Concentrated swine feeding operations and public health: A review of occupational and community health effects

Recent industry changes in swine-management practices have resulted in a gr owing controversy surrounding the environmental and public health effects o f modern swine production. The numerous wastes produced by intensive swine production not only pose a significant challenge to effective environmental management but also are associated with decreased air quality in confineme nt houses, potentially transferable antimicrobial resistance patterns, and several infectious agents that can be pathogenic to humans. Published studi es have documented a variety of contaminants, microbial agents, and health effects in those occupationally exposed to swine, and these have provided t he groundwork for an increasing body of research to evaluate possible commu nity health effects. Nonetheless, several factors limit our ability to defi ne and quantify the potential role of intensive swine-rearing facilities in occupational and community health. Our incomplete understanding and abilit y to detect specific exposures; the complicated nature of disease etiology, pathogenesis, and surveillance; and the inherent difficulties associated w ith study design all contribute to the inadequate level of knowledge that c urrently prevails. However, an evaluation of the published literature, and a recognition of the elements that may be compromising these studies, provi des the foundation from which future studies may develop.