Why would a COVID vaccine cause rare blood clots? Researchers have found clues

Fungal Infections Increase Mortality Rates In MDA5-Associated Interstitial Lung Disease

In patients with interstitial lung disease who test positive for antimelanoma differentiation-associated gene 5 antibodies (MDA5-ILD), fungal infection was associated with an increased rate of mortality, according to study results published in Clinical Rheumatology.

In patients with MDA5-ILD, fungal infection is common and confers the risk for more severe illness and mortality. To investigate the incidence, risk factors, and outcomes of fungal infection in these individuals, researchers conducted a retrospective analysis of data from patients diagnosed with MDA5-ILD at Nanjing Drum Tower Hospital in Nanjing, China, from April 2017 to November 2022.

The diagnosis of fungal infections was confirmed on the basis of host factors, clinical features, and mycologic findings. Patients who fulfilled at least 1 of these criteria were considered to have probable fungal infections. High‑dose corticosteroid therapy was defined as the administration of initial daily corticosteroid doses greater than 240 mg.

The primary study endpoint was 3-month and overall mortality. Patients were followed-up until March 2023.

"

[T]imely prevention and identification of fungal infection is crucial for the treatment of MDA5-ILD.

The study included 121 patients with MDA5-ILD, of whom, 61.2% were women and the mean age was 56.49 years.

During follow-up, 33.9% of patients (n=41) developed a fungal infection and 21.5% (n=26) developed a pyogenic infection. All patients initially received corticosteroids at a mean dose of 230.09 ± 177.46 mg on day 1 or 2, while 39% of patients with fungal infections reported ever receiving high-dose corticosteroid therapy. Overall, 85.4% of fungal infections were diagnosed within 3 months of corticosteroid use. The mean follow-up time for patients who developed fungal infections was 442.19 ± 623.49 days.

The mortality rate was 66.1% for the entire MDA5-ILD cohort. Patients with fungal infections faced a significantly higher overall mortality rate (85.4% vs 56.3%; P <.001) and 3-month mortality rate (85.7% vs 38.4%; P <.001) when compared against those without fungal infections. The mean survival time was 234.32 ± 464.76 days for patients with fungal infections.

According to multivariate regression analyses, decreased serum albumin levels (P =.024) and high-dose corticosteroid therapy (P =.008) were independently associated with increased mortality rates among patients with fungal infections.

Additionally, high-dose corticosteroid therapy was found to be an independent risk factor for fungal infections (P =.049), following adjustment for confounding variables.

Study limitations included the retrospective design, reliance on data from a single center, the small sample size, and variations in corticosteroid therapy use among patients.

"[T]imely prevention and identification of fungal infection is crucial for the treatment of MDA5-ILD," study authors concluded.

Norfolk Villagers Wage Long Campaign Against 'smelly' Farm

They are calling it the 'Stow Bedon stink'.

Villagers say that smells from a huge pig farm nearby are making their lives a misery.

Locals have complained of hazy clouds with a foul, ammonia stench rising above Cherry Tree Farm and then drifting over their homes.

They say they are sometimes unable to sit in their gardens and claim their food often tastes of urine.

The Stow Bedon village sign (Image: Newsquest)

Villagers claim their health is suffering as a result, with some reporting throat irritations.

However, the farm insists it is operating in accordance with regulations and has been liaising closely with the Environment Agency and local council to address concerns.

It says it has carried out a series of changes to try to minimise its impact. 

And some villagers claim the issues are being overstated and that such smells ought to be expected in the countryside.

The CherryTree Farm in Stow Bedon has been at the centre of a planning row (Image: Owen Sennitt)

PIG PROBLEMS

Cherry Tree Farm, which is a few hundred metres from the nearest homes, is operated by food giant Cranswick.

It expanded significantly in 2019 after it was granted permission to change its stock from 600 sows and their piglets to 7,000 fully-grown pigs.

The company insists it is operating within the parameters of its permit and that it is committed to ensuring it continues to be a sustainable, modern farm delivering much-needed local food and providing employment.

But villagers say that the odour problems have increased significantly in recent years.

The smell is from ammonia, a pungent gas that comes from manure and urine, which can be emitted at high levels at intensive livestock farms.

It does not remain in the environment for long, as it rapidly reacts to form ammonia compounds. However, it has a strong acidic smell and can cause irritation to the eyes, nose and throat. Ammonia can come from manure and urine from livestock (Image: Matthew Usher)

Since 2021 - when the site became operational - 380 complaints have also been made to the Environment Agency (EA) about the smell from Cherry Tree Farm.

The EA started investigating and found 12 occasions when the farm was in breach of its permit.

It also issued an enforcement notice requiring the operation to reduce its ammonia emissions - which officers said could "adversely affect" nearby habitats.

An aerial view of the farm's location in the village (Image: Google)

The notice required the operator to carry out an investigation into the root cause of the odour problems.

In total, the EA has carried out 40 odour assessments, 10 of which showed moderate-to-severe levels.

Breckland councillors Philip Cowen and Sarah Suggitt (Image: Breckland Council)

PLANNING ROW

EA officers also found that the pig buildings at the site, which became operational in June 2021, were not built within the permit's conditions.

It issued a separate enforcement notice requiring the company to make changes to the site and how it was operated.

This included extending chimney stacks and stopping the spreading of manure and slurry on surrounding fields.

This led the farm to put in a retrospective planning application, setting the scene for a new showdown with critics in the village.

More than 70 letters of objection have been lodged with the local council, Breckland, which is dealing with the issue.

There have also been frequent meetings in the village involving Breckland councillors and officers, including cabinet members Phil Cowen and Sarah Suggitt.

Ann Cuthbert says she regularly sees a haze she believes is a pollution plume over the Cherry Tree Farm site (Image: Ann Cuthbert)

ACTION ON SMELLS

Cranswick has made changes to its buildings in an effort to tackle the problems, including adding 70 metal chimneys for ventilation.

These were later raised in height by three metres after villagers said the odour was still reaching nearby homes and and excessive nitrogen readings were found at a nearby conservation area.

A spokesman for the company said: "After construction, the requirements for the operating permit changed, and in dialogue with the EA and local authority, the changes were implemented.

"We continue to work closely with the EA who confirm we operate within the agreed parameters of the permit relating to the local environment."

The company declined to comment on specific health concerns among villagers but said it was aware of locals' complaints and was "working closely with the EA on this matter".

A spokesman for the EA said there had been a reduction in public complaints this year.

He added: "We issued an enforcement notice last year due to breaches of permit at the site in relation to odour and emission.

"The operator has now made infrastructural and operational improvements on the site to further minimise odours off-site."

People cycling on roads surrounding Stow Bedon (Image: Newsquest)

STENCH PERSISTS

Despite this, locals say issues continue.

Ann Cuthbert, a solicitor who lives a short distance away from the farm, is one of the worst affected and has regularly reported incidents to the authorities for the last four years.

She has described plumes of hazy clouds being emitted from the farm regularly which linger around her home.

"We can smell the ammonia and it causes eye and lung irritation. When the pollution plumes are strong, food tastes like pig urine. Sometimes it can be so strong it is difficult to breathe when walking near the site."

Mrs Cuthbert worries about the effect it is having on her family's health.

She said her daughter had even been warned against having children by her doctor due to the risks of pollution and has been prescribed an inhaler to use during pollution incidents.

Tessa Fitzgerald, who lives near the farm in Stow Bedon (Image: Owen Sennitt)

'PRISONERS IN THEIR OWN HOMES'

Hannah Reed, chairwoman of Stow Bedon and Breckles Parish Council, has said the last few years have felt like "banging your head against the wall".

"It seems like we have exhausted every avenue and there is nothing more we can do about it. 

"At certain times it is disgusting and makes you choke. It should not be affecting people's health and right to enjoy their home."

Tessa Fitzgerald, who has lived in her home in Stow Bedon for 22 years, added: "When there is a smell it is quite strong. It depends on the wind direction. I'm sensitive to smells and it can give me an irritated windpipe.

"It is not just Cherry Tree Farm - authorities need to consider the accumulative effect of farms and not treat them individually.

"It makes you want to throw your hands up in the air as there doesn't  feel like there is anything we can do."

Another local, who did not wish to be named, said at times he can feel like a "prisoner in his own home."

'NORMAL COUNTRY SMELLS'

However, on the eastern side of Mere Road, where homes are further away, villagers were less concerned.

Allen Reeves, 71, said he sometimes "gets a wee whiff" but believes these are "normal country smells".

Philip Childs, a local parish councillor, added: "The smell is better than it used to be."

Livestock farming has been found to cause harmful air pollution (Image: Ian Burt)

HEALTH CONCERNS

While the effects of health from emissions from vehicles, and industry are well known, the health harms posed by farming are perhaps not as well understood.

Recent research by scientists has shown ammonia levels are four times higher in farming regions than other areas in Europe.

Ammonia, particularly when combined with industrial and car fumes, has been linked to higher death rates, respiratory problems, cardiovascular diseases, cognitive decline and low birth weights.

Norfolk area is a major centre for the UK's pig farming industry and in recent years there has been a significant increase in the number of permits for 'mega-farms' - sites with a capacity for at least 40,000 indoor or outdoor poultry birds, 700 indoor breeding pigs, or 2,500 indoor production pigs.

There is growing backlash to farms on this scale, and plans to build a huge chicken farm and pig farm in Methwold have provoked significant opposition among locals and even the CEO of Quorn, which has a factory close by.

Lizzie Wilson, chief executive of the National Pig Association, believes the strict rules pig farms like Cherry Tree Farm have to follow ensure emissions are kept to a minimum.

She said: "Environmentally permitted pig farms like Cherry Tree Farm are subject to far more stringent regulations and monitoring requirements to minimise emissions and nuisance, as well as being legally compliant with restrictions on muck and slurry to ensure any impact on water quality is tightly controlled."

St Margaret's Church in neighbouring Breckles (Image: Newsquest)

'A HOLY PLACE'

The rural village of Stow Bedon sits between the market towns of Attleborough and Watton and has long been a thriving farming community and was well-established before the Norman period.

Its name means "holy place" in old English and the parish has a number of churches which includes St Margarets in the nearby hamlet of Great Breckles, known for its Saxon round tower.

It later attracted wealthy individuals who built two grand halls - Breckles Hall and Stow Bedon Hall - built between 1500 to 1600.

In the Second World War, a decoy airfield was constructed to confuse incoming German bombers, which was situated behind Cherry Tree Farm. 

Ammonia Emissions In Scotland Have Risen By 50% In Just Five Years

Industrial emissions of ammonia – a pollutant which damages ecosystems and threatens human health – increased by more than 10 per cent in Scotland last year, new data has revealed.

New figures show that more than 11,000 tonnes of ammonia were released into Scotland's air and water in 2021 – one thousand tonnes more than in 2020.

This is part of a longer term trend which has seen reported ammonia emissions from industry, mainly agricultural, increase by over 50 per cent since 2017.

When ammonia is released into the air as a gas it can mix with industrial and car fumes to create a form of air pollution linked to respiratory problems, heart disease, and mental decline.

One health expert told The Ferret that "every effort must be made to control" ammonia emissions for the "sake of our health, our children's health, and the health of our elderly".

It has been estimated that thousands of deaths could be avoided in the UK each year if ammonia emissions from farms - the biggest producer of the pollution - were halved.

Green groups also warned that ammonia was causing "significant harm to Scotland's most important natural habitats" and added this was leading to the loss of some important species.

The figures, uncovered by independent investigative journalism co-operative The Ferret, come from the Scottish Environment Protection Agency's (Sepa) annual inventory of industrial pollution.

The 925 tonnes of ammonia emitted to the air last year was the highest amount since 2012, while the 10,300 tonnes released into water was a 53 per cent increase on levels reported five years ago.

Sepa pointed out that the majority of the growth in ammonia emissions came from an increase in the amount deposited into water, particularly from wastewater treatment plants at Seafield in Edinburgh and Nigg in the Highlands. Scottish Water said the increases in reported ammonia discharges at Seafield and Nigg were caused by "an improvement in monitoring from 2019-20".

Sepa blamed the rise in ammonia emissions to air on "production changes" in the agricultural sector.

Livestock farms were responsible for the vast majority of emissions to air in 2021. Ammonia is produced on farms through its use as a fertiliser and from animal waste.

Ammonia pollution from farms can drift into urban areas and combine with other toxic pollutants to create a small particulate matter – known as PM2.5 – which is considered one of the most deadly air pollutants.

Jill Belch, a professor of medicine at the University of Dundee said that PM2.5s made from ammonia are "really bad" because they are "so small they pass into the bloodstream where they spread to every organ in the body".

She said: "Ammonia gas is cleared very quickly from the atmosphere, however the danger lies in its combination with emissions from fossil fuel powered vehicles on nearby roads.," 

"PM2.5s have been linked to many serious diseases from poor childhood cognition and poor lung growth to heart attacks, strokes and dementia.

"Every effort must be made to control these emissions for the sake of our health, our children's health and the health of our elderly."

Ammonia pollution is also believed to be harming more than 60 per cent of the UK's land area.

It negatively affects biodiversity by causing nitrogen accumulation. Common and fast-growing species tend to be better adapted to nitrogen rich environments and out-compete smaller, rarer and more sensitive species.

The ammonia released to water was mostly reported by sewage and wastewater treatment plants like Seafield and Nigg. These two sites reported the biggest increases in their discharges of ammonia last year.

But although these facilities report the pollution, its real source is households and industrial sites. Sepa documents cite breweries, food processing plants, and farms as sources of the ammonia pollution that ends up at wastewater treatment plants.

The William Grant whisky distillery in Girvan was the only site with major ammonia emissions to water which was not involved in wastewater treatment. It produced nearly 2,000 tonnes of ammonia last year.

In water ecosystems, ammonia can build up in the organs and tissues of fish and other species potentially causing them to die.

Jenny Hawley, policy manager at Plantlife, which campaigns to protect the UK's wild plants, warned that the pollution can lead to "species loss" and "lowered resilience to climate change, pests and disease".

She added that in the "worst cases" this could cause "toxic damage to plants, lichen and fungi".

"Ammonia and other excess nitrogen in the air is causing significant harm to Scotland's most important natural habitats, from wildflower grasslands to temperate rainforest," Hawley told The Ferret.

Sarah Ison, the head of research at Compassion in World Farming, said shifting away from intensive farming and "allowing animals back onto the land" would be the "ideal scenario" to reduce ammonia pollution.

Ison said: "The largest ammonia emissions are from cattle, particularly dairy, but this can be reduced significantly by increasing the proportion of time cattle spend grazing.

"Housing animals, especially pigs on straw that is regularly topped up to ensure it is fresh and clean, also helps contain ammonia."

The National Farmers Union of Scotland's resources policy manager, Sarah Cowie, said that the body was "aware that ammonia emissions are an issue for the industry".

She said: "We are taking steps to promote best practice in the use and storage of organic and inorganic fertilisers." 

"With rising costs of fertiliser and a need for the industry to reduce emissions, we believe that more efficient use of fertiliser makes sense not only for the environment but also for businesses."

A spokesperson for Sepa said: "Our data for 2021 recorded an increase in ammonia emissions to water. This is largely due to two wastewater treatment plants.

"However, these sites discharge to the marine water environment where the discharge is highly diluted and the ammonia breaks down naturally."

They said the increase in ammonia emission to air was "likely due to production changes, such as increasing stock numbers and more free-range poultry".

"Sepa carries out inspections and provides clear guidance for farmers on management techniques to reduce the release of ammonia", the spokesperson added.

Scottish Water said it saw "no reason" why more ammonia should have been discharged at Nigg or Edinburgh in 2021 and that the increase was the result of an "improvement in monitoring".

"Both sites were compliant with licence discharge quality standards in 2021", the body noted.

The William Grant distillery did not respond to a request for comment.

---