Poultry Production in Maryland: Environmental Impacts and Community Health Issues

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Poultry Production in Maryland Environmental
Impacts and Community Health Issues

• Ellen Silbergeld
• EHS/BSPH
• July 2006

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Research at JHSPH on Poultry Production

• EPIDEMIOLOGY
• EXPOSURE, HEALTH OUTCOMES
• PRODUCT MONITORING
• POULTRY PRODUCTS TESTING
• ENVIRONMENTAL STUDIES
• PATHWAYS AND ROUTES OF EXPOSURE
• AIR, WATER, DUSTS, SOILS
• BIOTIC TRANSFERS WILDLIFE STUDIES
• MOLECULAR MICROBIOLOGY
• TRACKING PATHOGEN MOVEMENT
• TRACKING GENE TRANSFER
• MICROBIAL POPULATION GENETICS/DIVERSITY
• POLICY ANALYSIS
• ECONOMIC ANALYSES
• SCIENTIFIC BASIS for RISK ASSESSMENT

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The CAFO (Concentrated Animal Feeding Operation)
Changes in Food Animal Production since1930

• Factory farms integrated production model
• Concentrated, high volume housing and processing
• Highly intensive localization
• Broad integration of food production and
  distribution

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THE GEOGRAPHIC CONCENTRATION OF POULTRY
PRODUCTION 50 YEARS in US
US poultry production, 1949 Each dot 50,000
chickens
US poultry production 1991 Each dot 740,000
chickens
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DELMARVA POULTRY INDUSTRY

• 600-800 million broiler chickens produced
  annually.
• 6000 broiler chicken houses
• 2,500 chicken growers
• 15,000 poultry employees
• Total annual gross income of Delmarva broiler
  industry exceeds 1.3 billion dollars.

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Many Nonfood Routes of Exposure and Transfer
ENVIRONMENT rivers and streams
Irrigation Drinking water
Bay
Manure spreading
Swimming
Farm effluents
Sewage
Offal
FARMS
HUMANS
Slaughter Harvesting Processing
Handling Preparation Consumption
Animal feeds
Farmers, workers, communities

• High Risk Populations
• Children
• Elderly
• Immunocompromised

Contact
Adapted from Dr. Ruth Etzel USDA
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THE OTHER PRODUCT OF CAFOs
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The DelMarVa Penninsula The other product of
poultry production

• gt1,000,000 tons of manure produced by 800
  million chickens/yr
• Integrators own the birds
• Growers own the waste
• Management - largely land applied

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Why are we concerned?

• More biosolids applied than
  land can handle
• Contributes to surface and groundwater
  contamination
• Increased nutrient runoff into surface waters
• Detectable presence of drugs and resistance
  determinants in groundwater

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WHO IS AT RISK FOR EXPOSURE?

• Workers and growers who work in broiler houses
• Workers who handle live chickens at processing
  plants
• Household members of these persons
• Community residents

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The Poultry Environment Health Study

• HYPOTHESES
• PERSONS WITH DIRECT EXPOSURE TO THE POULTRY
  ENVIRONMENT ARE AT INCREASED RISK OF EXPOSURE TO
  ABR
• EXPOSED PERSONS ARE AT INCREASED RISK OF
  BACTERIA-ASSOCIATED OUTCOMES
• THERE IS A GRADIENT OF EXPOSURE, AND HEALTH RISK,
  AMONG WORKERS, THEIR FAMILIES AND THE COMMUNITY

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The Poultry Environment Health Study

• SUBJECTS
• POULTRY HOUSE WORKERS
• LIVE HANGERS
• GROWERS
• HOUSEHOLD MEMBERS
• COMMUNITY RESIDENTS

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Working in the poultry industry
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Living near the poultry industry
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The Poultry Environment Health Study

• EXPOSURE RISKS
• PATHOGENS
• ANTIBIOTIC RESISTANCE
• ANTIBIOTICS
• ARSENIC
• PATHWAYS
• AIR, WATER, DUSTS, WILDLIFE, CAUGHT FISH, FOOD
  PLANTS

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AIRBORNE BACTERIA IN CAFOS ARE MULTI DRUG
RESISTANT
VAN-R
MDR ERYTH-R TET-R
VM-R
Chapin et al (2005) EHP
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Air releases from CAFO ventilation systems
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The Poultry Environment Health Study

• OUTCOMES
• BACTERIAL CARRIAGE
• REPORTED DIARRHEAL DISEASE
• RESPIRATORY FUNCTION TESTS
• NEUROLOGICAL SYMPTOMS
• METHODS
• ISOLATION OF BACTERIA FROM STOOL MEASUREMENT OF
  ANTIBODIES IN SERA
• QUESTIONNAIRES
• RESPIRATORY FUNCTION TESTING

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Poultry Health Study Health Status in poultry
workers Preliminary Results

• Self reported symptoms PW and referents
• PW report more frequent GI symptoms
• OR 2-5
• PW report much more frequent respiratory symptoms
• OR 2.6-35
• PW report much more frequent neuromuscular
  symptoms, including paralysis, problems with
  vision and speech
• OR 5.4-13.8

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Arsenic sources - US
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ARSENIC THE FORGOTTEN ANTIBIOTIC

• extensive use of arsenicals in broiler feeds
• documented contamination of waste and amended
  land
• percolation into groundwater
• arsenic is a human carcinogen and associated with
  skin, liver, and cardiovascular disease

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ARSENIC and POULTRY

• Roxarsone, arsanilic acid used in poultry as
  coccidiostats and growth promoters 45 g/ton
  feed
• GP continuous lifelong exposure in feeds
• arsenicals excreted (gt70)
• 100-200 mg/bird (900 million/yr)
• 50,000-90,000 mt/year arsenic
• arsenicals inorganic arsenic
• leach into groundwater

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SHALLOW AQUIFERS IN DELMARVA
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A SUGGESTIVE TRACE?
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What does this tell us about avian flu?
?
?
?
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Wild avians contact poultry houses
Photo courtesy of Dr Donald Burke
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What are the risks of occupational contact and AF
exposure?

• Three papers
• Koopmans et al (2004)
• National surveillance study in Netherlands
  symptom driven
• 2003 H7N7 outbreak HPAI
• All farmers, workers, families, veterinarians in
  outbreak regions
• Bridges et al (2001)
• Outbreak investigation of poultry workers and
  govt investigators
• Hong Kong 1997-8 H5N1
• Myers et al (2006)
• Cross sectional study of Iowa pork farmers, meat
  processing workers, veterinarians Univ of Iowa
  referent group
• Swine influenza transmission risks

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Risks of Influenza A/ (H5/N1) infection in
poultry workers Hong Kong 1997-8

• Odds of antibody carriage
• Farm/hatchery workers 2.7
• Work on farm gt10 bird mortality 2.2
• Touching live poultry 5.8
• Feeding live poultry 2.4
• Butchering live poultry 3.1
• referents government workers

Occupational dose response observed
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ACKNOWLEDGEMENTS

• STUDENTS
• Jon Furuno, Amy Chapin, Lance Price, Jay Graham,
  Amira Roess, Meche Nweke, Keeve Nachman, Carter
  Erwin, Patrick Butler, Redwan Huq,
• COLLEAGUES
• Carol Resnick, Rocio Vailes, Pat Charache,
  Kellogg Schwab, Rolf Halden, Pat Breysse, Bill
  Spannhake, Kris Macri, Tim Buckley, Pat Charache,
  John Griffin, Kazim Sheikh, Vasken Aposhian,
  Tracy Hancock, Henrik Wegener
• Carole Morison, Patrick Harmon, Jim Lewis, Pilar
  Perez, Jackie Nowell -- UFCW
• FUNDING
• CLF, Grace, HHMI, NIOSH, Winslow and Baker
  Foundations