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How Do We Put America First If We Don’t Put Our Children First?

Health Impacts of CAFOs on Children

A multitude of studies demonstrate the threat of factory farms to human health. (1) Children, with their developing immune systems, are especially vulnerable to many of the health risks posed by CAFOs (2) ranging from asthma to antibiotic resistant infections to birth defects.


Asthma in Children


Hydrogen sulfide and ammonia are two of the most harmful gases produced by putrefying manure in confinement pits, and each can cause respiratory ailments. Children inhale more air relative to their size than adults, therefore, they are at greater risk of harm from these toxic gases.(3)

Studies conducted at the University of Iowa (UI) and other universities link factory farms with a higher incidence of childhood asthma. A study of farm children in Keokuk County, Iowa, found 44% of those living on CAFOs with hundreds of hogs and confinement pits had asthma symptoms compared to 26% of the children who lived on traditional farms without CAFOs. (3)

The number of children with asthma jumped to 56% if antibiotics were fed to hogs. "Farms that added antibiotics to feed tended to have larger numbers of livestock than farms that did not add antibiotics to feed," said UI College of Public Health Dean Emeritus James Merchant in a press statement. "The addition of antibiotics may serve as an indicator of larger swine operations, however, it is plausible that this route of antibiotic exposure may play some causal role in the development of childhood asthma.”

A University of North Carolina study of 58,169 students ages 12-14 years found a 5% higher incidence of asthma in adolescents attending school within three miles of a CAFO as compared to

those living further away. That figure jumped to a 24% greater incidence if CAFO odors were detectable indoors for a minimum of two days a month.  “Estimated exposure to airborne pollution from confined swine feeding operations is associated with adolescents’ wheezing symptoms,” the researchers concluded. (4)


Antibiotic Resistant Infections in Children Rising  - MRSA

70-80% of all antibiotics used in the US are administered to livestock raised in CAFOs primarily to prevent diseases and enhance growth. Low dosage antibiotic use in agriculture is a significant factor in the rise of antibiotic resistance bacteria, says the American Academy of Pediatrics. (5)


MRSA – Methicillin Resistant Staphylococcus aureus  - is a leading antibiotic-resistant bacterial infection in the US. It’s often difficult to treat and can be fatal in people with weakened immune systems.


MRSA is categorized as either hospital acquired or community acquired, and several studies have linked community-acquired MRSA (CA-MRSA) to hog confinements. A leading University of Iowa study found 64% of Iowa CAFO workers tested in 53 Iowa counties colonized the same strain of CA-MRSA as hogs in their confinements. That’s six times the rate of individuals who don’t come into contact with swine. (6)


“While carriage of S. aureus isn’t itself harmful, individuals who harbor the bacterium in their nose, throat, or on their skin are at risk of developing an active staph infection, and they can also pass the bacterium to other family or community members. Individuals who may be immunocompromised, or have existing conditions such as diabetes, are especially at risk from staph infections,” said study researcher Tarah Smith in Iowa Now. (7)


Neighbors living within one mile of a large factory farm (2500 hogs or more) have a nearly three times greater chance of colonizing CA-MRSA, according to another University of Iowa study. (8) Johns Hopkins University researchers also determined that 11% of their 446,480 subjects infected with MRSA lived adjacent to a field where liquid CAFO manure was applied. (9)

There have been sharp declines in hospital-acquired MRSA in adults (10), but a Centers for Disease Control and Prevention study found that children experienced a 10% increase in CA-MRSA from 2005 to 2010. Infants from 3-90 days old experienced a higher incidence as compared to older infants and children. Ninety-one percent of the children suffering from MRSA were hospitalized with 6% resulting in death. CA-MRSA accounted for 42% of the cases in the study. (11)


Antibiotic Resistance Increasing in Urinary Tract Infections


E. coli urinary tract infections (UTIs) are common in children. A new study found these infections are becoming harder to fight because of growing antibiotic resistance to E. coli UTI bacteria. (12)

A review of 56 studies in 26 countries found that half of all the UTI bacterial infections were resistant to ampicillin, a third to co-trimoxazole, and a quarter to trimenthoprim. Antibiotics are considered resistant when they fail 20% or more of the time.


Children are more at risk for UTI complications including kidney scarring and kidney failure, so prompt and effective treatment is necessary. “Bacterial infections resistant to antibiotics can limit the availability of effective treatment options,” researchers wrote, doubling the risk of patient mortality.


The review also found UTI resistance paralleled concerning increases in antibiotic resistance to drugs that are frequently used in treating Streptococcus pneumonia, Klebsiella pneumonia and Staphylococcus aureus (MRSA).


Antibiotic Resistance and Foodborne Illnesses in Children


Infants and children are at risk for antibiotic-resistant bacterial infections from meat, dairy, and egg products contaminated with pathogens.  A 2013 survey of the CDC’s Food Diseases Active Surveillance Network found that children younger than 5 years old were affected the most by foodborne illnesses. (5)

1.2 million Salmonella cases were reported in 2013. Of these, 123,452 children younger than 5 contracted Salmonella requiring 4670 hospitalizations and resulting in 38 deaths. Five percent of the cases were resistant to five or more classes of antibiotics.


Campylobacter is also a major foodborne bacterium in children. The CDC survey found 81,796 cases of campylobacter illness resulting in 1042 hospitalizations, and 6 deaths in children younger than 5 years in 2013. Resistance to ciprofloxacin used to treat campylobacter jumped from 13% in 1997 to nearly 25% in 2011.

“Because of the link between antibiotic use in food-producing animals and the occurrence of antibiotic-resistant infections in humans, antibiotic agents should be used in food-producing animals only to treat and control infectious diseases and not to promote growth or to prevent disease routinely,” writes the American Academy of Pediatrics.  

Blue Baby Syndrome, Birth Defects, and Nitrates

High nitrate levels in drinking water poses a potentially fatal threat to infants who ingest water with levels higher than 10 milligrams per liter.  Excessive nitrates leads to methemoglobinemia – known as blue baby syndrome – because it reduces the amount of oxygen traveling in a baby’s body. (13)


The Iowa Department of Natural Resources reports 92% of nitrate pollution in Iowa waterways originates from agriculture. (14) Factory farms contribute a significant amount to agricultural pollution via manure runoff and monocropping for feed production. 

Iowa DNR data reveals that over 60 Iowa municipalities experienced high nitrate levels in their water supply between 2010-2015, including the Des Moines Water Works. They also reported 260 cities and towns  - a third of Iowa’s 880 municipalities - are highly susceptible to nitrate and other pollutants. Nitrate removal systems are expensive, and unlike the Des Moines Water Works, many of these cities and towns have no ability to remove the excess nitrates, according to the DNR. (15)


High nitrate levels also accounted for an increase in birth defects when pregnant mothers drank water with nitrate levels of 5 mg or more daily. A Texas A&M Health Center/University of Iowa study found that Texas and Iowa mothers were twice as likely to give birth to babies with spina bifida than mothers who drank water with nitrate levels less than 0.91 mg daily.


Babies with limb deficiencies, cleft palate, and cleft lip were also 1.8, 1.9, and 1.8 times, respectively, more likely to be born of women who drank water with 5.42 or more mg of nitrates daily as compared to mothers drinking water with less than 1 mg nitrate per day.


The highest levels of nitrates would be found in private wells in agricultural areas, said the authors, and recommended expectant mothers get their water tested for nitrates. (16)



1. Iowa Alliance for Responsible Agriculture.

2. “Human Health Effects.” Iowa Concentrated Animal Feeding Operation Air Quality Study. Environmental Health Sciences Research Center, University of Iowa. December 2003.

3. Asthma and Farm Exposures in a Cohort of Rural Iowa Children. Environmental Health Perspectives. March 2005.

4.“Asthma symptoms among adolescents who attend public schools that are located near confined swine feeding operations.” Pediatrics. July 2006.

5. “Nontherapeutic Use of Antimicrobial Agents in Animal Agriculture: Implications for Pediatrics.” Pediatrics. November 2015.

6. “Methicillin-Resistant Staphylococcus aureus (MRSA) Strain ST398 Is Present in Midwestern U.S. Swine and Swine Workers.” PLOS One. January 2009.

7. “Study Finds Swine Farming Is a Risk Factor for Drug-Resistant Staph Infections.” Iowa Now. The University of Iowa. April 27, 2015.  

8. “Residential Proximity to Large Numbers of Swine in Feeding Operations Is Associated with Increased Risk of Methicillin-Resistant Staphylococcus aureus Colonization at Time of Hospital Admission in Rural Iowa Veterans.” Infection Control and Hospital Epidemiology. February 2014.

9. “High-Density Livestock Operations, Crop Field Application of Manure, and Risk of Community-Associated Methicillin-Resistant Staphylococcus aureus Infection in Pennsylvania.” JAMA Internal Medicine. November 2013.

10. “National Burden of Invasive Methicillin-Resistant Staphylococcus aureus Infections, United States, 2011.” JAMA Internal Medicine. November 25, 2013.

11. “Trends in Invasive Methicillin-Resistant Staphylococcus aureus Infections.” Pediatrics. October 2013.

12. “Antibiotic Resistance in Children with E Coli urinary Tract Infection.” The BJM. March 2016.

13. “Nitrate in Drinking Water: A Public Health Concern for All Iowans Executive Summary.” Iowa Environmental Council. September 2016.

14. “Iowa’s Nutrient Budget.” Iowa Department of Natural Resources. 2005.

15. “High Nitrate Levels Plague 60 Iowa Cities, Data Show.” Des Moines Register. July 4, 2015.

16. “Prenatal Nitrate Intake from Drinking Water and Selected Birth Defects in Offspring of Participants in the National Birth Defects Prevention Study.” Environmental Health Perspectives. September 2013.

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