The rapid global expansion of confined animal feeding operations (CAFOs) has created environ mental health concerns at local, regional, and global scales, including infectious and respiratory diseases, reduced quality of life, impacts on the built environment, and environmental injustice (Pew Commission on Industrial Food Animal Production 2008). CAFO airborne emissions, including ammonia, hydrogen sulfide (H 2 S), volatile organic compounds, and endotoxins, originate from confinement buildings, waste storage areas, and land application of animal waste (National Research Council 2003). North Carolina experienced a rapid transformation of swine production during the 1980s and 1990s. The number of producers declined, the size of operations grew, the swine population increased from approximately 2.5 million to 10 million, and production shifted to the eastern coastal plain region of the state (Furuseth 1997). In North Carolina, swine CAFOs are concentrated in low-income communities of color (mostly African American), where older housing and lack of central air conditioning could increase human exposure to air pollutants (Wing et al. 2000).