HOG AND POULTRY CAFOS IN NC AND GEOSPATIAL ASSOCIATIONS WITH INFANT BIRTH OUTCOMES

Concentrated animal feeding operation (CAFO) facilities can emit air- and water-borne contaminants to adjacent environments. Recently there has been increasing concern that these facilities may cause adverse health effects in nearby neighborhoods and residents. North Carolina has a large number of CAFOs, with more than 2000 swine and 4000 poultry facilities state-wide. This study sought to determine whether proximity to CAFOs within NC was associated with adverse health outcomes in families, with a particular focus on birth outcomes. Low birth weight and preterm birth are both risk factors for chronic diseases later in life. Using individual-level birth certificate data (NC Department of Vital Statistics), the NC swine CAFO permit data (NC Department of Environmental Quality), and the NC poultry CAFO locations (Environmental Working Group), this study investigated associations between CAFO size and distance to residence with birth outcomes, and specifically gestational age and infant birth weight. Two models were constructed, one using distance to the nearest CAFO and the second model using kernel density layers; both models were adjusted for potential confounding variables (e.g. maternal race, education, age, etc.) and stratified by infant sex. Results suggest that mothers living within 2 – 5 mi of a poultry CAFOs were 1.13 and 1.14 (p<0.01) times as likely to deliver preterm or low birth weight (LBW) infants, respectively, compared to those living greater than 5 mi from a CAFO. On average, infants (both sexes) born in households within 1 mi, 1 – 2 mi, and 2 – 5 mi radius from a poultry CAFO were born 0.1, 0.08, and 0.09 weeks earlier than those living farther away (p < 0.001). Models using the more sophisticated kernel density approach suggest that the number and size of adjacent hogs CAFOs may influence these outcomes. Although the magnitude of these effects was small, these findings suggest distance to poultry CAFOs may be a risk factor for preterm birth in NC, and interestingly, these effects may be sex-specific.