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

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 q...

Full description

Saved in:

Bibliographic Details
Published in:	Population health metrics 2018-07, Vol.16 (1), p.12-12, Article 12
Main Authors:	Gibson, Jack E, Ander, E Louise, Cave, Mark, Bath-Hextall, Fiona, Musah, Anwar, Leonardi-Bee, Jo
Format:	Article
Language:	eng
Subjects:	Arsenic Catchment area (health) [N06.850.505.400.800.200] Cohort Studies Diabetic retinopathy Elements [D01.268] England Environment Environment and public health [N06] Environmental aspects Environmental Exposure - adverse effects Environmental Exposure - analysis Environmental impact Epidemiology Feasibility studies Fluorescence Health care Health services Humans Internet Medical record linkage [E05.318.308.940.968] Medical Records Metals, Heavy - adverse effects Metals, Heavy - analysis Patients Primary care Primary Health Care Prospective Studies Residence characteristics [N06.850.505.400.800] Skin cancer Soil - chemistry Soil [D20.721] [G01.311.820] [N06.230.600] Soil contamination Soil Pollutants - adverse effects Soil Pollutants - analysis Soil properties Soil quality Soils Spatial Analysis Trace Elements - adverse effects Trace Elements - analysis Wales
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	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. 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. 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. 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.
ISSN:	1478-7954 1478-7954