{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T17:05:30Z","timestamp":1780333530794,"version":"3.54.1"},"reference-count":57,"publisher":"National Institute for Health and Care Research","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001921","name":"Public Health Research programme","doi-asserted-by":"publisher","award":["NIHR129449"],"award-info":[{"award-number":["NIHR129449"]}],"id":[{"id":"10.13039\/501100001921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journalslibrary.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"abs1-1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Exposure to particulate matter is linked to increased mortality, respiratory and cardiovascular diseases, including lung cancer, ischaemic heart disease and asthma, among other adverse health outcomes. Emissions of particulate matter from agriculture occur directly from farming activities and from reaction of ammonia with acidic pollutants to form fine particles (PM\n                      <jats:sub>2.5<\/jats:sub>\n                      : particles with diameter of 2.5\u00a0\u03bcm or less). In the United Kingdom, ammonia has slightly increased in recent years, in contrast to other PM\n                      <jats:sub>2.5<\/jats:sub>\n                      sources. In addition, NH\n                      <jats:sub>3<\/jats:sub>\n                      emissions can contribute to nitrogen deposition, which, in excess of critical thresholds, may result in biodiversity loss.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs1-2\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Our objectives were to assess the effectiveness and cost-effectiveness of inter-related interventions to: (1) assess the annual health impacts of air pollution (PM\n                      <jats:sub>2.5<\/jats:sub>\n                      ) from intensive livestock agriculture and farming on the general population; (2) valuate the effectiveness and cost-effectiveness of the specific interventions at the national level; (3) assess impacts on ecosystems; and (4) examine the extent to which rural residents are concerned about agriculture and their health.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs1-3\">\n                    <jats:title>Design and methods<\/jats:title>\n                    <jats:p>\n                      We performed a health impact assessment based on PM\n                      <jats:sub>2.5<\/jats:sub>\n                      exposures associated with three levels of agricultural intervention. We also performed an economic analysis, capturing valuation of health and productivity, and costs to the national health service, as well as an assessment of ecosystem impacts based on nitrogen deposition and biodiversity loss. A survey of rural residents\u2019 health was undertaken to investigate links between self-reported health and agriculture.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs1-4\">\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>The three intervention scenarios comprised 19 individual mitigation actions at a farm level, each with differing uptake levels in low, medium and high scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs1-5\">\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The health impact assessment and economic analyses included all-cause mortality, and incidence of lung cancer, ischaemic heart disease, cerebrovascular disease, and childhood asthma incidence. The ecosystem analysis examined biodiversity loss, and the rural residents survey addressed respiratory, gastrointestinal, and neurological diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs1-6\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Modest changes in PM\n                      <jats:sub>2.5<\/jats:sub>\n                      concentrations across the United Kingdom associated with the low, medium and high intervention scenarios resulted in relatively small impacts compared to national baseline levels of mortality and morbidity (i.e. \u22120.01% to \u22120.05%). Overall, United Kingdom-wide avoided costs ranged from \u00a378.1 to \u00a393.4M, with much lower annual avoided costs to the national health service. All habitats had a relative increase in biodiversity under all scenarios with expected benefits of \u00a33.4\u20134M. There were 450\u2013500 respondents in each of the 2 waves of the rural resident surveys. No associations were identified between any self-reported disease occurrence and farm-related variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs1-7\">\n                    <jats:title>Limitations<\/jats:title>\n                    <jats:p>Our approach used several different models, requiring important assumptions and uncertainties. Respondents to the residents\u2019 survey tended to be aged over 45 and female and findings are applicable primarily to this demographic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs1-8\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Based on the modest modelled changes in PM\n                      <jats:sub>2.5<\/jats:sub>\n                      concentrations associated with the intervention scenarios, we estimated small impacts with human health, as well as economic and ecosystem effects. We found no evidence of self-reported health issues in relation to farms or farming practices.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs1-9\">\n                    <jats:title>Future work<\/jats:title>\n                    <jats:p>\n                      Impacts from alternative farming interventions should be assessed to maximise PM\n                      <jats:sub>2.5<\/jats:sub>\n                      reductions in the United Kingdom.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs1-10\">\n                    <jats:title>Funding<\/jats:title>\n                    <jats:p>This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR129449.<\/jats:p>\n                  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