Poultry Production in Maryland: Environmental

Impacts and Community Health Issues

Ellen Silbergeld

EHS/BSPH

July 2006

Research at JHSPH on Poultry Production

EPIDEMIOLOGY EXPOSURE, HEALTH OUTCOMES

PRODUCT MONITORING POULTRY PRODUCTS TESTING

ENVIRONMENTAL STUDIES PATHWAYS AND ROUTES OF EXPOSURE

AIR, WATER, DUSTS, SOILS BIOTIC TRANSFERS – WILDLIFE STUDIES

MOLECULAR MICROBIOLOGY TRACKING PATHOGEN MOVEMENT TRACKING GENE TRANSFER MICROBIAL POPULATION GENETICS/DIVERSITY

POLICY ANALYSIS ECONOMIC ANALYSES SCIENTIFIC BASIS for RISK ASSESSMENT

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

Factory farms – integrated production model

Concentrated, high volume housing and processing

Highly intensive localization

Broad integration of food production and distribution

THE GEOGRAPHIC CONCENTRATION OF POULTRY PRODUCTION – 50 YEARS in US

US poultry production, 1949Each dot = 50,000 chickens

US poultry production 1991Each dot = 740,000 chickens

DELMARVA POULTRY INDUSTRY

600-800 million broiler chickens produced annually.

6000 broiler chicken houses

2,500 chicken growers

15,000 poultry employees

Total annual gross income of Delmarva broiler industry: exceeds 1.3 billion dollars.

ENVIRONMENTrivers and streams

FARMS HUMANSAnimalfeeds

Slaughter

Harvesting

Processing

Handling

Preparation

Consumption

Offal

IrrigationDrinking water

Manure spreading

Farm effluents Sewage

SwimmingBay

Contact High Risk Populations• Children• Elderly• Immunocompromised

Adapted from Dr. Ruth Etzel USDA

Many Nonfood Routes of Exposure and Transfer

Farmers, workers, communities

THE OTHER PRODUCT OF CAFOs

The DelMarVa Penninsula: The “other product” of poultry production

>1,000,000 tons of “manure” produced by ~800 million chickens/yr

Integrators own the birds Growers own the waste Management - largely land

applied

Why are we concerned?

More biosolids applied than land can handle

Contributes to surface and groundwater contamination

Increased nutrient runoff into surface waters

Detectable presence of drugs and resistance determinants in groundwater

WHO IS AT RISK FOR EXPOSURE?

Workers and growers who work in broiler houses

Workers who handle live chickens at processing plants

Household members of these personsCommunity residents

The Poultry Environment Health Study

HYPOTHESES PERSONS WITH DIRECT EXPOSURE TO

THE POULTRY ENVIRONMENT ARE AT INCREASED RISK OF EXPOSURE TO ABR

EXPOSED PERSONS ARE AT INCREASED RISK OF BACTERIA-ASSOCIATED OUTCOMES

THERE IS A GRADIENT OF EXPOSURE, AND HEALTH RISK, AMONG WORKERS, THEIR FAMILIES AND THE COMMUNITY

The Poultry Environment Health Study

SUBJECTS POULTRY HOUSE WORKERS “LIVE HANGERS” GROWERS HOUSEHOLD MEMBERS

COMMUNITY RESIDENTS

Working in the poultry industry

Living near the poultry industry

The Poultry Environment Health Study

EXPOSURE RISKS PATHOGENS ANTIBIOTIC RESISTANCE ANTIBIOTICS ARSENIC

PATHWAYS AIR, WATER, DUSTS, WILDLIFE, CAUGHT

FISH, FOOD PLANTS

Figure 2: Antibiotic-Resistant Bacteria Present in Indoor Air Samples Collected from a Swine CAFO

100 100 100 100

0

100 10097

86

0

100 100 100

67

00

10

20

30

40

50

60

70

80

90

100

110

Multi-drug Resistant(Resistant >=2 Classes

of Antibiotics)

Erythromycin(Breakpoint >= 8 ug/ml)

Tetracycline(Breakpoint >= 16 ug/ml)

Virginiamycin*(Breakpoint >= 4 ug/ml)

Vancomycin(Breakpoint >= 32 ug/ml)

Antibiotic

Perc

enta

ge o

f Tes

ted

Isolat

es R

esist

ant

Coagulase-negative Staphylococcus(n = 44) Viridans Group Streptococcus(n = 45)Non-E. faecalis Enterococcus(n = 29)

Figure 2: Antibiotic-Resistant Bacteria Present in Indoor Air Samples Collected from a Swine CAFO

100 100 100 100

0

100 10097

86

0

100 100 100

67

00

10

20

30

40

50

60

70

80

90

100

110

Multi-drug Resistant(Resistant >=2 Classes

of Antibiotics)

Erythromycin(Breakpoint >= 8 ug/ml)

Tetracycline(Breakpoint >= 16 ug/ml)

Virginiamycin*(Breakpoint >= 4 ug/ml)

Vancomycin(Breakpoint >= 32 ug/ml)

Antibiotic

Perc

enta

ge o

f Tes

ted

Isolat

es R

esist

ant

Coagulase-negative Staphylococcus(n = 44) Viridans Group Streptococcus(n = 45)Non-E. faecalis Enterococcus(n = 29)

AIRBORNE BACTERIA IN CAFOS ARE MULTI DRUG RESISTANT

VAN-RMDR ERYTH-R TET-R VM-R

Chapin et al (2005) EHP

Air releases from CAFO ventilation systems

The Poultry Environment Health Study

OUTCOMES BACTERIAL CARRIAGE REPORTED DIARRHEAL DISEASE RESPIRATORY FUNCTION TESTS NEUROLOGICAL SYMPTOMS

METHODS ISOLATION OF BACTERIA FROM STOOL;

MEASUREMENT OF ANTIBODIES IN SERA QUESTIONNAIRES RESPIRATORY FUNCTION TESTING

Poultry Health Study: Health Status in poultry workers– Preliminary Results

Self reported symptoms: PW and referents PW report more frequent GI symptoms

OR 2-5 PW report much more frequent respiratory symptoms

OR 2.6-35 PW report much more frequent neuromuscular

symptoms, including paralysis, problems with vision and speech

OR 5.4-13.8

Arsenic sources - US

ARSENIC – THE FORGOTTEN ANTIBIOTIC

extensive use of arsenicals in broiler feedsdocumented contamination of waste and

amended landpercolation into groundwaterarsenic is a human carcinogen and

associated with skin, liver, and cardiovascular disease

ARSENIC and POULTRY

Roxarsone, arsanilic acid used in poultry as coccidiostats and growth promoters – 45 g/ton feed

GP – continuous lifelong exposure in feeds arsenicals excreted (>70%) 100-200 mg/bird (900 million/yr) 50,000-90,000 mt/year arsenic arsenicals inorganic arsenic leach into groundwater

SHALLOW AQUIFERS IN DELMARVA

A SUGGESTIVE TRACE?

What does this tell us about avian flu?

?

?

?

Wild avians contact poultry houses

Photo courtesy of Dr Donald Burke

What are the risks of occupational contact and AF exposure? Three papers

Koopmans et al (2004) National surveillance study in Netherlands; symptom driven 2003 H7N7 outbreak HPAI All farmers, workers, families, veterinarians in outbreak

regions

Bridges et al (2001) Outbreak investigation of poultry workers and govt

investigators Hong Kong 1997-8 H5N1

Myers et al (2006) Cross sectional study of Iowa pork farmers, meat processing

workers, veterinarians; Univ of Iowa referent group Swine influenza transmission risks

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

Odds of antibody carriage: Farm/hatchery workers 2.7 Work on farm >10% bird mortality 2.2 Touching live poultry 5.8 Feeding live poultry 2.4 Butchering live poultry 3.1[referents: government workers]

Occupational dose: response observed

ACKNOWLEDGEMENTS

STUDENTS Jon Furuno, Amy Chapin, Lance Price, Jay Graham, Amira

Roess, Meche Nweke, Keeve Nachman, Carter Erwin, Patrick Butler, Redwan Huq,

COLLEAGUES Carol Resnick, Rocio Vailes, Pat Charache, Kellogg Schwab,

Rolf Halden, Pat Breysse, Bill Spannhake, Kris Macri, Tim Buckley, Pat Charache, John Griffin, Kazim Sheikh, Vasken Aposhian, Tracy Hancock, Henrik Wegener

Carole Morison, Patrick Harmon, Jim Lewis, Pilar Perez, Jackie Nowell -- UFCW

FUNDING CLF, Grace, HHMI, NIOSH, Winslow and Baker Foundations