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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

Gibson, Jack E.; Ander, E. Louise; Cave, Mark; Bath-Hextall, Fiona; Musah, Anwar; Leonardi-Bee, Jo

Authors

JACK GIBSON jack.gibson@nottingham.ac.uk
Assistant Professor in Epidemiology

E. Louise Ander

Mark Cave

Fiona Bath-Hextall

Anwar Musah mcxam23@nottingham.ac.uk

JO LEONARDI-BEE jo.leonardi-bee@nottingham.ac.uk
Professor of Medical Statistics and Epidemiology



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: 377 of 395 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.

Citation

Gibson, J. E., Ander, E. L., Cave, M., Bath-Hextall, F., Musah, A., & Leonardi-Bee, J. (2018). 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, 16(12), https://doi.org/10.1186/s12963-018-0168-2

Journal Article Type Article
Acceptance Date Jun 19, 2018
Publication Date Jul 16, 2018
Deposit Date Jun 6, 2018
Publicly Available Date Jul 16, 2018
Journal Population Health Metrics
Electronic ISSN 1478-7954
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 16
Issue 12
DOI https://doi.org/10.1186/s12963-018-0168-2
Public URL http://eprints.nottingham.ac.uk/id/eprint/52183
Publisher URL https://pophealthmetrics.biomedcentral.com/articles/10.1186/s12963-018-0168-2
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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