Bioaerosols have been associated with adverse respiratory-related health effects and are emitted in elevated concentrations from composting facilities. We used modelled Aspergillus fumigatus concentrations, a good indicator for bioaerosol emissions, to assess associations with respiratory-related hospital admissions. Mean daily Aspergillus fumigatus concentrations were estimated for each composting site for first full year of permit issue from 2005 onwards to 2014 for Census Output Areas (COAs) within 4 km of 76 composting facilities in England, as previously described (Williams et al., 2019). We fitted a hierarchical generalized mixed model to examine the risk of hospital admission with a primary diagnosis of (i) any respiratory condition, (ii) respiratory infections, (iii) asthma, (iv) COPD, (v) diseases due to organic dust, and (vi) Cystic Fibrosis, in relation to quartiles of Aspergillus fumigatus concentrations. Models included a random intercept for each COA to account for over-dispersion, nested within composting facility, on which a random intercept was fitted to account for clustering of the data, with adjustments for age, sex, ethnicity, deprivation, tobacco sales (smoking proxy) and traffic load (as a proxy for traffic-related air pollution). We included 249,748 respiratory-related and 3163 Cystic Fibrosis hospital admissions in 9606 COAs with a population-weighted centroid within 4 km of the 76 included composting facilities. After adjustment for confounders, no statistically significant effect was observed for any respiratory-related (Relative Risk (RR) = 0.99; 95% Confidence Interval (CI) 0.96-1.01) or for Cystic Fibrosis (RR = 1.01; 95% CI 0.56-1.83) hospital admissions for COAs in the highest quartile of exposure. Similar results were observed across all respiratory disease sub-groups. This study does not provide evidence for increased risks of respiratory-related hospitalisations for those living near composting facilities. However, given the limitations in the dispersion modelling, risks cannot be completely ruled out. Hospital admissions represent severe respiratory episodes, so further study would be needed to investigate whether bioaerosols emitted from composting facilities have impacts on less severe episodes or respiratory symptoms.

中文翻译：

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与英格兰堆肥设施中烟曲霉浓度的模型化有关的呼吸道入院风险。

生物气溶胶已与呼吸系统相关的不良健康影响相关联，并从堆肥设施中以高浓度排放。我们使用建模的烟曲霉浓度（一种良好的生物气溶胶排放指标）来评估与呼吸道相关住院的相关性。如前所述（Williams et al。，2019），据估计，从2005年起至2014年，在英格兰76个堆肥设施的4公里范围内，人口普查输出区域（COA）的首个整年许可证发放期间，每个堆肥场的日均烟曲霉平均浓度。 ）。我们拟合了分层的广义混合模型，以初步诊断以下各项来检查入院风险：（i）任何呼吸道疾病，（ii）呼吸道感染，（iii）哮喘，（iv）COPD，（v）有机粉尘引起的疾病，（vi）囊性纤维化，涉及烟曲霉浓度的四分位数。模型包括针对每个COA的随机截距，以解释过度分散，嵌套在堆肥设施中，在该随机截距上安装随机截距，以解释数据的聚类，并对年龄，性别，种族，贫困，烟草销售（吸烟）进行调整代理）和交通负荷（作为与交通相关的空气污染的代理）。我们在9606个COA中纳入了249,748例与呼吸相关的疾病和3163例囊性纤维化的住院患者，其中包括76个堆肥设施中4 km以内的人口加权质心。调整混杂因素后，对于与呼吸有关的任何疾病（相对风险（RR）= 0.99； 95％置信区间（CI）0.96-1.01））或囊性纤维化（RR = 1.01； 95％CI 0.56-），均未观察到统计学显着性影响1。83）最高四分位数的COA入院率。在所有呼吸系统疾病亚组中观察到相似的结果。这项研究没有为堆肥设施附近居住的人提供呼吸相关住院风险增加的证据。但是，鉴于色散建模的局限性，不能完全排除风险。医院入院代表严重的呼吸道发作，因此需要进一步研究以调查堆肥设施排放的生物气溶胶是否对不太严重的发作或呼吸道症状产生影响。这项研究没有为堆肥设施附近居住的人提供呼吸相关住院风险增加的证据。但是，鉴于色散建模的局限性，无法完全排除风险。医院入院代表严重的呼吸道发作，因此需要进一步研究以调查堆肥设施排放的生物气溶胶是否对不太严重的发作或呼吸道症状产生影响。这项研究没有为堆肥设施附近居住的人提供呼吸相关住院风险增加的证据。但是，鉴于色散建模的局限性，不能完全排除风险。医院入院代表严重的呼吸道发作，因此需要进一步研究以调查堆肥设施排放的生物气溶胶是否对不太严重的发作或呼吸道症状产生影响。