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Open Access 01-12-2018 | Research

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

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

Published in: Population Health Metrics | Issue 1/2018

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.

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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
Authors: Jack E. Gibson
E. Louise Ander
Mark Cave
Fiona Bath-Hextall
Anwar Musah
Jo Leonardi-Bee
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Population Health Metrics / Issue 1/2018
Electronic ISSN: 1478-7954
DOI: https://doi.org/10.1186/s12963-018-0168-2

At a glance: The STEP trials

Springer Medicine

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

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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