Residential proximity to high-density poultry operations associated with campylobacteriosis and infectious diarrhea

Melissa N. Poulsen, Jonathan Pollak, Deborah L. Sills, Joan A. Casey, Sara G. Rasmussen, Keeve E. Nachman, Sara E. Cosgrove, Dalton Stewart, Brian S. Schwartz

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Poultry carry zoonotic bacteria that can cause gastroenteritis in humans. Environmental transmission of pathogens from poultry operations may increase gastrointestinal infection risk in surrounding communities. To evaluate associations between residential proximity to high-density poultry operations and individual-level diarrheal illnesses, we conducted a nested case-control study among 514,488 patients in Pennsylvania (2006–2015). Using electronic health records, we identified cases of five gastrointestinal outcomes: three pathogen-specific infections, including Escherichia coli (n = 1425), Campylobacter (n = 567), and Salmonella (n = 781); infectious diarrhea (n = 781); and non-specific diarrhea (2012–2015; n = 28,201). We estimated an inverse-distance squared activity metric for poultry operations based on farm and patient addresses. Patients in the second and fourth (versus first) quartiles of the poultry operation activity metric had increased odds of Campylobacter (AOR [CI], Q2: 1.36 [1.01, 1.82]; Q3: 1.38 [0.98, 1.96]; Q4: 1.75 [1.31, 2.33]). Patients in the second, third, and fourth quartiles had increased odds of infectious diarrhea (Q2: 1.76 [1.29, 2.39]; Q3: 1.76 [1.09, 2.85]; Q4: 1.60 [1.12, 2.30]). Stratification revealed stronger relations of fourth quartile and both Campylobacter and infectious diarrhea in townships, the most rural community type in the study geography. Increasing extreme rainfall in the week prior to diagnosis strengthened fourth quartile Campylobacter associations. The poultry operation activity metric was largely unassociated with E. coli, Salmonella, and non-specific diarrhea. Findings suggest high-density poultry operations may be associated with campylobacteriosis and infectious diarrhea in nearby communities, highlighting additional public health concerns of industrial agriculture.

Original languageEnglish (US)
Pages (from-to)323-333
Number of pages11
JournalInternational Journal of Hygiene and Environmental Health
Issue number2
StatePublished - Mar 2018


  • Campylobacter
  • Diarrhea
  • Escherichia coli
  • Industrial food animal production
  • Poultry
  • Salmonella

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Residential proximity to high-density poultry operations associated with campylobacteriosis and infectious diarrhea'. Together they form a unique fingerprint.

Cite this