アブストラクト | 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. |
組織名 | Division of Epidemiology & Public Health, School of Medicine, University of;Nottingham, Clinical Sciences Building Phase II, City Hospital, Hucknall Road,;Nottingham, NG5 1PB, UK. jack.gibson@nottingham.ac.uk.;Centre for Environmental Geochemistry, British Geological Survey, Nicker Hill,;Keyworth, Nottingham, NG12 5GG, UK.;Environmental Geochemistry Baselines Group, British Geological Survey, Nicker;Hill, Keyworth, Nottingham, NG12 5GG, UK.;Centre for Evidence Based Health Care, School of Health Sciences, University of;Nottingham, Queen's Medical Centre, Nottingham, NG7 2HA, UK.;Nottingham, NG5 1PB, UK. |