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Association between rainfall and pediatric emergency department visits for acute gastrointestinal illness.

Drayna P, McLellan SL, Simpson P, Li SH, Gorelick MH - Environ. Health Perspect. (2010)

Bottom Line: Any rainfall 4 days prior was significantly associated with an 11% increase in AGI visits.Expected seasonal effects were also seen, with increased AGI visits in winter months.Further study is warranted to better address this association.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. patrick.c.drayna@vanderbilt.edu

ABSTRACT

Background: Microbial water contamination after periods of heavy rainfall is well described, but its link to acute gastrointestinal illness (AGI) in children is not well known.

Objectives: We hypothesize an association between rainfall and pediatric emergency department (ED) visits for AGI that may represent an unrecognized, endemic burden of pediatric disease in a major U.S. metropolitan area served by municipal drinking water systems.

Methods: We conducted a retrospective time series analysis of visits to the Children's Hospital of Wisconsin ED in Wauwatosa, Wisconsin. Daily visit totals of discharge International Classification of Diseases, 9th Revision codes of gastroenteritis or diarrhea were collected along with daily rainfall totals during the study period from 2002 to 2007. We used an autoregressive moving average model, adjusting for confounding variables such as sewage release events and season, to look for an association between daily visits and rainfall after a lag of 1-7 days.

Results: A total of 17,357 AGI visits were identified (mean daily total, 7.9; range, 0-56). Any rainfall 4 days prior was significantly associated with an 11% increase in AGI visits. Expected seasonal effects were also seen, with increased AGI visits in winter months.

Conclusions: We observed a significant association between rainfall and pediatric ED visits for AGI, suggesting a waterborne component of disease transmission in this population. The observed increase in ED visits for AGI occurred in the absence of any disease outbreaks reported to public health officials in our region, suggesting that rainfall-associated illness may be underestimated. Further study is warranted to better address this association.

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Related in: MedlinePlus

Total daily rainfall (Milwaukee County, Mitchell Airport) from 2002 to 2008, in yearly quarters (Q). Data from National Oceanic and Atmospheric Administration–National Climatic Data Center Record of Climatological Observations (unpublished data).
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f2-ehp-118-1439: Total daily rainfall (Milwaukee County, Mitchell Airport) from 2002 to 2008, in yearly quarters (Q). Data from National Oceanic and Atmospheric Administration–National Climatic Data Center Record of Climatological Observations (unpublished data).

Mentions: During the 2,191-day study period there were 776 days of rain (35.4% of days). The average daily rainfall on days with rainfall was 0.23 inches (range, 0.01–2.76) [0.58 cm (range, 0.02–7.01)], with a median of 0.1 inches (0.25 cm) (Figure 2). Extreme precipitation events [> 95th percentile defined as 24-hr rainfall > 1 inch (2.54 cm) or a 48-hr total > 1.5 inches (3.81 cm)] occurred 37 times. There were eight sewer overflows > 1 million gallons (3,785,412 L) reported during this period.


Association between rainfall and pediatric emergency department visits for acute gastrointestinal illness.

Drayna P, McLellan SL, Simpson P, Li SH, Gorelick MH - Environ. Health Perspect. (2010)

Total daily rainfall (Milwaukee County, Mitchell Airport) from 2002 to 2008, in yearly quarters (Q). Data from National Oceanic and Atmospheric Administration–National Climatic Data Center Record of Climatological Observations (unpublished data).
© Copyright Policy - public-domain
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2957926&req=5

f2-ehp-118-1439: Total daily rainfall (Milwaukee County, Mitchell Airport) from 2002 to 2008, in yearly quarters (Q). Data from National Oceanic and Atmospheric Administration–National Climatic Data Center Record of Climatological Observations (unpublished data).
Mentions: During the 2,191-day study period there were 776 days of rain (35.4% of days). The average daily rainfall on days with rainfall was 0.23 inches (range, 0.01–2.76) [0.58 cm (range, 0.02–7.01)], with a median of 0.1 inches (0.25 cm) (Figure 2). Extreme precipitation events [> 95th percentile defined as 24-hr rainfall > 1 inch (2.54 cm) or a 48-hr total > 1.5 inches (3.81 cm)] occurred 37 times. There were eight sewer overflows > 1 million gallons (3,785,412 L) reported during this period.

Bottom Line: Any rainfall 4 days prior was significantly associated with an 11% increase in AGI visits.Expected seasonal effects were also seen, with increased AGI visits in winter months.Further study is warranted to better address this association.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. patrick.c.drayna@vanderbilt.edu

ABSTRACT

Background: Microbial water contamination after periods of heavy rainfall is well described, but its link to acute gastrointestinal illness (AGI) in children is not well known.

Objectives: We hypothesize an association between rainfall and pediatric emergency department (ED) visits for AGI that may represent an unrecognized, endemic burden of pediatric disease in a major U.S. metropolitan area served by municipal drinking water systems.

Methods: We conducted a retrospective time series analysis of visits to the Children's Hospital of Wisconsin ED in Wauwatosa, Wisconsin. Daily visit totals of discharge International Classification of Diseases, 9th Revision codes of gastroenteritis or diarrhea were collected along with daily rainfall totals during the study period from 2002 to 2007. We used an autoregressive moving average model, adjusting for confounding variables such as sewage release events and season, to look for an association between daily visits and rainfall after a lag of 1-7 days.

Results: A total of 17,357 AGI visits were identified (mean daily total, 7.9; range, 0-56). Any rainfall 4 days prior was significantly associated with an 11% increase in AGI visits. Expected seasonal effects were also seen, with increased AGI visits in winter months.

Conclusions: We observed a significant association between rainfall and pediatric ED visits for AGI, suggesting a waterborne component of disease transmission in this population. The observed increase in ED visits for AGI occurred in the absence of any disease outbreaks reported to public health officials in our region, suggesting that rainfall-associated illness may be underestimated. Further study is warranted to better address this association.

Show MeSH
Related in: MedlinePlus