A systematic review of animal feeding operations including concentrated animal feeding operations (CAFOs) for exposure, health outcomes, and environmental justice.

BACKGROUND: Despite growing literature on animal feeding operations (AFOs) including concentrated animal feeding operations (CAFOs), research on disproportionate exposure and associated health burden is relatively limited and shows inconclusive findings. OBJECTIVE: We systematically reviewed previous literature on AFOs/CAFOs, focusing on exposure assessment, associated health outcomes, and variables related to environmental justice (EJ) and potentially vulnerable populations. METHODS: We conducted a systematic search of databases (MEDLINE/PubMed and Web of Science) and performed citation screening. Screening of titles, abstracts, and full-text articles and data extraction were performed independently by pairs of reviewers. We summarized information for each study (i.e., study location, study period, study population, study type, study design, statistical methods, and adjusted variables (if health association was examined), and main findings), AFO/CAFO characteristics and exposure assessment (i.e., animal type, data source, measure of exposure, and exposure assessment), health outcomes or symptoms (if health association was examined), and information related to EJ and potentially vulnerable populations (in relation to exposure and/or health associations, vulnerable populations considered, related variables, and main findings in relation to EJ and vulnerable populations). RESULTS: After initial screening of 10,963 papers, we identified 76 eligible studies. This review found that a relatively small number of studies (20 studies) investigated EJ and vulnerability issues related to AFOs/CAFOs exposure and/or associated health outcomes (e.g., respiratory diseases/symptoms, infections). We found differences in findings across studies, populations, the metrics used for AFO/CAFO exposure assessment, and variables related to EJ and vulnerability. The most commonly used metric for AFO/CAFO exposure assessment was presence of or proximity to facilities or animals. The most investigated variables related to disparities were race/ethnicity and socioeconomic status. CONCLUSION: Findings from this review provide suggestive evidence that disparities exist with some subpopulations having higher exposure and/or health response in relation to AFO/CAFO exposure, although results varied across studies.

Modeling and Analysis of Air Pollution and Environmental Justice: The Case for North Carolina's Hog Concentrated Animal Feeding Operations.

BACKGROUND: Concentrated animal feeding operations (CAFOs) emit pollutants that can cause negative impacts on human health. The concentration of hog production in North Carolina raises concerns regarding the disproportionate exposure of vulnerable communities to air pollution from CAFOs. OBJECTIVES: We investigated whether exposure to gaseous ammonia (NH3) and hydrogen sulfide (H2S) (in 2019) differs between subpopulations by examining demographics, including race/ethnicity, age, educational attainment, language proficiency, and socioeconomic status. METHODS: We used an Air Monitoring Station (AMS)/Environmental Protection Agency (EPA) Regulatory Model (AERMOD)-based Human Exposure Model (version 3) to estimate ambient concentrations of NH3 and H2S from hog farms in Duplin County and its surrounding counties in North Carolina and estimate subsequent exposures of communities within 50km of Duplin County, North Carolina, or the Duplin County Region. We combined estimated exposures with 2016 American Community Summary Census data, at the block group level, using spatial analysis to investigate whether exposures to these pollutants differ by race and ethnicity, age, income, education, and language proficiency. Based on these estimations, we assessed associated exposure risks to the impacted communities and used multivariable regression modeling to evaluate the relationship between average ammonia exposures from Duplin regional hog farms and the presence of vulnerable populations. RESULTS: The average [±standard deviation (SD)] annual estimated concentration of NH3 and H2S in the Duplin County Region is 1.75±2.81 µg/m3 and 0.0087±0.014 µg/m3, respectively. The maximum average annual ambient concentrations are estimated at 54.27±4.12 µg/m3 and 0.54±0.041 µg/m3 for NH3 and H2S, respectively. Our descriptive analysis reveals that people of low income, people of color, people with low educational attainment, and the linguistically isolated in the Duplin Region are disproportionately exposed to higher levels of pollutants than the average exposure for residents. Alternatively, our statistical results suggests that after adjusting for covariates, communities of color are associated with 1.70% (95% CI: -3.79, 0.44) lower NH3 concentrations per 1-SD increase. One-standard deviation increases in the adults with low educational attainment and children <19 years of age is associated with 1.26% (95% CI: -0.77, 3.33) and 1.20% (95% CI: -0.62, 3.05) higher NH3 exposure per 1-SD increase, respectively. DISCUSSION: Exposures to NH3 and H2S differed by race and ethnicity, educational attainment, language proficiency, and socioeconomic status. The observed associations between exposure to CAFO-generated pollutants and sociodemographic indicators differed among demographics. The disproportionate distribution of hog facilities and resulting pollutant exposures among communities may have adverse environmental and human health impacts, raising environmental justice concerns. https://doi.org/10.1289/EHP11344.

Use of artificial dermal substitute as a bridge in complex finger reconstruction.

Few reports exist regarding the use of an artificial dermal substitute ([ADS] Integra™) in the treatment of finger injuries. This retrospective case series evaluated the use of ADS as a bridge for finger reconstruction following complex injuries. The authors' facility treated 26 complex finger injury patients using ADS. Graft take was 92.3% (22/26), with most patients experiencing satisfactory range of motion (88.5% or 23/26). The authors conclude that ADS, as a bridge for reconstruction of complex finger injuries, offers advantages, such as improved contour, functionality, and decreased need for native flaps.