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Table 1 Summary of characteristics of studies included in the systematic review and meta-analysis by study design (cross-sectional, panel) and publication year (newer to older)

From: Industrial odour pollution and human health: a systematic review and meta-analysis

Study, Country, Study design

Industrial source

Study population, age group

Exposure assessment

Outcome assessment

Statistical analysis

Adjustment for confounders

Cross-sectional studies

 Kret 2018 [30], USA, Cross-sectional

Waste (landfill)

N = 343 adults households within a 3.2-km radius (173 exposed; 170 non-exposed)

Distance (km)

Questionnaire:

self-reported prevalence of diseases and 12 months symptoms; odour annoyance (5-point Likert scale)

Groups:

Odour nuisances

Lower respiratory symptoms

Upper respiratory symptoms

Gastrointestinal symptoms

Mucus irritation

General ill feeling

Model: n.a

Effect estimated: n.a

Weighted prevalence (95%CI)

Matching for percentage of white population and for 25+ population with education level at least high school. No effect estimate.

 Hayes 2017 [31], Australia, Cross-sectional

Wastewater treatment Plant

N = 153 residents within a 3-km radius on two exposed (with a history of high or low number of complaints) and one control sites

Questionnaire (presence/absence of bad smells and odours impacting community)

Questionnaire:

Self-reported psychological symptoms past week; odour annoyance (10-point scale)

Groups:

Mood states

Model: ANOVA

Effect estimated:

None

Social readjustment scale by Holmes and Rahe 1967 added as covariate

 Tjalvin 2015 [32], Norway, Cross-sectional

Chemical Industry (Chemical explosion in an Industrial harbour)

N = 284 workers in 2008 and 203 in 2012 (exposed workers employed in 2008 and/or clean-up workers, proximity to the explosion ≤1 km; control workers) range of age 18–67

Questionnaire: Workers exposure history

Subjective Health Complaints (SHC) score

Groups:

General ill feeling

Gastrointestinal symptoms

Upper respiratory symptoms

Immune function

Cardiovascular problems

Model:

Linear mixed effects models with random intercept and slope

Effect estimated: Mean difference

Age, gender, smoking habits, educational level.

 Tjalvin 2017 [33], Norway, cross-sectional (repeated survey of Tjalvin 2015)

Chemical Industry (Chemical explosion in an Industrial harbour)

N = 486 workers employed in 2008 (18% present during the explosion), in 2010 (n = 379), 2012 (n = 252)

Adults aged 18–67 years

Questionnaire: Low/high odour score (% of months each participant noticed the odour in 2008)

Questionnaire:

Subjective Health Complaints (SHC) score previous month; Impact of Event Scale-Revised (IES-R) previous 7 days

Groups:

General ill feeling

Mood states

Model:

Linear mixed effects models with random intercept and slope

Effect estimated: Mean difference

Age, gender, smoking habits, educational level, absence/presence during the explosion (>  1 km or ≤ 1 km)

 Boers 2016 [34], Netherlands, Cross-sectional

Animal feeding operations

N = 582 residents living near livestock farms

Mean age = 51 years old (SD 13)

(part of the population included in Hooiveld 2015)

Calculated exposure: 98th percentile of odour concentrations (OUE/m3) from Stacks dispersion model

Questionnaire:

Self-reported odour annoyance (4-point scale)

Groups:

Odour nuisances

Model: multivariate logistic regression analysis

Effect estimated: ORs(95%CI)

Age, educational level, indoor air pollution, asthma, or lower back pain

 Hooiveld 2015 [35], Netherlands, Cross-sectional

Animal feeding operations

N = 753 adults, residents with asthma or lower back pain

Questionnaire: Self-reported odour annoyance (yes/no)

Questionnaire:

Self-reported symptoms last month; general health (5-point Likert scale from bad to very good)

Groups:

Gastrointestinal symptoms

General ill feelings

Lower respiratory symptoms

Upper respiratory symptoms

Mood states

Model:

Multiple ordinal logistic, logistic and Poisson regression analysis.

Effect estimated: ORs(95%CI)

Smoking status, growing up at farm, age, gender, nationality, marital status, educational level, asthma or lower back pain, other environmental annoyances (noise, traffic and air pollution)

 Baldacci 2015 [36], Italy, Cross-sectional

Waste (incinerator)

N = 1407 residents within 4-km radius from the incinerator and a control group.

Mean age 44.4 (SD 22.1)

Questionnaire: Self-reported odour annoyance (no, slightly annoying, very annoying)

Questionnaire:

Self-reported symptoms past 12 months.

Groups:

Lower respiratory symptoms

Upper respiratory symptoms

Model: Multivariate logistic regression analysis

Effect estimated: ORs(95%CI)

Gender, age, residence/incinerator distance, educational level, working position, smoking status, passive smoking, residential time, occupational exposure.

 Blanes-Vidal 2015 [37], Denmark, Cross-sectional

Waste (biodegradable)

N = 454 Residents from six study areas in Denmark.

Mean age 54 (SD 14)

NH3 concentration: loge (NH3 exposure), NH3 exposure levels (< 2, 2–3, >  3 μg/m3), Questionnaire: Self-reported odour annoyance (no, slightly, moderately, very, extremely)

Questionnaire:

Self-reported symptoms past 2 years, odour annoyance ((no, slightly, moderately, very, extremely)

Groups:

Odour nuisances

Gastrointestinal symptoms

General ill feeling

Mood states

Model: multivariate logistic regression analysis.

Effect estimated: ORs(95%CI)

Age, gender, smoking habit, job, time spent at home per week, existence of household residents below 18 years old, years living in the region, and acute and chronic respiratory conditions

 Wing 2014 [38], USA, Cross-sectional

Sewage Sludge and Animal feeding operations

N = 158 adults, residents living near liquid TSS, 85 living near cake TSS, and 188 living in comparison areas

Questionnaire: Self-reported odour annoyance past six months (none/faint and moderate/strong/very strong)

Questionnaire:

Self-reported symptoms past six months

Groups:

Gastrointestinal symptoms

Mucus irritation

General ill feeling

Lower respiratory symptoms

Upper respiratory symptoms

Skin disorders

Model:

Linear and poisson regression analysis

Effect estimated: Mean factor score differences (95%CI) and PRs (95%CI)

Age, gender, race, educational level, smoking status, passive smoking, agricultural chemical odours and odours from burning

 Aatamila 2011 [39], Finland, Cross-sectional

Waste (Landfills and composting sites)

N = 1142 residents within a 5-km radius of six different biowaste sites

Range of age: 25–64 years

Distance zone (< 1.5, 1.5–3, > 3 km)

Questionnaire: odour perception (4-point scale) stratified into sensitive vs not sensitive, odour annoyance (4-point scale) categorized as annoyed vs not annoyed

Questionnaire:

Self-reported symptoms past 12 months

Groups:

Gastrointestinal symptoms

Mucus irritation

General ill feeling

Lower and upper respiratory symptoms

Skin disorders

Model:

Logistic regression analysis

Effect estimated: ORs(95%CI)

Model 1: adjusted for sex, age, educational level, Socio economic level and smoking

Model 2: additionally, adjusted for odour sensitivity

 Herr 2009 [40], Germany, Cross-sectional

Waste (composting sites)

N = 477 residents living “near” two composting sites. (263 EnvExp2 and 214 control group).

Individuals aged ≥16 years old

Distance (km): EnvExp2 (odour-only exposed) and a control group

Questionnaire:

Self-reported symptoms past 2 years

Groups:

Gastrointestinal symptoms

General ill feeling

Lower respiratory symptoms

Mood states

Skin disorders

Cardiovascular symptoms

Model:

Logistic regression analysis

Effect estimated: ORs(95%CI)

Adjusted for age, gender, and educational level

 Sucker 2008 [41], Germany, Cross-sectional

Industrial sites

N = 1434 adults from each household (the homemaking or the person spending most of the time at home)

Questionnaire: Log-values of odour frequency Intensity (6-point scale from “very slight” to “extremely strong”), Hedonic tone (9-point scale with values ranging from “-4” “extremely unpleasant” through “0” “neither pleasant nor unpleasant” to “+ 4” “extremely pleasant”)

Questionnaire: Odour annoyance; self-reported health complaints

Groups:

Odour nuisances

General ill feeling

Mucus irritation

Model:

Logistic regression analysis.

Effect estimated: ORs(95%CI)

Noise disturbance, length of residence, quality of residential area, tenant or owner, single/multiple houses, average time at home, perceived health, smoking habit, gender, age, marital status, educational level

 Radon 2007 [42], Germany, Cross-sectional

Animal feeding operations

N = 5556 Residents from four rural town with high density of AFOs

Mean age 33.6 (SD 7.4)

Questionnaire: Self-reported odour annoyance (4-point Likert scale from “not at all” to “strongly”)

Questionnaire:

Self-reported symptoms during the week.

Clinical measurements: Specific IgE to common allergens > 0.35 IU/mL, bronchial hyperresponsiveness to methacholine, forced expiratory volume in 1 s (FEV1)

Group:

Lower and upper respiratory symptoms

Immune function and allergy

Model:

Logistic and linear regression analysis

Effect estimated: ORs(95%CI)

Age, sex, active and passive smoking, educational level, number of siblings and parental allergies. FEV1 additionally, adjusted for passive smoking during childhood

 Mirabelli 2006 [43], USA, Cross-sectional

Animal feeding operations

N = 58,169 students of 265 schools within 3 miles of at least one AFO source

Range of age: aged 12–14

Questionnaire: self-reported indoor and outdoor odours from schools (binary coded variable, “reported”/“no reported”)

Questionnaire:

Current and past 12-month self-reported respiratory symptoms and medical care

Groups:

Lower respiratory symptoms

General ill feeling

Model: Random-intercepts binary regression analysis

Effect estimated:

PRs (95%CI)

Age, race, socioeconomic status, smoking, school exposures and household exposures

 Radon 2004 [44], Germany, Cross-sectional

Animal feeding operations

N = 2745 Residents living in rural towns close to intensive animal production

Mean age 32.7 (SD 7.7)

Questionnaire: Self-reported odour annoyance (4-point Likert scale from “not at all” to “extremely”)

QoL questionnaire:

Physical SF-12 score, emotional SF-12 score

Groups:

General ill feeling

Mood states

Model:

Multiple linear regression analysis

Effect estimated:

β (SE)

Age, gender, respiratory symptoms, smoking, living on or close to a farm and employment status.

 Segala 2003 [45], Canada, Cross-sectional

Wastewater treatment plant

N = 2867 residents from 8 nearby towns.

Distance zones:

3–4.5 km (N = 1003), mean age 47.5 (SD 15.2)

1.5–3 km (N = 1007), mean age 48.2 (SD 67.7)

<  1.5 km (N = 857), mean age 49.8 (SD 15.1)

Distance zones (< 1.5, 1.5–3, 3–4.5 km)

Questionnaire: Self-reported odour tolerance (“tolerant”, “moderately tolerant”, “intolerant”), odour annoyance (“annoyed with impact on health”, “annoyed without impact on health”, “not annoyed”)

Questionnaire:

Self-reported symptoms past month and year

Groups:

Gastrointestinal symptoms

Mucus irritation

Lower respiratory symptoms

Upper respiratory symptoms

General ill feeling

Cardiovascular problems

Model: Multivariate logistic regression analysis

Effect estimated: ORs(95%CI)

Age, sex, educational level, active vs inactive, smoking status, family size, satisfaction with neighbourhood life

 Georgieff 1999 [46], Bulgaria, Cross-sectional

Paper industry

N = 538 Residents from Stamboliisky town

Range of age: 16–60 years old

Questionnaire: Self-reported unpleasant odour (yes/no)

Questionnaire:

Self-reported symptoms

Groups:

General ill feeling

Lower respiratory symptoms

Mood states

Immune function and allergy

Model: n.a.

Effect estimated: n.a.

Percentages (%) of number of reported somatic symptoms

None

 Steinheider 1998 [47], Germany, Cross-sectional

Nettetal study

Fertilisers production plant

Nörvenich study

Pig rearing facilty

Nettetal study (N = 250)

Nörvenich study (N = 322)

Adults aged ≥18 years old

Nettetal study

1) Distance from the odour source

Close: within 400–800 m

Medium: 1600 m

Far (control area): 6 and 3.5 km

2) 11-point graphic scale of Odour annoyance

Nörvenich study

1) Log-values of odour frequency (odour hours/year). 34 observation points; 2) 11-point graphic scale of Odour annoyance

Questionnaire:

Self-reported symptoms and odour annoyance (11-point graphic scale)

Control variables (fever and asthma attacks)

Groups:

Odour nuisances

Gastrointestinal symptoms

General ill feeling

Lower respiratory symptoms

Mood states

Nettetal study

Model:

Analysis of variance

Effect estimated:

None

Nörvenich study

Model:

Linear regression analysis.

Effect estimated:

β (SE)

None

 Steinheider 1993 [48], Germany, Cross-sectional

Industrial sites

1) Duisburg- chemical plant

2) Dortmund – iron/steel plant

3) Brühl – castiron factory and sugar refinery

4) Rodenkirchen – oil refineries

N = 1539 adults, living near of four cities in North Rhine-Westphalia. Duisburg (N = 400), Dortmund (N = 400),

Brühl

(N = 539), Rodenkirchen (N = 200)

Log-values of odour frequency (odour hours/year).

Questionnaire: Self-reported odour annoyance (11-point scale)

Groups:

Odour nuisances

Model:

Multivariate linear regression analysis

Effect estimated: n.a.

Age, sex, educational level, profession, length of residence and perceived health. Dortmund, Brühl and Rodenkirchen added coping strategies to the model

 Lipscomb 1991 [49], USA, Cross-sectional

Waste (McColl waste disposal site)

N = 193 residents living nearby a disposal waste site

Adults ≥22 years old

Exposure areas (high, medium, and low) based on an odour survey conducted in 1981

Questionnaire:

Self-reported symptoms past 12 months

Groups:

Odour nuisances

Gastrointestinal symptoms

Mucus irritation

General ill feeling

Lower respiratory symptoms

Upper respiratory symptoms

Mood states

Skin disorders

Immune function and allergy

Model:

n.a.

Effect estimated: Crude PORs(95%CI)

None

 Shusterman 1991 [9], USA, Cross-sectional

Waste

N = 2040 residents living near three hazardous waste sites in Southern California

McColl. Acid petroleum sludge (N = 670)

Operating Industries. Municipal and sewage (N = 514)

Del Amo-Montrose. Residues from synthetic rubber manufacturing (N = 856)

Self-reported frequency of odour perception (“none”, “less than or equal to four times per month” and “greater than four times per month”

Questionnaire:

Self-reported symptoms

Groups:

Odour nuisances

Gastrointestinal symptoms

Mucus irritation

General ill feeling

Model:

n.a.

Effect estimated: PORs(95%CI)

None

 Deane 1978 [50], USA, Cross-sectional

Refineries and other petrochemical industries

N = 291 Residents living in three residential areas nearby refineries and petrochemical plants

Exposure areas estimated by dynamic olfactometry: High (Area I), Moderate (Area II), Low (Area III).

Questionnaire: Self-reported symptoms

Groups:

Odour nuisances

Gastrointestinal symptoms

Mucus irritation

General ill feeling

Lower respiratory symptoms

Upper respiratory symptoms

Mood states

Model: n.a.

Effect estimated: n.a.

Frequency of self-reporting outcomes

None

 Deane 1977 [51], USA, Cross-sectional

Paper industry

N = 140 Adults living in three residential areas nearby a pulp mill

Exposure areas: high (1–2 miles southeast of the mills), moderate (2–3 miles east of the mils), low (4 miles east of the mills)

Questionnaire:

Self-reported symptoms

Groups:

Odour nuisances

Gastrointestinal symptoms

Mucus irritation

General ill feeling

Lower respiratory symptoms

Upper respiratory symptoms

Mood states

Model:

n.a.

Effect estimated: Frequency of self-reporting outcomes

Analysis were stratified by odour annoyance and gender

Panel studies

 Van Kersen 2020 [29], Netherlands, Panel (3 months)

Animal feeding operations

N = 82 adults COPD non smokers residents in the eastern part of the province of Noord-Brabant and the northern part of the province of Limburg (high prevalence of lifestocks)

NH3 concentration (μg/m3), Questionnaire: Self-reported odour annoyance (no, yes)

Questionnaire:

Self-reported symptoms past 12-h

Clinical measurements: Lung function (forced expiratory volume or FEV1 and peak expiratory flow rate or PEF)

Groups:

Lower respiratory symptoms

Upper respiratory symptoms

Model: Generalized estimated equations (GEE) assuming a first order autoregressive

(AR1) correlation structure

Effect estimated: ORs (95%CI)

Adjustment for ambient temperature, relative humidity and day-in-study

(linear trend), PM10; Restriction to non-smokers by study design

 Wing 2013 [28], USA, Panel (2 weeks)

Animal feeding operations

N = 101 non-smoking residents living within 1.5 miles of an CAFOs source

Adults aged ≥18 years old.

Mean age 53.7 (19.2–89.5)

Data-collection diary: Self-reported odour annoyance (9-point Likert scale)

Systolic (SBP) and diastolic (DBP) blood pressure values

Groups:

Cardiovascular problems

Model:

Linear fixed-effects models Effect estimated:

β (SE)

Time-of-day (AM or PM)

 Heaney 2011 [24], USA, Panel (14 days)

Waste (landfill)

N = 23 adults, residents within 0.75 miles of the landfill

Questionnaire: 12-h of self-reported odour annoyance (5-point Likert scale)

Questionnaire:

Self-reported symptoms past 12-h

Groups:

Gastrointestinal symptoms

Mucus irritation

General ill feeling

Lower respiratory symptoms

Upper respiratory symptoms

Mood states

Skin disorders

Model: Conditional fixed effects logistic regression models

Effect estimated: ORs(95%CI)

Time of day (AM/PM)

 Schinasi 2011 [27], USA, Panel (14 days)

Animal feeding operations

N = 101 Non-smoking residents within 1.5 miles of an AFOs source

Mean age 53.7 (19.2–89.5)

Questionnaire: 12-h of self-reported odour annoyance (9-point scale)

Questionnaire:

Self-reported symptoms past 12-h

Clinical measurements: Lung function (forced expiratory volume or FEV1and peak expiratory flow rate or PEF)

Groups:

Gastrointestinal symptoms

Mucus irritation

General ill feeling

Lower respiratory symptoms

Upper respiratory symptoms

Skin disorders

Model: Conditional fixed effects logistic and linear regression analysis

Effect estimated:

β (SE)

Time of day (AM/PM)

 Horton 2009 [25], USA, Panel (2 weeks)

Animal feeding operations

N = 101 Non-smoking residents within 1.5 miles of an AFOs source

Mean age 53.7 (19.2–89.5)

12-h of self-reported odour annoyance (9-point scale)

Questionnaire:

Self-reported information on mood states

Groups:

Mood states

Odour nuisances

Model:

Logistic mixed models with random intercepts. Effect estimated: β (SE) and ORs(95%CI)

Time of day (AM/PM)

Avery 2004 [23], USA, Panel (2 weeks)

Animal feeding operations

N = 15 residents within 2.4 km of an intensive hog operation facility

Mean age 55.3 (SD 13.4).

Questionnaire: Self-reported odour annoyance (9-point scale, coded as a seven-level continuous variable)

Clinical measurements:

Log salivary IgA concentration (μg/ml) and secretion rate (μ g/ml)

Group:

Immune function and allergy

Model: Hierarchical mixed models

Effect estimated:

β (SE)

Day of data collection (1–14) and time of day (AM/PM)

Schiffman 1995 [26], USA, Panel (4 days)

Animal feeding operations

N = 88

Exposure group,:

Mean age 52.0 ± 13.4

Control group:

Mean age 51.7 ± 8.3

Distance and duration: Exposed living an average of 5.3 + 6.5 years near hog operations and comparison group

Profile of Mood States (POMS) factors and Total Mood Disturbance (TMD) score

Groups:

Mood states

Model: ANOVA

Effect estimated: n.a.

adjusted by design (matching by gender, age, race, and education)