Linkage of national soil quality measurements to primary care medical records in England and Wales: a new resource for investigating environmental impacts on human health
Abstract Background Long-term, low-level exposure to toxic elements in soil may be harmful to human health but large longitudinal cohort studies with sufficient follow-up time to study these effects are cost-prohibitive and impractical. Linkage of routinely collected medical outcome data to systemat...
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| Format: | Article |
| Language: | English |
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BMC
2018-07-01
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| Series: | Population Health Metrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12963-018-0168-2 |
| _version_ | 1819130193163321344 |
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| author | Jack E. Gibson E. Louise Ander Mark Cave Fiona Bath-Hextall Anwar Musah Jo Leonardi-Bee |
| author_facet | Jack E. Gibson E. Louise Ander Mark Cave Fiona Bath-Hextall Anwar Musah Jo Leonardi-Bee |
| author_sort | Jack E. Gibson |
| collection | DOAJ |
| description | Abstract Background Long-term, low-level exposure to toxic elements in soil may be harmful to human health but large longitudinal cohort studies with sufficient follow-up time to study these effects are cost-prohibitive and impractical. Linkage of routinely collected medical outcome data to systematic surveys of soil quality may offer a viable alternative. Methods We used the Geochemical Baseline Survey of the Environment (G-BASE), a systematic X-ray fluorescence survey of soil inorganic chemistry throughout England and Wales to obtain estimates of the concentrations of 15 elements in the soil contained within each English and Welsh postcode area. We linked these data to the residential postcodes of individuals enrolled in The Health Improvement Network (THIN), a large database of UK primary care medical records, to provide estimates of exposure. Observed exposure levels among the THIN population were compared with expectations based on UK population estimates to assess representativeness. Results Three hundred seventy-seven of three hundred ninety-five English and Welsh THIN practices agreed to participate in the linkage, providing complete residential soil metal estimates for 6,243,363 individuals (92% of all current and former patients) with a mean period of prospective computerised medical data collection (follow-up) of 6.75 years. Overall agreement between the THIN population and expectations was excellent; however, the number of participating practices in the Yorkshire & Humber strategic health authority was low, leading to restricted ranges of measurements for some elements relative to the known variations in geochemical concentrations in this area. Conclusions The linked database provides unprecedented population size and statistical power to study the effects of elements in soil on human health. With appropriate adjustment, results should be generalizable to and representative of the wider English and Welsh population. |
| first_indexed | 2024-12-22T08:55:43Z |
| format | Article |
| id | doaj.art-fc2ff49bb88d4d378bf8d42a14ad2b77 |
| institution | Directory Open Access Journal |
| issn | 1478-7954 |
| language | English |
| last_indexed | 2024-12-22T08:55:43Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Population Health Metrics |
| spelling | doaj.art-fc2ff49bb88d4d378bf8d42a14ad2b772022-12-21T18:31:51ZengBMCPopulation Health Metrics1478-79542018-07-011611910.1186/s12963-018-0168-2Linkage of national soil quality measurements to primary care medical records in England and Wales: a new resource for investigating environmental impacts on human healthJack E. Gibson0E. Louise Ander1Mark Cave2Fiona Bath-Hextall3Anwar Musah4Jo Leonardi-Bee5Division of Epidemiology & Public Health, School of Medicine, University of Nottingham, Clinical Sciences Building Phase II, City HospitalCentre for Environmental Geochemistry, British Geological SurveyEnvironmental Geochemistry Baselines Group, British Geological SurveyCentre for Evidence Based Health Care, School of Health Sciences, University of Nottingham, Queen’s Medical CentreDivision of Epidemiology & Public Health, School of Medicine, University of Nottingham, Clinical Sciences Building Phase II, City HospitalDivision of Epidemiology & Public Health, School of Medicine, University of Nottingham, Clinical Sciences Building Phase II, City HospitalAbstract Background Long-term, low-level exposure to toxic elements in soil may be harmful to human health but large longitudinal cohort studies with sufficient follow-up time to study these effects are cost-prohibitive and impractical. Linkage of routinely collected medical outcome data to systematic surveys of soil quality may offer a viable alternative. Methods We used the Geochemical Baseline Survey of the Environment (G-BASE), a systematic X-ray fluorescence survey of soil inorganic chemistry throughout England and Wales to obtain estimates of the concentrations of 15 elements in the soil contained within each English and Welsh postcode area. We linked these data to the residential postcodes of individuals enrolled in The Health Improvement Network (THIN), a large database of UK primary care medical records, to provide estimates of exposure. Observed exposure levels among the THIN population were compared with expectations based on UK population estimates to assess representativeness. Results Three hundred seventy-seven of three hundred ninety-five English and Welsh THIN practices agreed to participate in the linkage, providing complete residential soil metal estimates for 6,243,363 individuals (92% of all current and former patients) with a mean period of prospective computerised medical data collection (follow-up) of 6.75 years. Overall agreement between the THIN population and expectations was excellent; however, the number of participating practices in the Yorkshire & Humber strategic health authority was low, leading to restricted ranges of measurements for some elements relative to the known variations in geochemical concentrations in this area. Conclusions The linked database provides unprecedented population size and statistical power to study the effects of elements in soil on human health. With appropriate adjustment, results should be generalizable to and representative of the wider English and Welsh population.http://link.springer.com/article/10.1186/s12963-018-0168-2Environment and public health [N06]Residence characteristics [N06.850.505.400.800]Catchment area (health) [N06.850.505.400.800.200]Soil [D20.721] [G01.311.820] [N06.230.600]Elements [D01.268]Medical record linkage [E05.318.308.940.968] |
| spellingShingle | Jack E. Gibson E. Louise Ander Mark Cave Fiona Bath-Hextall Anwar Musah Jo Leonardi-Bee Linkage of national soil quality measurements to primary care medical records in England and Wales: a new resource for investigating environmental impacts on human health Population Health Metrics Environment and public health [N06] Residence characteristics [N06.850.505.400.800] Catchment area (health) [N06.850.505.400.800.200] Soil [D20.721] [G01.311.820] [N06.230.600] Elements [D01.268] Medical record linkage [E05.318.308.940.968] |
| title | Linkage of national soil quality measurements to primary care medical records in England and Wales: a new resource for investigating environmental impacts on human health |
| title_full | Linkage of national soil quality measurements to primary care medical records in England and Wales: a new resource for investigating environmental impacts on human health |
| title_fullStr | Linkage of national soil quality measurements to primary care medical records in England and Wales: a new resource for investigating environmental impacts on human health |
| title_full_unstemmed | Linkage of national soil quality measurements to primary care medical records in England and Wales: a new resource for investigating environmental impacts on human health |
| title_short | Linkage of national soil quality measurements to primary care medical records in England and Wales: a new resource for investigating environmental impacts on human health |
| title_sort | linkage of national soil quality measurements to primary care medical records in england and wales a new resource for investigating environmental impacts on human health |
| topic | Environment and public health [N06] Residence characteristics [N06.850.505.400.800] Catchment area (health) [N06.850.505.400.800.200] Soil [D20.721] [G01.311.820] [N06.230.600] Elements [D01.268] Medical record linkage [E05.318.308.940.968] |
| url | http://link.springer.com/article/10.1186/s12963-018-0168-2 |
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