THE MORBUS SENTINEL PRACTICE NETWORK - REPORT ON A STUDY IN SOUTH OLDENBURG

There has been considerable public concern that emissions from intensi ve livestock farming may have hazardous effects on human health, parti cularly on the respiratory system. From October 1991 to September 1992 , data on consultations of asthmatic children (up to 8 years) were obt ained by a network of 25 GP and paediatric practices in South Oldenbur g, a region with one of the highest livestock densities in Germany. Co mparable data from a similar network of 75 practices in 3 adjacent reg ions (Brunswick, Hanover, Verden) with average livestock density serve d as a reference. In South Oldenburg, 2084 consultations of 542 asthma tic children were observed, with asthma being the reason for visit in 734 of the contacts (36%). The boy-girl ratio was 2.1 : 1 among index patients and 1.9 : 1 among consultations. Consultation rate was 25.2 c ontacts by asthmatic children per 1,000 total consultations of childre n up to 8 years in South Oldenburg, compared to 17.8 per 1,000 in Ha-n ever, 15.7 per 1000 in Brunswick and 13.6 per 1,000 in Verden. Consult ations due to asthma scored 11.2/1,000 in South Oldenburg, 10.8/1,000 in Hanover, 7.2/1,000 in Brunswick and 6.5/1,000 in Verden. Asthmatic patients in South Oldenburg were younger (mean age 38 vs. 42 months) t han those observed in the reference regions. There were no regional pa tterns in sex ratio, severity of asthma, respiratory allergies or atop ic dermatitis. As this is an ecological study design, inferences conce rning the cause of the observed regional differences can only be weak. We therefore propose a case-control study in order to obtain exposure and health data on an individual level.