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

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 surve...

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Main Authors: Gibson, Jack E., Ander, E. Louise, Cave, Mark, Bath-Hextall, Fiona, Musah, Anwar, Leonardi-Bee, Jo
Format: Article
Published: BioMed Central 2018
Online Access:https://eprints.nottingham.ac.uk/52183/
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author Gibson, Jack E.
Ander, E. Louise
Cave, Mark
Bath-Hextall, Fiona
Musah, Anwar
Leonardi-Bee, Jo
author_facet Gibson, Jack E.
Ander, E. Louise
Cave, Mark
Bath-Hextall, Fiona
Musah, Anwar
Leonardi-Bee, Jo
author_sort Gibson, Jack E.
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-521832020-05-04T19:46:33Z https://eprints.nottingham.ac.uk/52183/ 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 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. BioMed Central 2018-07-16 Article PeerReviewed Gibson, Jack E., Ander, E. Louise, Cave, Mark, Bath-Hextall, Fiona, Musah, Anwar and Leonardi-Bee, Jo (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). ISSN 1478-7954 https://pophealthmetrics.biomedcentral.com/articles/10.1186/s12963-018-0168-2 doi:10.1186/s12963-018-0168-2 doi:10.1186/s12963-018-0168-2
spellingShingle Gibson, Jack E.
Ander, E. Louise
Cave, Mark
Bath-Hextall, Fiona
Musah, Anwar
Leonardi-Bee, Jo
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
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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
url https://eprints.nottingham.ac.uk/52183/
https://eprints.nottingham.ac.uk/52183/
https://eprints.nottingham.ac.uk/52183/