Maryn McKenna

Journalist and Author

Via Farmworkers, Superbugs Find a Route Away from Drug-Using Farms

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Pig farms from the air. Image: Maryn McKenna

Pig farms from the air. Image: Maryn McKenna

One of the persistent questions regarding antibiotic use in meat production, and its effect on the health of humans who live far away from production farms, is: How do the resistant bacteria that result get from one place to another? That is: Most people accept by now that using antibiotics in livestock-raising causes drug resistance to emerge in the systems of those animals, in their guts or on their skin. But whether those newly resistant bacteria leave the farm, and how they make the trip, is both fought over and—despite much investigation—still under-researched.

Some studies have shown that bacteria can move off farms in groundwater, on the feet of flies, and via dust on the wind. What is insufficiently explored—because it is difficult to get large meat-production facilities to cooperate—is whether farm workers themselves are serving as a transport vehicle.

A new study just published (and open-access, so anyone can read it) helps to answer that question. It looks at the possibility that workers on large hog farms are carrying away drug-resistant staph or MRSA, and especially a type of resistant staph — known familiarly as “pig MRSA” and more technically as “livestock-associated MRSA” — that emerged on hog farms a decade ago and is directly linked to farm-drug use.

(If you’ve been visiting Superbug the blog for a while, you might remember pig MRSA; the story of its discovery in a Dutch farmer’s daughter 10 years ago also was told for the first time in Superbug the book. If it’s a new concept to you, you might be interested in this archive here.)

The new study finds that hog farmers are carrying multi-drug resistant livestock-associated MRSA away from the farm and — this is the crucial bit — that their bodies are hanging onto those bacteria, in a way that might allow them to spread, for up to 14 days.

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"Pig MRSA" Carried by Workers from North Carolina Intensive Hog Farms

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Pig farms from the air. Maryn McKenna, Creative Commons License

I saved this post until today to allow everyone to get their holiday hot dogs guilt-free. Now that’s over: An important study has just been published which makes a close connection between the emergence of antibiotic-resistant bacteria, and the use of antibiotics on large-scale conventional hog farms. Bonus: It involves the resistant bacterium MRSA ST398 (known in shorthand as “pig MRSA”), which is widespread in Europe but up to this point has been found mainly in only one state in the US, Iowa. With this paper, the count rises to two(see Update): The study subjects in this paper are hog-farm workers in eastern North Carolina.

A quick explanation of why this is important: “Pig MRSA” is a particular strain of drug-resistant staph that is slightly different from the hospital and community (sports, gym) varieties. It was first spotted in the Netherlands in 2004, in the toddler daughter of pig farmers and in the family’s pigs. Since then, it has spread widely across Europe, not just in agriculture, but in healthcare and in everyday life, and has also been found widely in retail meat.

The question of whether livestock production’s use of antibiotics causes antibiotic-resistant bacteria to move into the wider world is much argued-over, and pig MRSA, or ST398 to be polite, is crucial to that dispute. That’s because, unlike most resistant bacteria, it has a genetic signature that makes an inarguable link back to farm drug use. More on that below. (If you want more, here’s an archive of my posts on ST398; the story of its emergence in 2004 and what happened afterward is told in my 2010 book SUPERBUG.)

Now, the study. Quick summary, with more unpacking to follow: Researchers checked livestock-farm workers in North Carolina to see whether they were carrying staph, and also drug-resistant staph. The workers formed two groups: one group worked at conventional hog operations, which routinely use antibiotics, and the other group at antibiotic-free farms. Both groups carried staph and also drug-resistant staph, which would be expected; about 30 percent of the population carries sensitive staph and about 4 percent carries the drug-resistant form. But, the key difference: Workers from the conventional, antibiotic-using farms were many times more likely to carry staph with the specific signature of farm-drug use.

That illuminates a potential occupational risk to the workers — and it also suggests that the workers could be a channel for that farm-influenced bacterium to move off the farm.

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Human Health, Hog Production and Environmental Harm

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I’ve been offline not just for deadlines (as usual), but also because I was preparing for the annual conference of the National Association of Science Writers; I am a member and was a presenter on a couple of panels. The NASW meeting is twinned every year with a second meeting hosted by the nonprofit Council for the Advancement of Science Writing; NASW sessions are peer-to-peer journalism learning, whereas CASW ones feature academic researchers talking about their newest work.

This year’s meetings (collectively called SciWri12, or #SciWri12 if you want to find them on Twitter) were held in Raleigh, NC, and one of the most striking talks there was a report from epidemiologist Steven Wing of the University of North Carolina, Chapel Hill about his decade-long work investigating the local health effects of very large swine farms. (I’ve written about Wing’s work before.)

The newest news is a paper that he and his team published just as his talk commenced, in the journal Environmental Health Perspectives, which finds an association between air pollution and odor in the near vicinity of swine farms, and hikes in blood pressure in local residents. When you put the pieces together — most hog c0nfinement operations are in poor, non-white areas; cardiovascular disease is endemic in African Americans;  North Carolina lies within the worst US area for cardiovascular disease, known as the “Stroke Belt” — you can see that anything that makes blood pressure chronically worse is bad news for public health.

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Giant pig farms: Antibiotic resistance is not the only problem

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When I talk about farming, I usually focus on antibiotic over-use and the way that it stimulates the emergence of drug-resistant organisms. That’s part of what my recent book is about, and to me, it’s the critical piece in the entire discussion of industrial-scale agriculture. If we didn’t use antibiotics in such vast quantities, confined animal-feeding operations, CAFOS, couldn’t exist: Animals couldn’t survive in those conditions without them.

But so many other negatives come from CAFOs — not just antibiotic resistance, but air and water contamination, and chronic human diseases caused by effluent and pollution. I’m grateful to be reminded of that via a webinar hosted this afternoon by the Institute for Agriculture and Trade Policy, which threw a sharp light on the impact of industrial-scale hog farming in North Carolina.

The webinar took a close look at new research by University of North Carolina associate professor Steven Wing. His paper, just published on the website of the journal Epidemiology, details the acute physical symptoms experienced by North Carolina residents who live in areas near very large hog farms: eye irritation, wheezing, chest tightness, shortness of breath, sore throat and nausea.

Emerging from the farms, Wing said, are “dust, and particles from dried feces, as well as spraying of waste that aerosolizes that material. There are several important gases such as ammonia and hydrogen sulfide… as well as bioaerosols, which include endotoxin from dead bacteria. Some of these materials… are allergenic and can cause respiratory problems.”

(See Wing’s image above of manure spraying, and dead-pig disposal, outside a North Carolina hog farm.)

To get that data, Wing and colleagues at UNC and Mount Sinai School of Medicine collaborated with residents of eastern North Carolina, especially the Concerned Citizens of Tillery, in a project dubbed Community Health Effects of Industrial Hog Operations (CHIEHO). They recruited 101 adults in 16 communities who agreed to sit outside for 10 minutes twice a day, every day for two weeks, and to log their symptoms and also measure their lung function with a flow meter. Separately, the team measured ambient air pollution with continuous monitors that were parked in each community.

Overall, between September 2003 and 2005, they received 2,900 responses about people’s symptoms in the previous 12 hours, 2,600 about symptoms that were provoked by those episodes of sitting outdoors, and 1,900 error-free measurements of lung function. And — no surprise for anyone who knows what these farms look like and smell like — the symptoms tracked with the air pollution measurements.

Wing asked: “Is it fair to tell anyone they can’t go outside their own home because it is too polluted to be there?”

Here’s why conditions outside those eastern North Carolina houses are so bad. Within two miles of each of the communities that contributed to the research, there was an average of 42,000 hogs. Within North Carolina as a whole, there are more than 10 million hogs on more than 2,400 farms. The distribution looks like this:

The spots where the dots cluster most densely are Duplin and Sampson counties. Duplin contains 45 hogs for every resident; Sampson, 32. Something else those areas have in common, mentioned during the webinar by Naeema Muhammad, from Concerned Citizens of Tillery:

Most of those operations are in eastern North Carolina, and eastern North Carolina is where you have your predominantly African-American communities, …other communities of color and also your highest rates of poverty. Looking at that map, we are able to use the phrase “environmental racism.”

Wing and colleagues add in their paper:

…in low-income communities of color… there is more potential for exposure to outdoor air pollutants due to older homes that are not air tight and have no air conditioning. Many residents also lack the financial resources to travel and choose activities that could help them avoid high pollution. Exposure to air pollution from hog operations is an environmental injustice in rural areas hosting facilities that supply pork to populations spared the burdens of its production.

IATP said today they will subsequently post a recording of the webinar along with its slides; I’ll update when it goes live.

Cite: Schinasi, L et al. Air Pollution, Lung Function, and Physical Symptoms in Communities Near Concentrated Swine Feeding Operations. Epidemiology 2011;22: 208–215. DOI: 10.1097/EDE.0b013e3182093c8b

Images: Dead pigs and manure spraying at a North Carolina farm/Institute for Agriculture and Trade Policy + S. Wing, UNC; map of North Carolina hogs farms/IATP + S. Wing, UNC (adapted from Wing et al. 2001)