 95% Confidence Interval (CI)0.96–1.01)or for Cystic Fibrosis (RR=1.01; 95% CI 0.56-1.83)hospital admissions for COAs in the highest quartile of exposure. Similar results were observed across all respiratory disease sub-groups.This study does not provide evidence for increased risks of respiratory-related hospitalisationsfor those livingnearcomposting facilities.However, given the limitations in the dispersion modelling, risks cannot be completelyruled out.Hospital admissions represent severe respiratory episodes, sofurther study would be needed to investigate whether bioaerosols emitted from compostingfacilitieshave impacts on less severeepisodes or respiratory symptoms.
Date Issued
2020-04
Date Acceptance
2019-11-18
Citation
Environmental Research, 2020, 183, pp.1-10
ISSN
0013-9351
Publisher
Elsevier
Start Page
1
End Page
10
Journal / Book Title
Environmental Research
Volume
183
Copyright Statement
© 2019 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/BY/4.0/).T
Identifier
https://www.sciencedirect.com/science/article/pii/S0013935119307467?via%3Dihub
Subjects
Aspergillus fumigatus
Asthma
Bioaerosol
Composting facility
Respiratory health
03 Chemical Sciences
05 Environmental Sciences
06 Biological Sciences
Toxicology
Publication Status
Published
Date Publish Online
2020-01-03