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Characterising populations living close to intensive farming and composting facilities in England

Characterising populations living close to intensive farming and composting facilities in England Front. Environ. Sci. Eng. 2021, 15(3): 40 https://doi.org/10.1007/s11783-020-1332-z RESEARCH ARTICLE Characterising populations living close to intensive farming and composting facilities in England 1,2 3 1 Philippa Douglas (✉) , Daniela Fecht , Deborah Jarvis 1 National Heart and Lung Institute, MRC Centre for Environment and Health, Imperial College London, London, SW3 6LZ, UK 2 Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Didcot, Oxfordshire, OX11 0RQ, UK 3 UK Small Area Health Statistics Unit, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, W2 1PG, UK HIGH LIGHTS GRAPHIC A BSTRA C T • Bioaerosol emitted from farming and composting facilities may pose health risks. • We describe population characteristics around these sites and infer public concern. • Sites were mapped and overlaid with population, demographic and school data. • Approximately 16% of the population and 15% of schools are located near these sites. • More community health studies need to be conducted around these sites. ABSTRA CT AR TICL E I N F O Bioaerosol exposure has been linked to adverse respiratory conditions. Intensive farming and composting facilities are important anthropogenic sources of bioaerosols. We aimed to characterise populations living close to intensive farming and composting facilities. We also infer whether the Article history: public are becoming more concerned about anthropogenic bioaerosol emissions, using reports of air Received 18 May 2020 pollution related incidents attributed to facilities. We mapped the location of 1,257 intensive farming Revised 28 September 2020 and 310 composting facilities in England in relation to the resident population and its characteristics Accepted 11 October 2020 (sex and age), area characteristics (deprivation proxy and rural/urban classification) and school locations stratified by pre-defined distance bands from these bioaerosol sources. We also calculated the Available online 4 November 2020 average number of air pollution related incidents per year per facility. We found that more than 16% of the population and 15% of schools are located within 4,828 m of an intensive farming facility or 4,000 m of a composting facility; few people (0.01%) live very close to these sites and tend to be older Keywords: people. Close to composting facilities, populations are more likely to be urban and more deprived. The Composting number of incidents were attributed to a small proportion of facilities; population characteristics Intensive farming around these facilities were similar. Results indicate that populations living near composting facilities Bioaerosol (particularly>250 to£4,000 m) are mostly located in urban areas (80%–88% of the population), Population characteristics which supports the need for more community health studies to be conducted. Results could also be Public health used to inform risk management strategies at facilities with higher numbers of incidents. © The Author(s) 2020. This article is published with open access at link.springer.com and journal.hep. com.cn 1 Introduction Food production and waste management is increasing to ✉ Corresponding author meet the demands of an expanding population (estimated E-mail: philippa.douglas@phe.gov.uk to rise by 4.5% in the UK, from mid-2018 to mid-2028 (ONS, 2020a)). The number of intensive farms in England Special Issue—Bioaerosol, Environment and Health (Responsible has increased by 77% from 709 farms in 2010 to 1,258 Editors: Can Wang, Jungho Hwang, Jingkun Jiang & Maosheng Yao) 2 Front. Environ. Sci. Eng. 2021, 15(3): 40 farms in 2017 to meet the increasing demand in food harmful effects on human health in the 2017 Chief Medical (Environment Agency, 2018a) (Fig. 1). Composting Officer for England’s annual report on health impacts of facilities provide a sustainable way of recycling biode- pollution (Chief Medical Officer, 2018). Exposure to gradable waste. The number of composting facilities in bioaerosols may represent a particular health risk to England has increased by 134% from 140 in 2010 to 327 in persons already living with allergies, respiratory diseases 2017 (Environment Agency, 2018b; Robertson et al., and those who are immunocompromised (Walser et al., 2019) (Fig. 1). 2015). Worldwide, approximately 30% of adults and 40% Intensive farming facilities and industrial scale compost- of children suffer from respiratory allergies, including ing facilities represent important anthropogenic sources of allergic rhinitis and asthma (Pawankar et al., 2013; Allergy bioaerosol. Bioaerosols are airborne microorganisms UK, 2020); asthma affects 5.4 million people in the UK consisting of a complex mixture of fungi, bacteria, pollen, (Allergy UK, 2020) with allergy being the cause of asthma particulate and by-products of cells (Pepper and Dowd, in around 80% of cases (Pawankar et al., 2013; Allergy 2009; Douwes et al., 2003; Pearson et al., 2015; Walser UK, 2020), and younger asthmatics having an even higher et al., 2015). Bioaerosols are ubiquitous in the natural incidence of allergies (Allergy UK, 2020). However, at environment but are emitted in elevated quantities from present, there are no quantitative dose-response estimates intensive farming and composting facilities. Due to their to derive health-related exposure limits for bioaerosol small size (typically< 3 µm in diameter), bioaerosols have emissions from intensive farming or composting facilities the potential to travel over large geographic distances (Pearson et al., 2015; Walser et al., 2015). (Tamer Vestlund et al., 2014; Fröhlich-Nowoisky et al., Recent systematic reviews of the literature (Pearson 2016; Feeney et al., 2018). Once aerosolised they are et al., 2015; Douglas et al., 2018; Robertson et al., 2019) subjected to prevailing air current, convection, diffusion highlighted that studies on health effects due to bioaerosol and gravitational settling (Brooks and Gerba, 2014). exposure have largely been conducted in occupational Exposure to bioaerosol poses important risks to human settings; few studies explored wider community health health. effects. In England, the extent of the population living in As bioaerosols are small, they are inhalable and can proximity to anthropogenic bioaerosol sources is, there- travel deeply into the lungs, and may trigger allergenic, fore, unknown, although it is widely thought that intensive immunological or inflammatory responses. Bioaerosol farming and composting facilities are mostly located in exposure may cause exacerbations of, for example, allergic rural areas away from residential homes and schools. The and non-allergic asthma, rhinitis, hypersensitivity pneu- aim of our study was to identify the population living close monitis, allergic alveolitis, allergic bronchopulmonary to intensive farming and composting facilities and describe Aspergillosis, chronic bronchitis, chronic obstructive their socio-demographic characteristics. We also, use pulmonary disease (COPD), organic dust toxic syndrome, reports of air pollution-related incidents attributed to and toxic pneumonitis (Lacey and Dutkiewicz, 1994; Swan intensive farming and composting facilities collected by the Environment Agency (EA) in England between 2011 et al., 2003; Sykes et al., 2007; Wery, 2014; Pearson et al., 2015). Bioaerosols were highlighted as a substance that and 2017 to calculate the average number of air pollution needs to be considered as a pollutant with potentially related incidents per year per facility, and describe the Fig. 1 The number of permitted intensive farming and composting facilities in England 2010‒2017. Contains Environment Agency information © Environment Agency. Philippa Douglas et al. Characteristics of populations around intensive farms and composting facilities 3 socio-demographic characteristics around facilities with of households without a car), 3) overcrowding (the reported incidents. proportion of household with a density of ≥1 person per room), 4) low social class (proportion of persons living in households with an economically active head of household 2 Materials and methods in a low social class) (Carstairs and Morris, 1989). We categorised scores into quintiles for analysis. We did not 2.1 Intensive farming and composting facility locations consider using Index of Multiple Deprivation (IMD) data as this is produced at lower layer super output area (LSOA) We included all intensive farming and composting (average population of 1,500 people), and the geographical facilities in England with a permit to operate at the end area covered by each LSOA is too large for the purposes of of 2017, data were provided by the EA. Intensive farming this study. facilities are regulated under the Industrial Emission We categorised COAs as rural or urban using ONS 2011 Directive (IED), which defines intensives farming as rural-urban classification data where COAs are categorised installations with >40,000 places for poultry, or >2,000 as urban if the population weighted centre is within an area places for production pigs (over 30 kg), or >750 places for with a resident population above 10,000 people (includes sows (2010/75/EU) (The European Parliament and the ‘major conurbations’, ‘minor conurbations’, ‘city & Council of the European Union, 2010). If classed as town’); all other COAs were categorised as rural (includes intensive farming under the IED, a permit from the EA is ‘town & fringe’, ‘villages’,and ‘hamlets & isolated required. Similarly, composting facilities also require a dwellings’) (ONS, 2020c). permit from the EA to operate, if they store or treat >80 tonnes of compost at any one time (>60 tonnes if the waste 2.4 School locations is brought in from another location or if the resultant compost is used elsewhere) (Environment Agency, 2014). We obtained information on school locations in England Both datasets included a unique facility identifier (permit (last updated in July 2017) from The Department for number), facility name, address, permit issue date, type of Education (GOV.UK, 2017), which contains information facility (for intensive farming the principle use is listed, for 24,302 schools. The data contains the school address, e.g., an intensive farming facility could have pigs and type of school (nursery, primary, secondary etc.), and the poultry, but is registered under the primary operation), and age range of the students attending the school. We a national grid reference. National grid references were reclassified schools broadly into primary or secondary used to geocode the intensive farming and composting schools based on the school type: Secondary includes facilities; national grid references are checked by the EA ‘Secondary’, ‘Middle deemed secondary’ and ‘16 plus’ when the permit is given, and usually refer to the facility school types (13%, n = 3,257); Primary includes all other entrance (EA, Environment and Business Department, school types including ‘Nursey’, ‘Primary’, ‘Middle personal communication, 15th June 2018). deemed primary’, ‘All through’ and ‘Not applicable’ (87%, n = 21,045). We geocoded schools based on the 2.2 Population characteristics postcode centroid of their address; 144 schools (< 1%) could not be geocoded and we removed these from the We used population data from the most recent census analysis. (2011), available from the Office for National Statistics (ONS) at Census Output Area (COA) (average population 2.5 Data analysis of 300 people). This is the highest spatial resolution at which population estimates are available by sex and age We mapped population and area-level characteristics at categories (age is provided in five year age bands (0–4, 5–9 population weighted COA centroid and schools data at etc. up to >85)) (ONS, 2020b). We calculated the number postcode centroids in relation to distance to the nearest (i) of children (classed as being aged£19 years), and number intensive farming facility and (ii) composting facility. The of older adults (classed as being aged ≥65 years) per population-weighted centroid for each COAwas calculated COA. by adjusting the geometric COA centroid using postcode headcount information as weights (Equation 1), to reflect 2.3 Area-level characteristics the population distribution within a given COA as follows: We used Carstairs 2011, a deprivation score available at Σ X POP COA¼1 PC PC COA level, as a proxy for area-level socioeconomic status. X ¼ , COA  POPWC PC The Carstairs index consists of four domains which are calculated using census data from ONS: 1) male Σ Y POP COA¼1 PC PC unemployment (proportion of economically active males Y ¼ , (1) COA  POPWC PC aged ≥16 years), 2) lack of car ownership (the proportion n 4 Front. Environ. Sci. Eng. 2021, 15(3): 40 where: X and Y are the x, y calculate the average number of air pollution related COA POPWC COA POPWC coordinates of the population weighted COA centroid; incidents per year per facility, and describe the socio- X and Y are the x, y coordinates of postcode centroids demographic characteristics around facilities with reported PC PC within the COA; POP is the population associated with incidents. Although air pollution-related incidents are not PC each postcode centroid within the COA; and PC is the just limited to bioaerosols, this information may still be number of postcodes in the COA. indicative of incidents related to or caused by bioaerosols. The distance of each COA population weighted centroid Detailed methods are provided in Appendix A, and CICS and school postcode centroid to the nearest (i) intensive definitions are provided in Appendix B. farming facility and (ii) composting facility was calculated using ArcMap (version 10.2). Patterns in population and 3 Results area-level characteristics were analysed in relation to distance from composting facilities and intensive farms. We used distance bands of (0,100], (100,500], (500,1000], At the end of 2017, there were 1,257 intensive farming and (1000,4828] (3 miles), >4828 m (the rest of England) for 310 composting facilities with a permit to operate in intensive farming facilities and distance bands of (0,250], England. Of the 1,257 intensive farms, 1,046 were (250,750], (750,1500], (1500,2500], (2500,4000] and primarily poultry farms, 176 were primarily pig farms >4,000 m (the rest of England) for composting facilities, and 35 were primarily sow farms. Of the 310 permitted corresponding to different bioaerosol exposure proxies composting facilities, 158 were classed as open windrow used in published literature (Table 1). Population and area- (compost process is usually conducted entirely outdoors; level characteristics for each distance band were compared bioaerosols emissions are uncontrolled and uncontained), to the rest of England using a Chi-squared test. Statistical 25 facilities were in-vessel (compost process is mostly analyses were conducted using Stata (version 15.0). conducted indoors, occasionally with an outdoor matura- tion element; bioaerosol emissions may be somewhat more 2.6 Air pollution-related incidents controlled and contained), 24 were classed as both open windrow and 103 were not classified. We obtained Common Incident Classification Scheme Intensive farming facilities mostly clustered in rural areas, with a large proportion located in the East (near the (CICS) data from the EA on the number of air pollution- counties the counties of Norfolk, Suffolk, and Lincoln- related incidents, and notifications of these incidents, shire) and the West (in areas bordering Wales). Compost- attributed to intensive farming and composting facilities, to Table 1 Justification for distance bands used for descriptive statistics for both intensive farms and composting facilities Distance (m) Justification Intensive farms 100 Current distance set by the EA whereby an intensive farm has to conduct a ‘site specific bioaerosols risk assessment’ if there are any ‘sensitive receptors’ (e.g. a dwelling or workplace) within 100 m of the intensive farm (GOV.UK, 2018) 500 Distance used in two cross-sectional epidemiological studies that used proxy measures for exposure (Radon et al., 2007; Smit et al., 2014). 1,000 Distance used two epidemiological studies (one case-control and one cross-sectional) that used proxy measures for exposure (Smit et al., 2014; Huijskens et al., 2016). Schinasi et al., (2011) measured and detected bioaerosol (endotoxin) at around this distance (the exact location of monitoring is not stated in this study, although it is implied that is was conducted ‘within 1.5 km’ of the farming facility). 4,828 Distance used in a cross-sectional epidemiological study that used proxy measures for exposure (equates to approx. 3 miles) (Mirabelli et al., 2006) Composting sites 250 Current distance set by the EA whereby a composting facility has to conduct a ‘site specific bioaerosols risk assessment’ if there are any ‘sensitive receptors’ (e.g. a dwelling or workplace) within 250 m of the composting facility (Environment Agency, 2018c) 750 Distance bioaerosols have been detected above background levels from composting facilities at this distance (Pankhurst et al., 2011; Williams et al., 2013), and was a distance band used in a small area ecological epidemiological study (Douglas et al., 2016) 1,500 Distance bioaerosols have been detected from composting facilities (Reinthaler et al., 1997; Williams et al., 2013), and was a distance band used in a small area ecological study (Douglas et al., 2016) 2,500 Control distance used in small area ecological study were it was assumed that there was no contribution above background levels (Douglas et al., 2016) 4,000 Full extent of the area included in a recent dispersion modelling study that estimated bioaerosol exposure from composting facilities (Williams et al., 2019) and subsequent epidemiological analysis (Roca-Barcelo et al., 2020). A larger area was used compared to (Douglas et al., 2016) to account for the influence of wind speed and direction. Philippa Douglas et al. Characteristics of populations around intensive farms and composting facilities 5 ing facilities were more evenly spread across the UK, their schools and 594 secondary schools); 2 primary schools are distribution broadly reflecting population density with located within 100 m of an intensive farming facility. higher concentrations near large towns and cities, around Overall, the population within 100 m of an intensive London and the conurbations in the North West of farming facility is significantly older, less deprived, and England. more likely to be rural compared to those living >100 m of an intensive farming facility (p< 0.01). Within 4,828 m of 3.1 Characteristics of population residing close to intensive an intensive farming facility, there is a higher proportion of farming facilities older adults, those classed as least deprived (a very small proportion is classified as being the most deprived (0.00– Table 2 presents summary statistics of population char- 12.21%)), and a lower proportion of people living in an acteristics for COAs close to intensive farming facilities by urban area, compared to the rest of England. distance bands. Approximately a fifth of the population in Deprivation patterns, however, vary considerably when England (over 9.4 million people, 18%) live within 4,828 stratified by rural and urban areas (Fig. 2). There is a larger m of an intensive farming facility; only 1,242 people proportion of more deprived populations living within (< 0.01%) live within COAs whose population weighted urban areas close to intensive farms compared to rural centroid is within 100 m of an intensive farming facility. areas. Twenty percent of schools in England (n = 4,815) are Rural areas consist of populations in less deprived within 4,828 m of an intensive farm (4,221 primary (Carstairs quintile 1 and 2) areas in all distance bands, Table 2 Characteristics of Census Output Areas (COAs) and their population by distance bands from intensive farming facilities Parameters Distance from the facility (m) £100 (100,500] (500,1000] (1000,4828] >4828 No. of COAs (%) 5 215 920 29,973 140,235 (< 0.01) (0.13) (0.54) (17.49) (81.84) Total Population (%) 1,242 64,351 280,089 9,128,573 43,624,402 (< 0.01) (0.12) (0.53) (17.19) (82.16) No. Males (%) 607 32,266 137,846 4,481,040 21,476,765 (48.87) (50.14) (49.22) (49.09) (49.23) b,c No. of Children (%) 287 14,322 63,921 2,130,369 10,500,165 (23.11) (22.26) (22.82) (23.34) (24.07) b,d No. of Older adults (%) 286 12,988 56,294 1,707,134 6,952,847 (23.03) (20.18) (20.10) (18.70) (15.94) Population per Carstairs 1 825 19,021 102,127 2,504,974 8,210,471 deprivation quintile (%) , (66.43) (29.56) (36.46) (27.44) (18.82) 1 = least deprived 2 283 21,008 85,862 2,357,213 8,637,416 (22.79) (32.65) (30.66) (25.82) (19.80) 30 14,687 49,188 1,789,619 8,490,728 (0.00) (22.82) (17.56) (19.60) (19.46) 4 134 5,855 27,964 1,362,499 8,468,270 (10.79) (9.10) (9.98) (14.93) (19.41) 50 3,780 14,948 1,114,163 9,817,387 (0.00) (5.87) (5.34) (12.21) (22.50) Population in Urban areas (%) 0 22,723 104,559 5,976,977 37,630,978 (0.00) (35.31) (37.33) (65.48) (86.26) No. of Schools (%) Total 2 34 154 4,625 19,343 (0.01) (0.14) (0.64) (19.14) (80.07) Primary education 2 31 138 4,050 16,695 (100.00) (91.18) (89.61) (87.57) (86.31) Secondary education 0 3 16 575 2,648 (0.00) (8.82) (10.39) (12.43) (13.69) Notes: a. Comparison area; b. Based on data available at COA level, where the COA population weighted centroid falls within the stated distance bands; c. Number of children aged£19 years, based on data available at COA level; d. Number of elderly adults aged≥65 years, based on data available at COA level; e. Based on data available at postcode level; f. Number of schools classed as ‘Primary’, ‘Middle deemed primary’, ‘Nursery’, ‘All through’, ‘Not applicable’ or classification is missing (mean average lowest age of students = 4.19, mean average highest age of students = 11.48); g. Number of schools classed as ‘Secondary’, ‘Middle deemed secondary’, or ’16 plus’ (mean average lowest age of students = 11.06, mean average highest age of students = 17.30). 6 Front. Environ. Sci. Eng. 2021, 15(3): 40 Fig. 2 Proportion of the population living within each Carstairs deprivation quintile by distance band from intensive farming facility, for urban areas (top) and rural areas (bottom). A deprivation quintile of 1 represents the least deprived areas. although this is more marked within 100 m of an intensive The number of incidents and notifications attributed farming facility. We explored this further by applying an to intensive farm facilities per year are presented in adapted Carstairs index for use in rural settings (Rural Appendix D. Carstairs, RCar) (Fecht et al., 2017), which we applied to populations living in rural areas near intensive farms in a 3.2 Population characteristics around composting facilities sensitivity analysis (see Appendix C for methods and results). When using RCar, the population living in each Table 3 presents summary statistics of population char- deprivation quintile changes markedly, with a much lower acteristics for COAs close to composting facilities by proportion of people being classified in the least deprived distance bands. Approximately a sixth of the population in quintiles, and a higher proportion being classified in the England (over 8.5 million people, 16%) live within 4,000 more deprived quintiles. Overall, the population living m of a composting facility; only 3,634 people (0.01%) live within 4,828 m of an intensive farm, particularly those within COAs whose population weighted centroid is living within 100 m, remain classified as being not very within 100 m of a composting facility. Fifteen percent of deprived, but a larger proportion of the population is more schools in England (n = 3,707) are within 4,000 m of a deprived than shown in Table 2. composting facility (3,205 primary schools and 502 Philippa Douglas et al. Characteristics of populations around intensive farms and composting facilities 7 Table 3 Characteristics of Census Output Areas (COAs) and their population by distance bands to composting facilities Distance from the facility (m) £250 (250,750] (750,1500] (1500,2500] (2500,4000] >4000 No. of COAs (%) 14 393 2,638 7,333 17,148 143,822 (0.01) (0.23) (1.54) (4.28) (10.01) (83.93) Total Population (%) 3,634 117,795 800,567 2,273,864 5,397,106 44,505,691 (0.01) (0.22) (1.51) (4.28) (10.16) (83.82) No. Males (%) 1,784 58,998 394,825 1,119,335 2,665,270 21,888,312 (49.09) (50.09) (49.32) (49.23) (49.38) (49.18) b,c No. of Children (%) 793 28,767 195,119 558,989 1,319,026 10,606,380 (21.82) (24.42) (24.37) (24.58) (24.44) (23.83) b,d No. of Older adults (%) 670 17,017 120,309 343,102 803,207 7,445,244 (18.45) (14.45) (15.03) (15.09) (14.88) (16.73) Population per Carstairs1 1,075 18,579 126,054 363,433 847,395 9,480,882 deprivation quintile (%) (29.58) (15.77) (15.75) (15.98) (15.70) (21.30) 1 = least deprived 2 621 22,547 133,273 396,851 946,459 9,602,031 (17.09) (19.14) (16.65) (17.45) (17.54) (21.57) 3 496 24,225 150,469 408,199 979,953 8,780,880 (13.65) (20.57) (18.79) (17.95) (18.16) (19.73) 4 539 19,606 161,655 451,892 1,057,539 8,173,491 (14.83) (16.64) (20.19) (19.88) (19.59) (18.37) 5 903 32,838 229,116 653,489 1,565,760 8,468,172 (24.85) (27.88) (28.62) (28.74) (29.01) (19.03) Population in Urban areas (%) 1,884 95,321 672,577 1,938,788 4,773,548 36,253,119 (51.84) (80.92) (84.01) (85.26) (88.45) (81.46) No. of Schools (%) Total 1 47 368 972 2,319 20,451 (< 0.01) (0.19) (1.52) (4.02) (9.60) (84.66) Primary educationf 1 41 329 843 1,991 17,711 (100.00) (87.23) (89.40) (89.40) (86.73) (86.60) Secondary educa- 0 6 39 129 328 2,740 tiong (0.00) (12.77) (10.60) (13.27) (13.27) (13.40) Notes: a. Comparison area – ‘the rest of England’; b. Based on data available at COA level, where the COA population weighted centroid falls within the stated distance bands; c. Number of children aged£19 years, based on data available at COA level; d. Number of older adults aged≥65 years, based on data available at COA level; e. Based on data available at postcode level; f. Number of schools classed as ‘Primary’, ‘Middle deemed primary’, ‘Nursery’, ‘All through’, ‘Not applicable’ or classification is missing (mean average lowest age of students = 4.19, mean average highest age of students = 11.48); g. Number of schools classed as ‘Secondary’, ‘Middle deemed secondary’,or ’16 plus’ (mean average lowest age of students = 11.06, mean average highest age of students = 17.30). secondary schools; one school (a primary school) is The number of incidents and notifications attributed to located within 250 m of a composting facility. composting facilities per year are presented in Appendix E. Overall, the population living within 250 m of a composting facility as a significantly lower proportion of 4 Discussion children, a higher proportion of older adults, less deprived, and more likely to be rural (p< 0.03) compared to those This is the first study that characterises populations living living >250 m of a composting facility. Within 4,000 m around intensive farming and composting facilities in there was a higher proportion of people living classified as most deprived compared to the rest of England, although England. Over 16% of the population and more than 15% within 250 m there was a higher proportion of people of schools are located within 4,828 of an intensive farming classified as the least deprived. Fewer people live in urban facility or 4,000 m of a composting facility, which areas within 250 m of a composting facility, compared to contradicts previous opinion that such facilities are mostly those living >250 m of a composting facility. located away from housing and schools. The population Deprivation patterns, however, vary considerably when living within 4,000 m of a composting facility are mostly stratified by rural and urban areas (Fig. 3). Populations are located in urban settings, which also contradicts previous more deprived in urban areas compared to rural areas in all opinion that they are mostly located in rural settings. In distance bands, although this is more marked nearer to a addition, our study assesses the number of air pollution composting facility. related incidents and notifications attributed to intensive 8 Front. Environ. Sci. Eng. 2021, 15(3): 40 Fig. 3 Proportion of the population living within each Carstairs deprivation quintile by distance band from composting facility for urban areas (top) and rural areas (bottom). A deprivation quintile of 1 represents the least deprived areas farming and composting facilities over time, to calculate described in section 2.1, intensive farming and composting the average number of air pollution related incidents per facilities over a certain capacity require a permit from the year per facility and describe the socio-demographic EA. If there are any ‘sensitive receptors’ (workplaces or characteristics around facilities with reported incidents. dwellings) located within 100 m of an intensive farming facility or 250 m of a composting facility, then a site- 4.1 Results interpretation specific bioaerosol risk assessment is required (Environ- ment Agency, 2018c). As this is potentially more time Although a large proportion of the population and schools consuming and costly to the facility, facilities may are located within 4,828 m or 4,000 m of an intensive therefore purposely cite themselves in areas where these farming or composting facility, there are few people and conditions are met. schools within 100 m or 250 m, respectively. This may be a Areas very close (100 m or 250 m) to intensive farming reflection on how these facilities are regulated; as or composting facilities are more rural, with a higher Philippa Douglas et al. Characteristics of populations around intensive farms and composting facilities 9 proportion of older adults who are less deprived. This may farms (which may lead to increased environmental reflect affluent over 65 year olds moving to more rural pollution). Overall, however, there are fewer incidents areas upon retirement. attributed to intensive farming facilities compared to Areas further away from intensive farming facilities composting facilities. There are also fewer composting (100–4,828 m) also inhibit similar population character- facilities than intensive farms, meaning that on average istics, however, areas further away from composting there are more incidents per composting facility. facilities (250–4,000 m) are more urban, deprived, and with fewer older people and more children. Children, 4.2 Evidence from epidemiological studies deprived populations, and older people are potentially more susceptible to the health risks of bioaerosol exposure. It was beyond the scope of this study to conduct analyses Older adults are more susceptible to respiratory infections of health records/outcomes in relation to proximity to as the immune system function declines in old age (The intensive farming and composting facilities. However, a Parliamentary Office of Science and Technology, 2017; recent systematic review summarised results from 16 Thomas et al., 2019) and therefore are likely to be at studies that used proxy measures for exposure to examine greater risk of exposure to pathogenic bioaerosol species community health effects surrounding intensive farming and components, as they are emitted in elevated levels facilities (Douglas et al., 2018). The findings from these from these sources. Children are more prone to environ- heterogenous studies were mixed, with some reporting mental risks as they are still developing their lungs and adverse associations with respiratory health, while others immune systems; increased reported asthma prevalence report protective associations. Four studies concerned has been reported in four studies examining children living children (Hoopman et al., 2006; Mirabelli et al., 2006; or attending schools near an intensive farm (Hoopman Siguardson and Kline 2006; Pavilonis et al., 2013), which et al., 2006; Mirabelli et al., 2006; Sigurdarson and Kline, reported relatively consistent evidence of increased self- 2006; Pavilonis et al., 2013). However, further work is reported asthma incidence in children living, or attending needed to confirm this. schools, near intensive farming facilities. In addition, Deprivation was classified using the Carstairs index, a Douglas et al., (2016) used distance from composting composite measure of deprivation which focuses of facility as a proxy for exposure to examine the health deprivation dimensions associated with urban areas, such effects of communities living near composting facilities. as overcrowding and car ownership. The nature of This was followed up by a more recent study which used deprivation experienced in rural areas, however, is modelled Aspergillus fumigatus to estimate bioaerosol different to that in urbans areas (Fecht et al., 2017). exposure (Roca Barcelo et al., 2020). Neither of these Rural deprivation is characterised by dimensions such as studies provided evidence for an increased risk of fuel poverty, hidden unemployment and poor access to respiratory-related hospital admissions (although hospital services, amenities and health care (Cloke et al., 1997; admissions represent severe respiratory episodes). Older Defra, 2019). Therefore, the deprivation indices used in community health studies were summarised in a systematic this study may not be as relevant for rural populations, review conducted by Pearson et al., (2015). such as those living near intensive farming facilities. We applied an adapted Carstairs index for use in rural settings 4.3 Strengths and limitations (RCar) to populations living in rural areas near intensive farms in a sensitivity analysis (Appendix C). However, the We were able to include all intensive farming and RCar still contains the variables originally used in the composting facilities with a permit to operate at the end Carstairs index and does not capture the additional of 2017 in England in our study, and incident and dimensions of deprivation associated with in rural areas. notification data attributed to these facilities using In addition, as COA boundaries reflect population databases collected by the EA for permitting and distribution with, on average, 300 people, COAs in rural regulatory purposes. These data were not collected for areas cover much larger areas; pockets of deprivation the purpose used in this study, and therefore provided some within the larger rural COAs could be masked. limitations when adapting the data. We geocoded the Incidents were often related to a small proportion of locations of the sites using the national grid reference intensive farming and composting facilities, suggesting provided in the data. This would have introduced some that there are some facilities that have problems with their errors, as the national grid reference may not reflect the emissions. The number of incidents and notifications location of bioaerosol emissions from these facilities. relating to composting facilities are decreasing. This may However, the national grid references are checked by the be due to populations becoming more ecologically and EA, and will represent the location of the site, typically environmentally aware, and therefore becoming more depicting the site entrance (EA, Environment and Business accepting of composting facilities (as a sustainable way of Department, personal communication, 15th June 2018). recycling organic material), and less accepting of intensive We used incident and notification data to calculate the 10 Front. Environ. Sci. Eng. 2021, 15(3): 40 average number of air pollution related incidents per year We summarised population characteristics based on area per facility and describe the socio-demographic character- level data, not individual level data. Socio-demographic istics around facilities with reported incidents. This data characteristics are not available on a national scale at captured all incidents relating to ‘Atmospheric Pollutant individual level, and therefore we use area level data and Effects’, which is not limited solely to bioaerosols, and available at COA level instead, which is the highest may also include odour. Therefore, many of the notifica- resolution that detailed population data are available. tions recorded may not be attributable to bioaerosol When summarising population characteristics data with exposure. distance from anthropogenic sources, we would have We also did not account for that fact that the radii around introduced unavoidable errors, as some COAs, particularly these facilities may overlap, and-some of the population those located in rural area, cover large areas, and therefore may live within close proximity to more than one intensive the actual distance between individual residents to an farming and/or composting facility, and therefore be more anthropogenic bioaerosol source will vary considerably exposed to anthropogenic bioaerosol concentrations. within the COA. To mitigate this source of potential We summarised population characteristics within misclassification, we used population-weighted centroids defined distance bands around the intensive farming and to assign distance from each anthropogenic bioaerosol composting facilities, as described in Table 1. These source to the population within the COA, rather than distances were justified, where possible, based on results geometric centroids, to reflect the population within each from studies that measured bioaerosol concentrations in COA. communities surrounding these facilities. However, other We were able to use the most recent data available at the distance bands were added based on values used in time of analysis; intensive farming and composting facility epidemiological studies that used proxy measured for permit information were available for 2017; school exposure. Unfortunately, there are a limited number of information from July 2017; and population data were studies that have measured bioaerosols from intensive available from the last UK census in 2011, However, this farming and composting facilities in the surrounding information might have slightly changed since data was community, and in the few studies that have, this has last collected. been typically limited to sampling within 1–1.5 km (see Table 1).Therefore, we are currently unable to say with 4.4 Future work and impact certainty that bioaerosols will disperse as far as 4,828 m from intensive farming facilities or 4,000 m from Previous systematic reviews have highlighted the need for composting facilities, the full extent of the distance more community health studies to be conducted in regards bands examined in this study. However, bioaerosols to bioaerosols exposure from intensive farming and emitted from these facilities may, theoretically, stay composting facilities (Pearson et al., 2015; Douglas suspended over longer distances due to their small size et al., 2018; Robertson et al., 2019). This study has and travel over large geographical distances (Tamer highlighted that a large proportion of the population in Vestlund et al., 2014; Fröhlich-Nowoisky et al., 2016; England live near these pollutant sources and reinforces Feeney et al., 2018). This theory is also supported by a these recommendations. Future studies should consider recent dispersion modelling study, where Aspergillus assessing the health risks of vulnerable populations, fumigatus concentrations were estimated within 4 km of including children living near composting facilities, composting facilities in England (Williams et al., 2019); particularly those in more deprived areas. although modelled concentrations typically plateaued at The data used in the study can be utilised to identify approximately 1.5–2 km, there were some postcodes intensive farming and composting facilities with large, or within the highest quintile of modelled concentrations more vulnerable, populations living around them, which beyond 2 km. can inform risk management strategies, targeted at specific It was only possible to include farms classed as intensive sites. This data can also inform future bioaerosol sampling under the IED, as these are regulated by the EA. It was not campaigns, exposure assessment and health studies, so that possible to include other types of farms (e.g. smaller sites with large, vulnerable or deprived populations or a poultry and pig farms, cattle and sheep farms), although large number of schools in proximity to the sites, or sites these may still represent an important anthropogenic with a lot of notifications or incidents can be targeted. source of bioaerosols. There are other anthropogenic sources of bioaerosol, including sewage treatment works 5 Conclusions and wastewater treatment plants, which were not explored in this study. Bioaerosol emissions and dispersion from We have described the characteristics of populations living such sources are not well explored, and site-specific near intensive farming and composting facilities, and bioaerosol risk assessment are not required from the EA for calculated the average number of air pollution related these facilities. Philippa Douglas et al. Characteristics of populations around intensive farms and composting facilities 11 If material is not included in the article’s Creative Commons licence and your incidents per year per facility and described the socio- intended use is not permitted by statutory regulation or exceeds the permitted demographic characteristics around these facilities. Results use, you will need to obtain permission directly from the copyright holder. To show that around a sixth of the population (16.9%) live view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. within 4,000 m of a composting facility and a fifth of the population (18.0%) live within 4,828 m (3 miles) of an intensive farm in England. However, few people live very References close to composting facilities (0.01% live within 250 m) or intensive farms (< 0.01% live within 100 m), although Allergy U K (2020). Allergy prevalence: Useful facts and figures. these people tend to be older compared to the rest of the Available online at the website www.allergyuk.org/assets/000/001/ population. In addition, people near composting facilities 369/Stats_for_Website_original.pdf?1505209830 (accessed March live in more urban areas, which are more deprived. The 31, 2020) number of incidents relating to atmospheric pollutant and Asthma U K (2020). Asthma facts and statistics. Available online at effects attributed to composting facilities are decreasing the website www.asthma.org.uk/about/media/facts-and-statistics/ (61.40% decrease in incidents reported in 2011 vs 2017), (accessed March 31, 2020) but increasing for intensive farms (92.31% increase in Brooks J P, Gerba CBioaerosol contamination of produce: Potential incidents reported in 2011 vs. 2017), but are limited to a issues from an unexplored contaminent route (2014). In: Matthews K small proportion of sites. Results indicate that populations R, Sapers G M, Gerba, C P, eds. The Produce Contamination living in the vicinity of composting facilities are mostly Problem. Causes and solutions. 2nd ed. New York: Academic Press located in urban areas. This supports the need for more Carstairs V, Morris R (1989). Deprivation: Explaining differences in community health studies to be conducted, particularly in mortality between Scotland and England and Wales. British Medical populations potentially more susceptible to the health Journal, 299(6704): 886–889 effects of bioaerosol exposure, including older adults and Chief Medical Officer (2018). Annual Report of the Chief Medical children. Results could also be used to inform risk Officer 2017. Available online at the website www.gov.uk/govern- management strategies at high incident sites, and future ment/publications/chief-medical-officer-annual-report-2017-health- monitoring campaigns. impacts-of-all-pollution-what-do-we-know (accessed March 31, Acknowledgements Philippa Douglas was funded by the MRC-PHE 2020). Centre for Environment and Health via an early career research fellowship. Cloke P, Milbourne P, Thomas C (1997). Living lives in different ways? The research was part funded by the National Institute for Health Research Deprivation, marginalization and changing lifestyles in rural Health Protection Research Unit (NIHR HPRU) in Health Impact of England. Transactions of the Institute of British Geographers, 22: Environmental Hazards at King’s College London in partnership with Public 210–230 Health England (PHE) and Imperial College London. The work of the UK Small Area Health Statistics Unit is funded by Public Health England as part Defra (2019). Department of Environment, Food, and Rural Affairs. Fuel of the MRC-PHE Centre for Environment and Health, funded also by the UK Poverty Statistics. Available online at the website www.gov.uk/ Medical Research Council. The views expressed are of the authors and not government/statistics/fuel-energy-and-fuel-poverty-in-rural-areas necessarily those of the MRC, the NHS, the NIHR, the Department of Health (accessed March 31, 2020) & Social Care or Public Health England. We thank the Environment Agency Douglas P, Bakolis I, Fecht D, Pearson C, Leal Sanzhez M, Kinnersley (EA) for providing the composting and intensive farming facility permit and CICs data, and for aiding with its interpretation; these data were provided to R, De Hoogh K, Hansell A L (2016). Respiratory hospital admission us via email under the Environment Agency Conditional Licence (at the risk near large composting facilities. International Journal of Hygiene website www.gov.uk/government/publications/environment-agency-condi- and Environmental Health, 219(4–5): 372–379 tional-licence/environment-agency-conditional-licence). The population Douglas P, Robertson S, Gay R, Hansell A L, Gant T W (2018). A data were supplied by the Office for National Statistics (ONS), derived systematic review of the public health risks of bioaerosols from from small area population estimates, data available under the UK Open Government License v.3.0 (Contains National Statistics data © Crown intensive farming. International Journal of Hygiene and Environ- copyright and database right 2020. Contains OS data © Crown copyright mental Health, 221(2): 134–173 (2020)). Schools data were obtained from the .GOV website (freely available Douwes J, Thorne P, Pearce N, Heederik D (2003). Bioaerosol health online at website www.gov.uk/government/publications/schools-in-eng- effects and exposure assessment: progress and prospects. 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UK trends Al-Ashaab R, Nelson A, Gladding T, Simpson A, Coughlin D, in infectiuos disease. Available online at the website post.parliament. Hansell A (2013). Department for Environment Food and Rural uk/research-briefings/post-pn-0545/ (accessed March 31, 2020) Affairs Report WR1121 – Monitoring bioaerosol and odour Thomas E T, Guppy M, Straus S E, Bell K J L, Glasziou P (2019). Rate emissions rom composting facilities. Available online at the website of normal lung function decline in ageing adults: A systematic review randd.defra.gov.uk/Default.aspx?Menu = Menu&Module = More&- of prosective cohort studies. BMJ Open, 9(6): e028150 Location = None&Completed = 0&ProjectID = 17214 (accessed July Walser S M, Gerstner D G, Brenner B, Bunger J, Eikmann T, Janssen B, 17, 2020) Kolb S, Kolk A, Nowak D, Raulf M, Sagunski H, Sedlmaier N, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png "Frontiers of Environmental Science & Engineering" Springer Journals

Characterising populations living close to intensive farming and composting facilities in England

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Front. Environ. Sci. Eng. 2021, 15(3): 40 https://doi.org/10.1007/s11783-020-1332-z RESEARCH ARTICLE Characterising populations living close to intensive farming and composting facilities in England 1,2 3 1 Philippa Douglas (✉) , Daniela Fecht , Deborah Jarvis 1 National Heart and Lung Institute, MRC Centre for Environment and Health, Imperial College London, London, SW3 6LZ, UK 2 Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Didcot, Oxfordshire, OX11 0RQ, UK 3 UK Small Area Health Statistics Unit, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, W2 1PG, UK HIGH LIGHTS GRAPHIC A BSTRA C T • Bioaerosol emitted from farming and composting facilities may pose health risks. • We describe population characteristics around these sites and infer public concern. • Sites were mapped and overlaid with population, demographic and school data. • Approximately 16% of the population and 15% of schools are located near these sites. • More community health studies need to be conducted around these sites. ABSTRA CT AR TICL E I N F O Bioaerosol exposure has been linked to adverse respiratory conditions. Intensive farming and composting facilities are important anthropogenic sources of bioaerosols. We aimed to characterise populations living close to intensive farming and composting facilities. We also infer whether the Article history: public are becoming more concerned about anthropogenic bioaerosol emissions, using reports of air Received 18 May 2020 pollution related incidents attributed to facilities. We mapped the location of 1,257 intensive farming Revised 28 September 2020 and 310 composting facilities in England in relation to the resident population and its characteristics Accepted 11 October 2020 (sex and age), area characteristics (deprivation proxy and rural/urban classification) and school locations stratified by pre-defined distance bands from these bioaerosol sources. We also calculated the Available online 4 November 2020 average number of air pollution related incidents per year per facility. We found that more than 16% of the population and 15% of schools are located within 4,828 m of an intensive farming facility or 4,000 m of a composting facility; few people (0.01%) live very close to these sites and tend to be older Keywords: people. Close to composting facilities, populations are more likely to be urban and more deprived. The Composting number of incidents were attributed to a small proportion of facilities; population characteristics Intensive farming around these facilities were similar. Results indicate that populations living near composting facilities Bioaerosol (particularly>250 to£4,000 m) are mostly located in urban areas (80%–88% of the population), Population characteristics which supports the need for more community health studies to be conducted. Results could also be Public health used to inform risk management strategies at facilities with higher numbers of incidents. © The Author(s) 2020. This article is published with open access at link.springer.com and journal.hep. com.cn 1 Introduction Food production and waste management is increasing to ✉ Corresponding author meet the demands of an expanding population (estimated E-mail: philippa.douglas@phe.gov.uk to rise by 4.5% in the UK, from mid-2018 to mid-2028 (ONS, 2020a)). The number of intensive farms in England Special Issue—Bioaerosol, Environment and Health (Responsible has increased by 77% from 709 farms in 2010 to 1,258 Editors: Can Wang, Jungho Hwang, Jingkun Jiang & Maosheng Yao) 2 Front. Environ. Sci. Eng. 2021, 15(3): 40 farms in 2017 to meet the increasing demand in food harmful effects on human health in the 2017 Chief Medical (Environment Agency, 2018a) (Fig. 1). Composting Officer for England’s annual report on health impacts of facilities provide a sustainable way of recycling biode- pollution (Chief Medical Officer, 2018). Exposure to gradable waste. The number of composting facilities in bioaerosols may represent a particular health risk to England has increased by 134% from 140 in 2010 to 327 in persons already living with allergies, respiratory diseases 2017 (Environment Agency, 2018b; Robertson et al., and those who are immunocompromised (Walser et al., 2019) (Fig. 1). 2015). Worldwide, approximately 30% of adults and 40% Intensive farming facilities and industrial scale compost- of children suffer from respiratory allergies, including ing facilities represent important anthropogenic sources of allergic rhinitis and asthma (Pawankar et al., 2013; Allergy bioaerosol. Bioaerosols are airborne microorganisms UK, 2020); asthma affects 5.4 million people in the UK consisting of a complex mixture of fungi, bacteria, pollen, (Allergy UK, 2020) with allergy being the cause of asthma particulate and by-products of cells (Pepper and Dowd, in around 80% of cases (Pawankar et al., 2013; Allergy 2009; Douwes et al., 2003; Pearson et al., 2015; Walser UK, 2020), and younger asthmatics having an even higher et al., 2015). Bioaerosols are ubiquitous in the natural incidence of allergies (Allergy UK, 2020). However, at environment but are emitted in elevated quantities from present, there are no quantitative dose-response estimates intensive farming and composting facilities. Due to their to derive health-related exposure limits for bioaerosol small size (typically< 3 µm in diameter), bioaerosols have emissions from intensive farming or composting facilities the potential to travel over large geographic distances (Pearson et al., 2015; Walser et al., 2015). (Tamer Vestlund et al., 2014; Fröhlich-Nowoisky et al., Recent systematic reviews of the literature (Pearson 2016; Feeney et al., 2018). Once aerosolised they are et al., 2015; Douglas et al., 2018; Robertson et al., 2019) subjected to prevailing air current, convection, diffusion highlighted that studies on health effects due to bioaerosol and gravitational settling (Brooks and Gerba, 2014). exposure have largely been conducted in occupational Exposure to bioaerosol poses important risks to human settings; few studies explored wider community health health. effects. In England, the extent of the population living in As bioaerosols are small, they are inhalable and can proximity to anthropogenic bioaerosol sources is, there- travel deeply into the lungs, and may trigger allergenic, fore, unknown, although it is widely thought that intensive immunological or inflammatory responses. Bioaerosol farming and composting facilities are mostly located in exposure may cause exacerbations of, for example, allergic rural areas away from residential homes and schools. The and non-allergic asthma, rhinitis, hypersensitivity pneu- aim of our study was to identify the population living close monitis, allergic alveolitis, allergic bronchopulmonary to intensive farming and composting facilities and describe Aspergillosis, chronic bronchitis, chronic obstructive their socio-demographic characteristics. We also, use pulmonary disease (COPD), organic dust toxic syndrome, reports of air pollution-related incidents attributed to and toxic pneumonitis (Lacey and Dutkiewicz, 1994; Swan intensive farming and composting facilities collected by the Environment Agency (EA) in England between 2011 et al., 2003; Sykes et al., 2007; Wery, 2014; Pearson et al., 2015). Bioaerosols were highlighted as a substance that and 2017 to calculate the average number of air pollution needs to be considered as a pollutant with potentially related incidents per year per facility, and describe the Fig. 1 The number of permitted intensive farming and composting facilities in England 2010‒2017. Contains Environment Agency information © Environment Agency. Philippa Douglas et al. Characteristics of populations around intensive farms and composting facilities 3 socio-demographic characteristics around facilities with of households without a car), 3) overcrowding (the reported incidents. proportion of household with a density of ≥1 person per room), 4) low social class (proportion of persons living in households with an economically active head of household 2 Materials and methods in a low social class) (Carstairs and Morris, 1989). We categorised scores into quintiles for analysis. We did not 2.1 Intensive farming and composting facility locations consider using Index of Multiple Deprivation (IMD) data as this is produced at lower layer super output area (LSOA) We included all intensive farming and composting (average population of 1,500 people), and the geographical facilities in England with a permit to operate at the end area covered by each LSOA is too large for the purposes of of 2017, data were provided by the EA. Intensive farming this study. facilities are regulated under the Industrial Emission We categorised COAs as rural or urban using ONS 2011 Directive (IED), which defines intensives farming as rural-urban classification data where COAs are categorised installations with >40,000 places for poultry, or >2,000 as urban if the population weighted centre is within an area places for production pigs (over 30 kg), or >750 places for with a resident population above 10,000 people (includes sows (2010/75/EU) (The European Parliament and the ‘major conurbations’, ‘minor conurbations’, ‘city & Council of the European Union, 2010). If classed as town’); all other COAs were categorised as rural (includes intensive farming under the IED, a permit from the EA is ‘town & fringe’, ‘villages’,and ‘hamlets & isolated required. Similarly, composting facilities also require a dwellings’) (ONS, 2020c). permit from the EA to operate, if they store or treat >80 tonnes of compost at any one time (>60 tonnes if the waste 2.4 School locations is brought in from another location or if the resultant compost is used elsewhere) (Environment Agency, 2014). We obtained information on school locations in England Both datasets included a unique facility identifier (permit (last updated in July 2017) from The Department for number), facility name, address, permit issue date, type of Education (GOV.UK, 2017), which contains information facility (for intensive farming the principle use is listed, for 24,302 schools. The data contains the school address, e.g., an intensive farming facility could have pigs and type of school (nursery, primary, secondary etc.), and the poultry, but is registered under the primary operation), and age range of the students attending the school. We a national grid reference. National grid references were reclassified schools broadly into primary or secondary used to geocode the intensive farming and composting schools based on the school type: Secondary includes facilities; national grid references are checked by the EA ‘Secondary’, ‘Middle deemed secondary’ and ‘16 plus’ when the permit is given, and usually refer to the facility school types (13%, n = 3,257); Primary includes all other entrance (EA, Environment and Business Department, school types including ‘Nursey’, ‘Primary’, ‘Middle personal communication, 15th June 2018). deemed primary’, ‘All through’ and ‘Not applicable’ (87%, n = 21,045). We geocoded schools based on the 2.2 Population characteristics postcode centroid of their address; 144 schools (< 1%) could not be geocoded and we removed these from the We used population data from the most recent census analysis. (2011), available from the Office for National Statistics (ONS) at Census Output Area (COA) (average population 2.5 Data analysis of 300 people). This is the highest spatial resolution at which population estimates are available by sex and age We mapped population and area-level characteristics at categories (age is provided in five year age bands (0–4, 5–9 population weighted COA centroid and schools data at etc. up to >85)) (ONS, 2020b). We calculated the number postcode centroids in relation to distance to the nearest (i) of children (classed as being aged£19 years), and number intensive farming facility and (ii) composting facility. The of older adults (classed as being aged ≥65 years) per population-weighted centroid for each COAwas calculated COA. by adjusting the geometric COA centroid using postcode headcount information as weights (Equation 1), to reflect 2.3 Area-level characteristics the population distribution within a given COA as follows: We used Carstairs 2011, a deprivation score available at Σ X POP COA¼1 PC PC COA level, as a proxy for area-level socioeconomic status. X ¼ , COA  POPWC PC The Carstairs index consists of four domains which are calculated using census data from ONS: 1) male Σ Y POP COA¼1 PC PC unemployment (proportion of economically active males Y ¼ , (1) COA  POPWC PC aged ≥16 years), 2) lack of car ownership (the proportion n 4 Front. Environ. Sci. Eng. 2021, 15(3): 40 where: X and Y are the x, y calculate the average number of air pollution related COA POPWC COA POPWC coordinates of the population weighted COA centroid; incidents per year per facility, and describe the socio- X and Y are the x, y coordinates of postcode centroids demographic characteristics around facilities with reported PC PC within the COA; POP is the population associated with incidents. Although air pollution-related incidents are not PC each postcode centroid within the COA; and PC is the just limited to bioaerosols, this information may still be number of postcodes in the COA. indicative of incidents related to or caused by bioaerosols. The distance of each COA population weighted centroid Detailed methods are provided in Appendix A, and CICS and school postcode centroid to the nearest (i) intensive definitions are provided in Appendix B. farming facility and (ii) composting facility was calculated using ArcMap (version 10.2). Patterns in population and 3 Results area-level characteristics were analysed in relation to distance from composting facilities and intensive farms. We used distance bands of (0,100], (100,500], (500,1000], At the end of 2017, there were 1,257 intensive farming and (1000,4828] (3 miles), >4828 m (the rest of England) for 310 composting facilities with a permit to operate in intensive farming facilities and distance bands of (0,250], England. Of the 1,257 intensive farms, 1,046 were (250,750], (750,1500], (1500,2500], (2500,4000] and primarily poultry farms, 176 were primarily pig farms >4,000 m (the rest of England) for composting facilities, and 35 were primarily sow farms. Of the 310 permitted corresponding to different bioaerosol exposure proxies composting facilities, 158 were classed as open windrow used in published literature (Table 1). Population and area- (compost process is usually conducted entirely outdoors; level characteristics for each distance band were compared bioaerosols emissions are uncontrolled and uncontained), to the rest of England using a Chi-squared test. Statistical 25 facilities were in-vessel (compost process is mostly analyses were conducted using Stata (version 15.0). conducted indoors, occasionally with an outdoor matura- tion element; bioaerosol emissions may be somewhat more 2.6 Air pollution-related incidents controlled and contained), 24 were classed as both open windrow and 103 were not classified. We obtained Common Incident Classification Scheme Intensive farming facilities mostly clustered in rural areas, with a large proportion located in the East (near the (CICS) data from the EA on the number of air pollution- counties the counties of Norfolk, Suffolk, and Lincoln- related incidents, and notifications of these incidents, shire) and the West (in areas bordering Wales). Compost- attributed to intensive farming and composting facilities, to Table 1 Justification for distance bands used for descriptive statistics for both intensive farms and composting facilities Distance (m) Justification Intensive farms 100 Current distance set by the EA whereby an intensive farm has to conduct a ‘site specific bioaerosols risk assessment’ if there are any ‘sensitive receptors’ (e.g. a dwelling or workplace) within 100 m of the intensive farm (GOV.UK, 2018) 500 Distance used in two cross-sectional epidemiological studies that used proxy measures for exposure (Radon et al., 2007; Smit et al., 2014). 1,000 Distance used two epidemiological studies (one case-control and one cross-sectional) that used proxy measures for exposure (Smit et al., 2014; Huijskens et al., 2016). Schinasi et al., (2011) measured and detected bioaerosol (endotoxin) at around this distance (the exact location of monitoring is not stated in this study, although it is implied that is was conducted ‘within 1.5 km’ of the farming facility). 4,828 Distance used in a cross-sectional epidemiological study that used proxy measures for exposure (equates to approx. 3 miles) (Mirabelli et al., 2006) Composting sites 250 Current distance set by the EA whereby a composting facility has to conduct a ‘site specific bioaerosols risk assessment’ if there are any ‘sensitive receptors’ (e.g. a dwelling or workplace) within 250 m of the composting facility (Environment Agency, 2018c) 750 Distance bioaerosols have been detected above background levels from composting facilities at this distance (Pankhurst et al., 2011; Williams et al., 2013), and was a distance band used in a small area ecological epidemiological study (Douglas et al., 2016) 1,500 Distance bioaerosols have been detected from composting facilities (Reinthaler et al., 1997; Williams et al., 2013), and was a distance band used in a small area ecological study (Douglas et al., 2016) 2,500 Control distance used in small area ecological study were it was assumed that there was no contribution above background levels (Douglas et al., 2016) 4,000 Full extent of the area included in a recent dispersion modelling study that estimated bioaerosol exposure from composting facilities (Williams et al., 2019) and subsequent epidemiological analysis (Roca-Barcelo et al., 2020). A larger area was used compared to (Douglas et al., 2016) to account for the influence of wind speed and direction. Philippa Douglas et al. Characteristics of populations around intensive farms and composting facilities 5 ing facilities were more evenly spread across the UK, their schools and 594 secondary schools); 2 primary schools are distribution broadly reflecting population density with located within 100 m of an intensive farming facility. higher concentrations near large towns and cities, around Overall, the population within 100 m of an intensive London and the conurbations in the North West of farming facility is significantly older, less deprived, and England. more likely to be rural compared to those living >100 m of an intensive farming facility (p< 0.01). Within 4,828 m of 3.1 Characteristics of population residing close to intensive an intensive farming facility, there is a higher proportion of farming facilities older adults, those classed as least deprived (a very small proportion is classified as being the most deprived (0.00– Table 2 presents summary statistics of population char- 12.21%)), and a lower proportion of people living in an acteristics for COAs close to intensive farming facilities by urban area, compared to the rest of England. distance bands. Approximately a fifth of the population in Deprivation patterns, however, vary considerably when England (over 9.4 million people, 18%) live within 4,828 stratified by rural and urban areas (Fig. 2). There is a larger m of an intensive farming facility; only 1,242 people proportion of more deprived populations living within (< 0.01%) live within COAs whose population weighted urban areas close to intensive farms compared to rural centroid is within 100 m of an intensive farming facility. areas. Twenty percent of schools in England (n = 4,815) are Rural areas consist of populations in less deprived within 4,828 m of an intensive farm (4,221 primary (Carstairs quintile 1 and 2) areas in all distance bands, Table 2 Characteristics of Census Output Areas (COAs) and their population by distance bands from intensive farming facilities Parameters Distance from the facility (m) £100 (100,500] (500,1000] (1000,4828] >4828 No. of COAs (%) 5 215 920 29,973 140,235 (< 0.01) (0.13) (0.54) (17.49) (81.84) Total Population (%) 1,242 64,351 280,089 9,128,573 43,624,402 (< 0.01) (0.12) (0.53) (17.19) (82.16) No. Males (%) 607 32,266 137,846 4,481,040 21,476,765 (48.87) (50.14) (49.22) (49.09) (49.23) b,c No. of Children (%) 287 14,322 63,921 2,130,369 10,500,165 (23.11) (22.26) (22.82) (23.34) (24.07) b,d No. of Older adults (%) 286 12,988 56,294 1,707,134 6,952,847 (23.03) (20.18) (20.10) (18.70) (15.94) Population per Carstairs 1 825 19,021 102,127 2,504,974 8,210,471 deprivation quintile (%) , (66.43) (29.56) (36.46) (27.44) (18.82) 1 = least deprived 2 283 21,008 85,862 2,357,213 8,637,416 (22.79) (32.65) (30.66) (25.82) (19.80) 30 14,687 49,188 1,789,619 8,490,728 (0.00) (22.82) (17.56) (19.60) (19.46) 4 134 5,855 27,964 1,362,499 8,468,270 (10.79) (9.10) (9.98) (14.93) (19.41) 50 3,780 14,948 1,114,163 9,817,387 (0.00) (5.87) (5.34) (12.21) (22.50) Population in Urban areas (%) 0 22,723 104,559 5,976,977 37,630,978 (0.00) (35.31) (37.33) (65.48) (86.26) No. of Schools (%) Total 2 34 154 4,625 19,343 (0.01) (0.14) (0.64) (19.14) (80.07) Primary education 2 31 138 4,050 16,695 (100.00) (91.18) (89.61) (87.57) (86.31) Secondary education 0 3 16 575 2,648 (0.00) (8.82) (10.39) (12.43) (13.69) Notes: a. Comparison area; b. Based on data available at COA level, where the COA population weighted centroid falls within the stated distance bands; c. Number of children aged£19 years, based on data available at COA level; d. Number of elderly adults aged≥65 years, based on data available at COA level; e. Based on data available at postcode level; f. Number of schools classed as ‘Primary’, ‘Middle deemed primary’, ‘Nursery’, ‘All through’, ‘Not applicable’ or classification is missing (mean average lowest age of students = 4.19, mean average highest age of students = 11.48); g. Number of schools classed as ‘Secondary’, ‘Middle deemed secondary’, or ’16 plus’ (mean average lowest age of students = 11.06, mean average highest age of students = 17.30). 6 Front. Environ. Sci. Eng. 2021, 15(3): 40 Fig. 2 Proportion of the population living within each Carstairs deprivation quintile by distance band from intensive farming facility, for urban areas (top) and rural areas (bottom). A deprivation quintile of 1 represents the least deprived areas. although this is more marked within 100 m of an intensive The number of incidents and notifications attributed farming facility. We explored this further by applying an to intensive farm facilities per year are presented in adapted Carstairs index for use in rural settings (Rural Appendix D. Carstairs, RCar) (Fecht et al., 2017), which we applied to populations living in rural areas near intensive farms in a 3.2 Population characteristics around composting facilities sensitivity analysis (see Appendix C for methods and results). When using RCar, the population living in each Table 3 presents summary statistics of population char- deprivation quintile changes markedly, with a much lower acteristics for COAs close to composting facilities by proportion of people being classified in the least deprived distance bands. Approximately a sixth of the population in quintiles, and a higher proportion being classified in the England (over 8.5 million people, 16%) live within 4,000 more deprived quintiles. Overall, the population living m of a composting facility; only 3,634 people (0.01%) live within 4,828 m of an intensive farm, particularly those within COAs whose population weighted centroid is living within 100 m, remain classified as being not very within 100 m of a composting facility. Fifteen percent of deprived, but a larger proportion of the population is more schools in England (n = 3,707) are within 4,000 m of a deprived than shown in Table 2. composting facility (3,205 primary schools and 502 Philippa Douglas et al. Characteristics of populations around intensive farms and composting facilities 7 Table 3 Characteristics of Census Output Areas (COAs) and their population by distance bands to composting facilities Distance from the facility (m) £250 (250,750] (750,1500] (1500,2500] (2500,4000] >4000 No. of COAs (%) 14 393 2,638 7,333 17,148 143,822 (0.01) (0.23) (1.54) (4.28) (10.01) (83.93) Total Population (%) 3,634 117,795 800,567 2,273,864 5,397,106 44,505,691 (0.01) (0.22) (1.51) (4.28) (10.16) (83.82) No. Males (%) 1,784 58,998 394,825 1,119,335 2,665,270 21,888,312 (49.09) (50.09) (49.32) (49.23) (49.38) (49.18) b,c No. of Children (%) 793 28,767 195,119 558,989 1,319,026 10,606,380 (21.82) (24.42) (24.37) (24.58) (24.44) (23.83) b,d No. of Older adults (%) 670 17,017 120,309 343,102 803,207 7,445,244 (18.45) (14.45) (15.03) (15.09) (14.88) (16.73) Population per Carstairs1 1,075 18,579 126,054 363,433 847,395 9,480,882 deprivation quintile (%) (29.58) (15.77) (15.75) (15.98) (15.70) (21.30) 1 = least deprived 2 621 22,547 133,273 396,851 946,459 9,602,031 (17.09) (19.14) (16.65) (17.45) (17.54) (21.57) 3 496 24,225 150,469 408,199 979,953 8,780,880 (13.65) (20.57) (18.79) (17.95) (18.16) (19.73) 4 539 19,606 161,655 451,892 1,057,539 8,173,491 (14.83) (16.64) (20.19) (19.88) (19.59) (18.37) 5 903 32,838 229,116 653,489 1,565,760 8,468,172 (24.85) (27.88) (28.62) (28.74) (29.01) (19.03) Population in Urban areas (%) 1,884 95,321 672,577 1,938,788 4,773,548 36,253,119 (51.84) (80.92) (84.01) (85.26) (88.45) (81.46) No. of Schools (%) Total 1 47 368 972 2,319 20,451 (< 0.01) (0.19) (1.52) (4.02) (9.60) (84.66) Primary educationf 1 41 329 843 1,991 17,711 (100.00) (87.23) (89.40) (89.40) (86.73) (86.60) Secondary educa- 0 6 39 129 328 2,740 tiong (0.00) (12.77) (10.60) (13.27) (13.27) (13.40) Notes: a. Comparison area – ‘the rest of England’; b. Based on data available at COA level, where the COA population weighted centroid falls within the stated distance bands; c. Number of children aged£19 years, based on data available at COA level; d. Number of older adults aged≥65 years, based on data available at COA level; e. Based on data available at postcode level; f. Number of schools classed as ‘Primary’, ‘Middle deemed primary’, ‘Nursery’, ‘All through’, ‘Not applicable’ or classification is missing (mean average lowest age of students = 4.19, mean average highest age of students = 11.48); g. Number of schools classed as ‘Secondary’, ‘Middle deemed secondary’,or ’16 plus’ (mean average lowest age of students = 11.06, mean average highest age of students = 17.30). secondary schools; one school (a primary school) is The number of incidents and notifications attributed to located within 250 m of a composting facility. composting facilities per year are presented in Appendix E. Overall, the population living within 250 m of a composting facility as a significantly lower proportion of 4 Discussion children, a higher proportion of older adults, less deprived, and more likely to be rural (p< 0.03) compared to those This is the first study that characterises populations living living >250 m of a composting facility. Within 4,000 m around intensive farming and composting facilities in there was a higher proportion of people living classified as most deprived compared to the rest of England, although England. Over 16% of the population and more than 15% within 250 m there was a higher proportion of people of schools are located within 4,828 of an intensive farming classified as the least deprived. Fewer people live in urban facility or 4,000 m of a composting facility, which areas within 250 m of a composting facility, compared to contradicts previous opinion that such facilities are mostly those living >250 m of a composting facility. located away from housing and schools. The population Deprivation patterns, however, vary considerably when living within 4,000 m of a composting facility are mostly stratified by rural and urban areas (Fig. 3). Populations are located in urban settings, which also contradicts previous more deprived in urban areas compared to rural areas in all opinion that they are mostly located in rural settings. In distance bands, although this is more marked nearer to a addition, our study assesses the number of air pollution composting facility. related incidents and notifications attributed to intensive 8 Front. Environ. Sci. Eng. 2021, 15(3): 40 Fig. 3 Proportion of the population living within each Carstairs deprivation quintile by distance band from composting facility for urban areas (top) and rural areas (bottom). A deprivation quintile of 1 represents the least deprived areas farming and composting facilities over time, to calculate described in section 2.1, intensive farming and composting the average number of air pollution related incidents per facilities over a certain capacity require a permit from the year per facility and describe the socio-demographic EA. If there are any ‘sensitive receptors’ (workplaces or characteristics around facilities with reported incidents. dwellings) located within 100 m of an intensive farming facility or 250 m of a composting facility, then a site- 4.1 Results interpretation specific bioaerosol risk assessment is required (Environ- ment Agency, 2018c). As this is potentially more time Although a large proportion of the population and schools consuming and costly to the facility, facilities may are located within 4,828 m or 4,000 m of an intensive therefore purposely cite themselves in areas where these farming or composting facility, there are few people and conditions are met. schools within 100 m or 250 m, respectively. This may be a Areas very close (100 m or 250 m) to intensive farming reflection on how these facilities are regulated; as or composting facilities are more rural, with a higher Philippa Douglas et al. Characteristics of populations around intensive farms and composting facilities 9 proportion of older adults who are less deprived. This may farms (which may lead to increased environmental reflect affluent over 65 year olds moving to more rural pollution). Overall, however, there are fewer incidents areas upon retirement. attributed to intensive farming facilities compared to Areas further away from intensive farming facilities composting facilities. There are also fewer composting (100–4,828 m) also inhibit similar population character- facilities than intensive farms, meaning that on average istics, however, areas further away from composting there are more incidents per composting facility. facilities (250–4,000 m) are more urban, deprived, and with fewer older people and more children. Children, 4.2 Evidence from epidemiological studies deprived populations, and older people are potentially more susceptible to the health risks of bioaerosol exposure. It was beyond the scope of this study to conduct analyses Older adults are more susceptible to respiratory infections of health records/outcomes in relation to proximity to as the immune system function declines in old age (The intensive farming and composting facilities. However, a Parliamentary Office of Science and Technology, 2017; recent systematic review summarised results from 16 Thomas et al., 2019) and therefore are likely to be at studies that used proxy measures for exposure to examine greater risk of exposure to pathogenic bioaerosol species community health effects surrounding intensive farming and components, as they are emitted in elevated levels facilities (Douglas et al., 2018). The findings from these from these sources. Children are more prone to environ- heterogenous studies were mixed, with some reporting mental risks as they are still developing their lungs and adverse associations with respiratory health, while others immune systems; increased reported asthma prevalence report protective associations. Four studies concerned has been reported in four studies examining children living children (Hoopman et al., 2006; Mirabelli et al., 2006; or attending schools near an intensive farm (Hoopman Siguardson and Kline 2006; Pavilonis et al., 2013), which et al., 2006; Mirabelli et al., 2006; Sigurdarson and Kline, reported relatively consistent evidence of increased self- 2006; Pavilonis et al., 2013). However, further work is reported asthma incidence in children living, or attending needed to confirm this. schools, near intensive farming facilities. In addition, Deprivation was classified using the Carstairs index, a Douglas et al., (2016) used distance from composting composite measure of deprivation which focuses of facility as a proxy for exposure to examine the health deprivation dimensions associated with urban areas, such effects of communities living near composting facilities. as overcrowding and car ownership. The nature of This was followed up by a more recent study which used deprivation experienced in rural areas, however, is modelled Aspergillus fumigatus to estimate bioaerosol different to that in urbans areas (Fecht et al., 2017). exposure (Roca Barcelo et al., 2020). Neither of these Rural deprivation is characterised by dimensions such as studies provided evidence for an increased risk of fuel poverty, hidden unemployment and poor access to respiratory-related hospital admissions (although hospital services, amenities and health care (Cloke et al., 1997; admissions represent severe respiratory episodes). Older Defra, 2019). Therefore, the deprivation indices used in community health studies were summarised in a systematic this study may not be as relevant for rural populations, review conducted by Pearson et al., (2015). such as those living near intensive farming facilities. We applied an adapted Carstairs index for use in rural settings 4.3 Strengths and limitations (RCar) to populations living in rural areas near intensive farms in a sensitivity analysis (Appendix C). However, the We were able to include all intensive farming and RCar still contains the variables originally used in the composting facilities with a permit to operate at the end Carstairs index and does not capture the additional of 2017 in England in our study, and incident and dimensions of deprivation associated with in rural areas. notification data attributed to these facilities using In addition, as COA boundaries reflect population databases collected by the EA for permitting and distribution with, on average, 300 people, COAs in rural regulatory purposes. These data were not collected for areas cover much larger areas; pockets of deprivation the purpose used in this study, and therefore provided some within the larger rural COAs could be masked. limitations when adapting the data. We geocoded the Incidents were often related to a small proportion of locations of the sites using the national grid reference intensive farming and composting facilities, suggesting provided in the data. This would have introduced some that there are some facilities that have problems with their errors, as the national grid reference may not reflect the emissions. The number of incidents and notifications location of bioaerosol emissions from these facilities. relating to composting facilities are decreasing. This may However, the national grid references are checked by the be due to populations becoming more ecologically and EA, and will represent the location of the site, typically environmentally aware, and therefore becoming more depicting the site entrance (EA, Environment and Business accepting of composting facilities (as a sustainable way of Department, personal communication, 15th June 2018). recycling organic material), and less accepting of intensive We used incident and notification data to calculate the 10 Front. Environ. Sci. Eng. 2021, 15(3): 40 average number of air pollution related incidents per year We summarised population characteristics based on area per facility and describe the socio-demographic character- level data, not individual level data. Socio-demographic istics around facilities with reported incidents. This data characteristics are not available on a national scale at captured all incidents relating to ‘Atmospheric Pollutant individual level, and therefore we use area level data and Effects’, which is not limited solely to bioaerosols, and available at COA level instead, which is the highest may also include odour. Therefore, many of the notifica- resolution that detailed population data are available. tions recorded may not be attributable to bioaerosol When summarising population characteristics data with exposure. distance from anthropogenic sources, we would have We also did not account for that fact that the radii around introduced unavoidable errors, as some COAs, particularly these facilities may overlap, and-some of the population those located in rural area, cover large areas, and therefore may live within close proximity to more than one intensive the actual distance between individual residents to an farming and/or composting facility, and therefore be more anthropogenic bioaerosol source will vary considerably exposed to anthropogenic bioaerosol concentrations. within the COA. To mitigate this source of potential We summarised population characteristics within misclassification, we used population-weighted centroids defined distance bands around the intensive farming and to assign distance from each anthropogenic bioaerosol composting facilities, as described in Table 1. These source to the population within the COA, rather than distances were justified, where possible, based on results geometric centroids, to reflect the population within each from studies that measured bioaerosol concentrations in COA. communities surrounding these facilities. However, other We were able to use the most recent data available at the distance bands were added based on values used in time of analysis; intensive farming and composting facility epidemiological studies that used proxy measured for permit information were available for 2017; school exposure. Unfortunately, there are a limited number of information from July 2017; and population data were studies that have measured bioaerosols from intensive available from the last UK census in 2011, However, this farming and composting facilities in the surrounding information might have slightly changed since data was community, and in the few studies that have, this has last collected. been typically limited to sampling within 1–1.5 km (see Table 1).Therefore, we are currently unable to say with 4.4 Future work and impact certainty that bioaerosols will disperse as far as 4,828 m from intensive farming facilities or 4,000 m from Previous systematic reviews have highlighted the need for composting facilities, the full extent of the distance more community health studies to be conducted in regards bands examined in this study. However, bioaerosols to bioaerosols exposure from intensive farming and emitted from these facilities may, theoretically, stay composting facilities (Pearson et al., 2015; Douglas suspended over longer distances due to their small size et al., 2018; Robertson et al., 2019). This study has and travel over large geographical distances (Tamer highlighted that a large proportion of the population in Vestlund et al., 2014; Fröhlich-Nowoisky et al., 2016; England live near these pollutant sources and reinforces Feeney et al., 2018). This theory is also supported by a these recommendations. Future studies should consider recent dispersion modelling study, where Aspergillus assessing the health risks of vulnerable populations, fumigatus concentrations were estimated within 4 km of including children living near composting facilities, composting facilities in England (Williams et al., 2019); particularly those in more deprived areas. although modelled concentrations typically plateaued at The data used in the study can be utilised to identify approximately 1.5–2 km, there were some postcodes intensive farming and composting facilities with large, or within the highest quintile of modelled concentrations more vulnerable, populations living around them, which beyond 2 km. can inform risk management strategies, targeted at specific It was only possible to include farms classed as intensive sites. This data can also inform future bioaerosol sampling under the IED, as these are regulated by the EA. It was not campaigns, exposure assessment and health studies, so that possible to include other types of farms (e.g. smaller sites with large, vulnerable or deprived populations or a poultry and pig farms, cattle and sheep farms), although large number of schools in proximity to the sites, or sites these may still represent an important anthropogenic with a lot of notifications or incidents can be targeted. source of bioaerosols. There are other anthropogenic sources of bioaerosol, including sewage treatment works 5 Conclusions and wastewater treatment plants, which were not explored in this study. Bioaerosol emissions and dispersion from We have described the characteristics of populations living such sources are not well explored, and site-specific near intensive farming and composting facilities, and bioaerosol risk assessment are not required from the EA for calculated the average number of air pollution related these facilities. Philippa Douglas et al. Characteristics of populations around intensive farms and composting facilities 11 If material is not included in the article’s Creative Commons licence and your incidents per year per facility and described the socio- intended use is not permitted by statutory regulation or exceeds the permitted demographic characteristics around these facilities. Results use, you will need to obtain permission directly from the copyright holder. To show that around a sixth of the population (16.9%) live view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. within 4,000 m of a composting facility and a fifth of the population (18.0%) live within 4,828 m (3 miles) of an intensive farm in England. However, few people live very References close to composting facilities (0.01% live within 250 m) or intensive farms (< 0.01% live within 100 m), although Allergy U K (2020). Allergy prevalence: Useful facts and figures. these people tend to be older compared to the rest of the Available online at the website www.allergyuk.org/assets/000/001/ population. In addition, people near composting facilities 369/Stats_for_Website_original.pdf?1505209830 (accessed March live in more urban areas, which are more deprived. The 31, 2020) number of incidents relating to atmospheric pollutant and Asthma U K (2020). Asthma facts and statistics. Available online at effects attributed to composting facilities are decreasing the website www.asthma.org.uk/about/media/facts-and-statistics/ (61.40% decrease in incidents reported in 2011 vs 2017), (accessed March 31, 2020) but increasing for intensive farms (92.31% increase in Brooks J P, Gerba CBioaerosol contamination of produce: Potential incidents reported in 2011 vs. 2017), but are limited to a issues from an unexplored contaminent route (2014). In: Matthews K small proportion of sites. Results indicate that populations R, Sapers G M, Gerba, C P, eds. The Produce Contamination living in the vicinity of composting facilities are mostly Problem. Causes and solutions. 2nd ed. New York: Academic Press located in urban areas. This supports the need for more Carstairs V, Morris R (1989). Deprivation: Explaining differences in community health studies to be conducted, particularly in mortality between Scotland and England and Wales. British Medical populations potentially more susceptible to the health Journal, 299(6704): 886–889 effects of bioaerosol exposure, including older adults and Chief Medical Officer (2018). Annual Report of the Chief Medical children. Results could also be used to inform risk Officer 2017. Available online at the website www.gov.uk/govern- management strategies at high incident sites, and future ment/publications/chief-medical-officer-annual-report-2017-health- monitoring campaigns. impacts-of-all-pollution-what-do-we-know (accessed March 31, Acknowledgements Philippa Douglas was funded by the MRC-PHE 2020). Centre for Environment and Health via an early career research fellowship. Cloke P, Milbourne P, Thomas C (1997). Living lives in different ways? The research was part funded by the National Institute for Health Research Deprivation, marginalization and changing lifestyles in rural Health Protection Research Unit (NIHR HPRU) in Health Impact of England. Transactions of the Institute of British Geographers, 22: Environmental Hazards at King’s College London in partnership with Public 210–230 Health England (PHE) and Imperial College London. The work of the UK Small Area Health Statistics Unit is funded by Public Health England as part Defra (2019). Department of Environment, Food, and Rural Affairs. Fuel of the MRC-PHE Centre for Environment and Health, funded also by the UK Poverty Statistics. Available online at the website www.gov.uk/ Medical Research Council. The views expressed are of the authors and not government/statistics/fuel-energy-and-fuel-poverty-in-rural-areas necessarily those of the MRC, the NHS, the NIHR, the Department of Health (accessed March 31, 2020) & Social Care or Public Health England. We thank the Environment Agency Douglas P, Bakolis I, Fecht D, Pearson C, Leal Sanzhez M, Kinnersley (EA) for providing the composting and intensive farming facility permit and CICs data, and for aiding with its interpretation; these data were provided to R, De Hoogh K, Hansell A L (2016). Respiratory hospital admission us via email under the Environment Agency Conditional Licence (at the risk near large composting facilities. International Journal of Hygiene website www.gov.uk/government/publications/environment-agency-condi- and Environmental Health, 219(4–5): 372–379 tional-licence/environment-agency-conditional-licence). The population Douglas P, Robertson S, Gay R, Hansell A L, Gant T W (2018). A data were supplied by the Office for National Statistics (ONS), derived systematic review of the public health risks of bioaerosols from from small area population estimates, data available under the UK Open Government License v.3.0 (Contains National Statistics data © Crown intensive farming. International Journal of Hygiene and Environ- copyright and database right 2020. Contains OS data © Crown copyright mental Health, 221(2): 134–173 (2020)). Schools data were obtained from the .GOV website (freely available Douwes J, Thorne P, Pearce N, Heederik D (2003). Bioaerosol health online at website www.gov.uk/government/publications/schools-in-eng- effects and exposure assessment: progress and prospects. 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Published: Nov 4, 2020

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