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Risk of respiratory hospital admission associated with modelled concentrations of Aspergillus fumigatus from composting facilities in England

Roca-Barcelo, Aina; Douglas, Philippa; Fecht, Daniela; Sterrantino, Anna Freni; Williams, Ben; Blangiardo, Marta; Gulliver, John; Hayes, Enda T.; Hansell, Anna L.


Aina Roca-Barcelo

Philippa Douglas

Daniela Fecht

Anna Freni Sterrantino

Ben Williams
Research Fellow in Air Quality Management Resource Centre

Marta Blangiardo

John Gulliver

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Enda Hayes
Professor in Air Quality and Carbon Management

Anna L. Hansell


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.


Roca-Barcelo, A., Douglas, P., Fecht, D., Sterrantino, A. F., Williams, B., Blangiardo, M., …Hansell, A. L. (2020). Risk of respiratory hospital admission associated with modelled concentrations of Aspergillus fumigatus from composting facilities in England. Environmental Research, 183,

Journal Article Type Article
Acceptance Date Nov 18, 2019
Online Publication Date Jan 3, 2020
Publication Date Apr 1, 2020
Deposit Date Feb 11, 2020
Publicly Available Date Feb 13, 2020
Journal Environmental Research
Print ISSN 0013-9351
Electronic ISSN 1096-0953
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 183
Article Number 108949
Keywords Biochemistry; General Environmental Science; Bioaerosol; Aspergillus fumigatus; Composting facility; Respiratory health; Asthma
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