Industrial Food Animal Production and Community Health

Current environmental health reports

Volumn 2, Issue 3, 2015, Pages 259-271

  Casey, Joan A ^a   Kim, Brent F ^b   Larsen, Jesper ^c   Price, Lance B ^d,e   Nachman, Keeve E ^b  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH   (United States)

^c STATENS SERUM INSTITUT   (Denmark)

^d GEORGE WASHINGTON UNIVERSITY   (United States)

^e TRANSLATIONAL GENOMICS RESEARCH INSTITUTE   (United States)

Author keywords

Air pollution; Asthma; CAFOs; IFAP; Odor; Zoonotic disease

Indexed keywords

MANURE;

ADVERSE EFFECTS; AIR POLLUTION; ANIMAL; ANIMAL HUSBANDRY; ASTHMA; HUMAN; LIVESTOCK; MANURE; MICROBIOLOGY; POULTRY; PROCEDURES; PUBLIC HEALTH; RISK FACTOR; RURAL POPULATION; TRANSMISSION; ZOONOSIS;

AIR POLLUTION; ANIMAL HUSBANDRY; ANIMALS; ASTHMA; ENVIRONMENTAL MICROBIOLOGY; HUMANS; LIVESTOCK; MANURE; POULTRY; PUBLIC HEALTH; RISK FACTORS; RURAL POPULATION; ZOONOSES;

EID: 84949214429     PISSN: None     EISSN: 21965412     Source Type: Journal    
DOI: 10.1007/s40572-015-0061-0     Document Type: Review

References (119)

1. Constance DH. The southern model of broiler production and its global implications. Cult Agric. 2008;30(1‐2):17–31.
2. Hartung J. A short history of livestock production. In: Banhazi AAT, ed. Livestock housing: modern management to ensure optimal health and welfare of farm animals. Wageningen: Wageningen Academic Publishers, 2013:21-34.
3. USDA. 2012 U.S. Census of Agriculture. Available: http://www.agcensus.usda.gov/Publications/2012/ - full_report. Accessed 6 May 2015.
4. Price LB, Koch BJ, Hungate BA. Ominous projections for global antibiotic use in food-animal production. Proc Natl Acad Sci U S A. 2015;112(18):5554–5.
5. Rinsky JL, Nadimpalli M, Wing S, et al. Livestock-associated methicillin and multidrug resistant Staphylococcus aureus is present among industrial, not antibiotic-free livestock operation workers in North Carolina. PLoS One. 2013;8(7):e67641.
6. Juska A. “Profits to the Danes, for us–hog stench?” The campaign against Danish swine CAFOs in rural Lithuania. J Rural Stud. 2010;26(3):250–9.
7. Friese A, Schulz J, Zimmermann K, et al. Occurrence of livestock-associated methicillin-resistant Staphylococcus aureus in turkey and broiler barns and contamination of air and soil surfaces in their vicinity. Appl Environ Microbiol. 2013;79(8):2759–66.
8. Schulz J, Friese A, Klees S, et al. Longitudinal study of the contamination of air and of soil surfaces in the vicinity of pig barns by livestock-associated methicillin-resistant Staphylococcus aureus. Appl Environ Microbiol. 2012;78(16):5666–71.
9. Leedom Larson KR, Harper AL, Hanson BM, et al. Methicillin-resistant Staphylococcus aureus in pork production shower facilities. Appl Environ Microbiol. 2011;77(2):696–8.
10. Novais C, Freitas AR, Silveira E, et al. Spread of multidrug-resistant Enterococcus to animals and humans: an underestimated role for the pig farm environment. J Antimicrob Chemother. 2013;68(12):2746–54.
11. Graham JP, Evans SL, Price LB, et al. Fate of antimicrobial-resistant enterococci and staphylococci and resistance determinants in stored poultry litter. Environ Res. 2009;109(6):682–9.
12. Jahne MA, Rogers SW, Ramler IP, et al. Hierarchal clustering yields insight into multidrug-resistant bacteria isolated from a cattle feedlot wastewater treatment system. Environ Monit Assess. 2015;187(1):1–15.
13. Koike S, Krapac IG, Oliver HD, et al. Monitoring and source tracking of tetracycline resistance genes in lagoons and groundwater adjacent to swine production facilities over a 3-year period. Appl Environ Microbiol. 2007;73(15):4813–23.
14. Brooks JP, Adeli A, McLaughlin MR. Microbial ecology, bacterial pathogens, and antibiotic resistant genes in swine manure wastewater as influenced by three swine management systems. Water Res. 2014;57:96–103.
15. Hölzel CS, Schwaiger K, Harms K, et al. Sewage sludge and liquid pig manure as possible sources of antibiotic resistant bacteria. Environ Res. 2010;110(4):318–26.
16. Sapkota AR, Michael Hulet R, Zhang G, et al. Lower prevalence of antibiotic-resistant enterococci on US conventional poultry farms that transitioned to organic practices. Environ Health Perspect. 2011;119(11):1622.
17. Ahmad A, Ghosh A, Schal C, et al. Insects in confined swine operations carry a large antibiotic resistant and potentially virulent enterococcal community. BMC Microbiol. 2011;11(1):23.
18. Graham JP, Price LB, Evans SL, et al. Antibiotic resistant enterococci and staphylococci isolated from flies collected near confined poultry feeding operations. Sci Total Environ. 2009;407(8):2701–10.
19. Van de Giessen A, van Santen-Verheuvel M, Hengeveld P, et al. Occurrence of methicillin-resistant Staphylococcus aureus in rats living on pig farms. Prev Vet Med. 2009;91(2):270–3.
20. Alvarado CS, Gandara A, Flores C, et al. Seasonal changes in airborne fungi and bacteria at a dairy cattle concentrated animal feeding operation in the southwest United States. J Environ Health. 2009;71(9):40–4.
21. Chapin A, Rule A, Gibson K, et al. Airborne multidrug-resistant bacteria isolated from a concentrated swine feeding operation. Environ Health Perspect. 2005;113(2):137-42
22. Brooks J, McLaughlin M, Scheffler B, et al. Microbial and antibiotic resistant constituents associated with biological aerosols and poultry litter within a commercial poultry house. Sci Total Environ. 2010;408(20):4770–7.
23. Schulze A, van Strien R, Ehrenstein V, et al. Ambient endotoxin level in an area with intensive livestock production. Ann Agric Environ Med. 2006;13(1):87–91.
24. Winkel A, Mosquera J, Koerkamp PWG, et al. Emissions of particulate matter from animal houses in the Netherlands. Atmos Environ. 2015;111:202–12.
25. Donham KJ, Lee JA, Thu K, et al. Assessment of air quality at neighbor residences in the vicinity of swine production facilities. J Agromedicine. 2006;11(3-4):15–24.
26. Wilson SM, Serre ML. Examination of atmospheric ammonia levels near hog CAFOs, homes, and schools in Eastern North Carolina. Atmos Environ. 2007;41(23):4977–87.
27. Wing S, Horton RA, Marshall SW, et al. Air pollution and odor in communities near industrial swine operations. Environ Health Perspect. 2008;116(10):1362–8.
28. Donham KJ, Popendorf WJ. Ambient levels of selected gases inside swine confinement buildings. Am Ind Hyg Assoc J. 1985;46(11):658–61.
29. Donham KJ, Lee JA, Thu K, et al. Assessment of air quality at neighbor residences in the vicinity of swine production facilities. J Agromedicine. 2006;11(3-4):15–24.
30. Gibbs SG, Green CF, Tarwater PM, et al. Isolation of antibiotic-resistant bacteria from the air plume downwind of a swine confined or concentrated animal feeding operation. Environ Health Perspect. 2006;114(7):1032–7.
31. McEachran AD, Blackwell BR, Hanson JD, et al. Antibiotics, bacteria, and antibiotic resistance genes: aerial transport from cattle feed yards via particulate matter. Environ Health Perspect. 2015;123(4):337–43.
32. Schulze A, Rommelt H, Ehrenstein V, et al. Effects on pulmonary health of neighboring residents of concentrated animal feeding operations: exposure assessed using optimized estimation technique. Arch Environ Occup Health. 2011;66(3):146–54.
33. Heederik D, Sigsgaard T, Thorne PS, et al. Health effects of airborne exposures from concentrated animal feeding operations. Environ Health Perspect. 2007;115(2):298–302.
34. Viegas S, Faísca VM, Dias H, et al. Occupational exposure to poultry dust and effects on the respiratory system in workers. J Toxicol Environ Health A. 2013;76(4-5):230–9.
35. Larsson BM, Palmberg L, Malmberg PO, et al. Effect of exposure to swine dust on levels of IL-8 in airway lavage fluid. Thorax. 1997;52(7):638–42.
36. Muller-Suur C, Larsson K, Malmberg P, et al. Increased number of activated lymphocytes in human lung following swine dust inhalation. Eur Respir J. 1997;10(2):376–80.
37. Price LB, Graham JP, Lackey LG, et al. Elevated risk of carrying gentamicin-resistant Escherichia coli among U.S. poultry workers. Environ Health Perspect. 2007;115(12):1738–42.
38. Wardyn SE, Forshey BM, Farina SA, et al. Swine farming is a risk factor for infection with and high prevalence of carriage of multidrug-resistant Staphylococcus aureus. Clin Infect Dis. 2015;61(1):59–66.
39. Sapkota AR, Curriero FC, Gibson KE, et al. Antibiotic-resistant enterococci and fecal indicators in surface water and groundwater impacted by a concentrated swine feeding operation. Environ Health Perspect. 2007;115(7):1040–5.
40. Soupir M, Mostaghimi S, Yagow E, et al. Transport of fecal bacteria from poultry litter and cattle manures applied to pastureland. Water Air Soil Pollut. 2006;169(1-4):125–36.
41. Fahrenfeld N, Knowlton K, Krometis LA, et al. Effect of manure application on abundance of antibiotic resistance genes and their attenuation rates in soil: field-scale mass balance approach. Environ Sci Technol. 2014;48(5):2643–50.
42. Marti R, Tien Y-C, Murray R, et al. Safely coupling livestock and crop production systems: how rapidly do antibiotic resistance genes dissipate in soil following a commercial application of swine or dairy manure? Appl Environ Microbiol. 2014;80(10):3258–65.
43. Chee-Sanford JC, Mackie RI, Koike S, et al. Fate and transport of antibiotic residues and antibiotic resistance genes following land application of manure waste. J Environ Qual. 2009;38(3):1086–108.
44. Burkholder J, Libra B, Weyer P, et al. Impacts of waste from concentrated animal feeding operations on water quality. Environ Health Perspect. 2007;115(2):308–12.
45. Graham J, Nachman K. Managing waste from confined animal feeding operations in the United States: the need for sanitary reform. J Water Health. 2010;8(4):646–70.
46. Donham KJ. Community and occupational health concerns in pork production: a review. J Anim Sci. 2010;88(13 Suppl):E102–11.
47. Greger M, Koneswaran G. The public health impacts of concentrated animal feeding operations on local communities. Fam Community Health. 2010;33(1):11–20.
48. McElroy KG. Environmental health effects of concentrated animal feeding operations: implications for nurses. Nurs Adm Q. 2010;34(4):311–9.
49. O’Connor AM, Auvermann B, Bickett-Weddle D, et al. The association between proximity to animal feeding operations and community health: a systematic review. PLoS One. 2010;5(3):e9530.
50. Wing S, Horton RA, Rose KM. Air pollution from industrial swine operations and blood pressure of neighboring residents. Environ Health Perspect. 2013;121(1):92–6. This is a community-based participatory repeated measurement study where individuals served as their own controls. In the first study of IFAP and blood pressure they saw increased hog odor and hydrogen sulfide were positively associated with blood pressure, suggesting a psychophysiological mechanism.
51. Schinasi L, Horton RA, Guidry VT, et al. Air pollution, lung function, and physical symptoms in communities near concentrated swine feeding operations. Epidemiology. 2011;22(2):208–15.
52. Horton RA, Wing S, Marshall SW, et al. Malodor as a trigger of stress and negative mood in neighbors of industrial hog operations. Am J Public Health. 2009;99 Suppl 3:S610–5.
53. Auchincloss AH, Gebreab SY, Mair C, et al. A review of spatial methods in epidemiology, 2000-2010. Annu Rev Public Health. 2012;33:107–22.
54. Avery RC, Wing S, Marshall SW, et al. Odor from industrial hog farming operations and mucosal immune function in neighbors. Arch Environ Health. 2004;59(2):101–8.
55. Mirabelli MC, Wing S, Marshall SW, et al. Asthma symptoms among adolescents who attend public schools that are located near confined swine feeding operations. Pediatrics. 2006;118(1):e66–75.
56. Tajik M, Muhammad N, Lowman A, et al. Impact of odor from industrial hog operations on daily living activities. New Solut. 2008;18(2):193–205.
57. Radon K, Peters A, Praml G, et al. Livestock odours and quality of life of neighbouring residents. Ann Agric Environ Med. 2004;11(1):59–62.
58. Radon K, Schulze A, Ehrenstein V, et al. Environmental exposure to confined animal feeding operations and respiratory health of neighboring residents. Epidemiology. 2007;18(3):300–8.
59. Blanes-Vidal V, Baelum J, Nadimi ES, et al. Chronic exposure to odorous chemicals in residential areas and effects on human psychosocial health: dose-response relationships. Sci Total Environ. 2014;490:545–54.
60. Blanes-Vidal V, Suh H, Nadimi ES, et al. Residential exposure to outdoor air pollution from livestock operations and perceived annoyance among citizens. Environ Int. 2012;40:44–50.
61. Kaye WE, Hall HI, Lybarger JA. Recall bias in disease status associated with perceived exposure to hazardous substances. Ann Epidemiol. 1994;4(5):393–7.
62. Deiters C, Gunnewig V, Friedrich AW, et al. Are cases of methicillin-resistant Staphylococcus aureus clonal complex (CC) 398 among humans still livestock-associated? Int J Med Microbiol. 2015;305(1):110–3.
63. Larsen J, Petersen A, Sorum M, et al. Methicillin-resistant Staphylococcus aureus CC398 is an increasing cause of disease in people with no livestock contact in Denmark. Euro Surveill. 2015. in press. This study used temporal and spatial analyses to analyze zoonotic spread of MRSA to people with no direct livestock exposure. It also used typing methods to show that isolates from this study population are similar to isolates from livestock workers.
64. Kelesidis T, Chow AL. Proximity to animal or crop operations may be associated with de novo daptomycin-non-susceptible Enterococcus infection. Epidemiol Infect. 2014;142(1):221–4.
65. Blake SB. Spatial relationships among dairy farms, drinking water quality, and maternal-child health outcomes in the San Joaquin Valley. Public Health Nurs. 2014;31(6):492–9.
66. Feingold BJ, Silbergeld EK, Curriero FC, et al. Livestock density as risk factor for livestock-associated methicillin-resistant Staphylococcus aureus, the Netherlands. Emerg Infect Dis. 2012;18(11):1841.
67. Sneeringer S. Does animal feeding operation pollution hurt public health? A national longitudinal study of health externalities identified by geographic shifts in livestock production. Am J Agric Econ. 2009;91(1):124–37.
68. Carrel M, Schweizer ML, Sarrazin MV, et al. Residential proximity to large numbers of swine in feeding operations is associated with increased risk of methicillin-resistant Staphylococcus aureus colonization at time of hospital admission in rural Iowa veterans. Infect Control Hosp Epidemiol. 2014;35(2):190–3.
69. Kilburn KH. Human impairment from living near confined animal (hog) feeding operations. J Environ Public Health. 2012;2012:565690.
70. Sigurdarson ST, Kline JN. School proximity to concentrated animal feeding operations and prevalence of asthma in students. Chest. 2006;129(6):1486–91.
71. Wing S, Wolf S. Intensive livestock operations, health, and quality of life among eastern North Carolina residents. Environ Health Perspect. 2000;108(3):233–8.
72. Hermans T, Jeurissen L, Hackert V, et al. Land-applied goat manure as a source of human Q-fever in the Netherlands, 2006-2010. PLoS One. 2014;9(5):e96607.
73. Smit LA, van der Sman-de Beer F, Opstal-van Winden AW, et al. Q fever and pneumonia in an area with a high livestock density: a large population-based study. PLoS One. 2012;7(6):e38843.
74. Casey JA, Curriero FC, Cosgrove SE, et al. High-density livestock operations, crop field application of manure, and risk of community-associated methicillin-resistant Staphylococcus aureus infection in Pennsylvania. JAMA Intern Med. 2013;173(21):1980–90.
75. Casey JA, Shopsin B, Cosgrove SE, et al. High-density livestock production and molecularly characterized MRSA infections in Pennsylvania. Environ Health Perspect. 2014;122(5):464–70.
76. Pavilonis BT, Sanderson WT, Merchant JA. Relative exposure to swine animal feeding operations and childhood asthma prevalence in an agricultural cohort. Environ Res. 2013;122:74–80.
77. Smit LA, Hooiveld M, van der Sman-de Beer F, et al. Air pollution from livestock farms, and asthma, allergic rhinitis and COPD among neighbouring residents. Occup Environ Med. 2014;71(2):134–40.
78. Sommer SG, Østergård HS, Løfstrøm P, et al. Validation of model calculation of ammonia deposition in the neighbourhood of a poultry farm using measured NH3 concentrations and N deposition. Atmos Environ. 2009;43(4):915–20.
79. Hackert VH, van der Hoek W, Dukers-Muijrers N, et al. Q fever: single-point source outbreak with high attack rates and massive numbers of undetected infections across an entire region. Clin Infect Dis. 2012;55(12):1591–9. This study use distance-based methods to investigate the relationship between a possible index farm and human Q fever cases.
80. Sabat AJ, Budimir A, Nashev D, et al. Overview of molecular typing methods for outbreak detection and epidemiological surveillance. Euro Surveill. 2013;18(4):20380.
81. Von Essen SG, Auvermann BW. Health effects from breathing air near CAFOs for feeder cattle or hogs. J Agromedicine. 2005;10(4):55–64.
82. Illi S, Depner M, Genuneit J, et al. Protection from childhood asthma and allergy in Alpine farm environments-the GABRIEL Advanced Studies. J Allergy Clin Immunol. 2012;129(6):1470–7 e6.
83. Merchant JA, Naleway AL, Svendsen ER, et al. Asthma and farm exposures in a cohort of rural Iowa children. Environ Health Perspect. 2005;113(3):350–6
84. Bouvery NA, Souriau A, Lechopier P, et al. Experimental Coxiella burnetii infection in pregnant goats: excretion routes. Vet Res. 2003;34(4):423–33.
85. Goorhuis A, Bakker D, Corver J, et al. Emergence of Clostridium difficile infection due to a new hypervirulent strain, polymerase chain reaction ribotype 078. Clin Infect Dis. 2008;47(9):1162–70.
86. Odoi A, Martin SW, Michel P, et al. Determinants of the geographical distribution of endemic giardiasis in Ontario, Canada: a spatial modelling approach. Epidemiol Infect. 2004;132(5):967–76.
87. Schiffman SS, Studwell CE, Landerman LR, et al. Symptomatic effects of exposure to diluted air sampled from a swine confinement atmosphere on healthy human subjects. Environ Health Perspect. 2005;113(5):567–76.
88. Hooiveld M, van Dijk C, van der Sman-de Beer F, et al. Odour annoyance in the neighbourhood of livestock farming - perceived health and health care seeking behaviour. Ann Agric Environ Med. 2015;22(1):55–61.
89. Cushing L, Morello-Frosch R, Wander M, et al. The haves, the have-nots, and the health of everyone: the relationship between social inequality and environmental quality. Annu Rev Public Health. 2015;36:193–209.
90. Mirabelli MC, Wing S, Marshall SW, et al. Race, poverty, and potential exposure of middle-school students to air emissions from confined swine feeding operations. Environ Health Perspect. 2006;114(4):591.
91. Wilson SM, Howell F, Wing S, et al. Environmental injustice and the Mississippi hog industry. Environ Health Perspect. 2002;110 Suppl 2:195–201.
92. Wing S, Cole D, Grant G. Environmental injustice in North Carolina’s hog industry. Environ Health Perspect. 2000;108(3):225.
93. Brulle RJ, Pellow DN. Environmental justice: human health and environmental inequalities. Annu Rev Public Health. 2006;27:103–24.
94. Irwin LK, Gray S, Oberdorster E. Vitellogenin induction in painted turtle, Chrysemys picta, as a biomarker of exposure to environmental levels of estradiol. Aquat Toxicol. 2001;55(1-2):49–60.
95. Leet JK, Lee LS, Gall HE, et al. Assessing impacts of land-applied manure from concentrated animal feeding operations on fish populations and communities. Environ Sci Technol. 2012;46(24):13440–7.
96. Leet JK, Sassman S, Amberg JJ, et al. Environmental hormones and their impacts on sex differentiation in fathead minnows. Aquat Toxicol. 2015;158:98–107.
97. Orlando EF, Kolok AS, Binzcik GA, et al. Endocrine-disrupting effects of cattle feedlot effluent on an aquatic sentinel species, the fathead minnow. Environ Health Perspect. 2004;112(3):353–8.
98. Sellin MK, Snow DD, Schwarz M, et al. Agrichemicals in Nebraska, USA, watersheds: occurrence and endocrine effects. Environ Toxicol Chem. 2009;28(11):2443–8.
99. Durhan EJ, Lambright CS, Makynen EA, et al. Identification of metabolites of trenbolone acetate in androgenic runoff from a beef feedlot. Environ Health Perspect. 2006;114 Suppl 1:65–8.
100. Schiffer B, Daxenberger A, Meyer K, et al. The fate of trenbolone acetate and melengestrol acetate after application as growth promoters in cattle: environmental studies. Environ Health Perspect. 2001;109(11):1145–51.
101. Ankley GT, Jensen KM, Makynen EA, et al. Effects of the androgenic growth promoter 17-beta-trenbolone on fecundity and reproductive endocrinology of the fathead minnow. Environ Toxicol Chem. 2003;22(6):1350–60.
102. Bell RA, Grzywacz JG, Quandt SA, et al. Medical skepticism and complementary therapy use among older rural African-Americans and Whites. J Health Care Poor Underserved. 2013;24(2):777–87.
103. Fry JP, Laestadius LI, Grechis C, et al. Investigating the role of state and local health departments in addressing public health concerns related to industrial food animal production sites. PLoS One. 2013;8(1):e54720.
104. Cook WK. Integrating research and action: a systematic review of community-based participatory research to address health disparities in environmental and occupational health in the USA. J Epidemiol Community Health. 2008;62(8):668–76.
105. Levy S. Reduced antibiotic use in livestock: how Denmark tackled resistance. Environ Health Perspect. 2014;122(6):A160–5.
106. Kim J, Goldsmith P. A spatial hedonic approach to assess the impact of swine production on residential property values. Environ Resour Econ. 2009;42(4):509–34.
107. Diez Roux AV, Mair C. Neighborhoods and health. Ann N Y Acad Sci. 2010;1186(1):125–45.
108. Van den Bogaard A, Bruinsma N, Stobberingh E. The effect of banning avoparcin on VRE carriage in The Netherlands. J Antimicrob Chemother. 2000;46(1):146–8.
109. Ko G, Simmons I, Otto D, Likirdopulos CA, et al. Endotoxin levels at swine farms using different waste treatment and management technologies. Environ Sci Technol. 2010;44(9):3442–8.
110. Trabue S, Scoggin K, Li H, et al. Speciation of volatile organic compounds from poultry production. Atmos Environ. 2010;44(29):3538–46.
111. Schiffman SS, Bennett JL, Raymer JH. Quantification of odors and odorants from swine operations in North Carolina. Agr Forest Meteorol. 2001;108(3):213–40.
112. Levy I, Mihele C, Lu G, et al. Evaluating multipollutant exposure and urban air quality: pollutant interrelationships, neighborhood variability, and nitrogen dioxide as a proxy pollutant. Environ Health Perspect. 2014;122(1):65.
113. Bobb JF, Valeri L, Henn BC, et al. Bayesian kernel machine regression for estimating the health effects of multi-pollutant mixtures. Biostatistics. 2014. doi: 10.1093/biostatistics/kxu058
114. Arnon S, Dahan O, Elhanany S, et al. Transport of testosterone and estrogen from dairy-farm waste lagoons to groundwater. Environ Sci Technol. 2008;42(15):5521–6.
115. Bartelt-Hunt S, Snow DD, Damon-Powell T, et al. Occurrence of steroid hormones and antibiotics in shallow groundwater impacted by livestock waste control facilities. J Contam Hydrol. 2011;123(3):94–103.
116. Lockhart K, King A, Harter T. Identifying sources of groundwater nitrate contamination in a large alluvial groundwater basin with highly diversified intensive agricultural production. J Contam Hydrol. 2013;151:140–54.
117. United States Environmental Protection Agency. Private drinking water wells. Available at: http://water.epa.gov/drink/info/well/. Accessed 25 June 2015.
118. Wing S. Social responsibility and research ethics in community-driven studies of industrialized hog production. Environ Health Perspect. 2002;110(5):437–44.
119. Leung MW, Yen IH, Minkler M. Community based participatory research: a promising approach for increasing epidemiology’s relevance in the 21st century. Int J Epidemiol. 2004;33(3):499–506.