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Extreme Precipitation and Emergency Room Visits for Gastrointestinal Illness in Areas with and without Combined Sewer Systems: An Analysis of Massachusetts Data, 2003-2007.

Jagai JS, Li Q, Wang S, Messier KP, Wade TJ, Hilborn ED - Environ. Health Perspect. (2015)

Bottom Line: Combined sewer overflows (CSOs) occur in combined sewer systems when sewage and stormwater runoff are released into water bodies, potentially contaminating water sources.Only the region with drinking water exposed to CSOs demonstrated a significant increased cumulative risk for rate (CRR) of ER visits for GI for all ages in the 8-day period following extreme rainfall: CRR: 1.13 (95% CI: 1.00, 1.28) compared with no rainfall.Jagai JS, Li Q, Wang S, Messier KP, Wade TJ, Hilborn ED. 2015.

View Article: PubMed Central - PubMed

Affiliation: Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois, Chicago, Illinois, USA.

ABSTRACT

Background: Combined sewer overflows (CSOs) occur in combined sewer systems when sewage and stormwater runoff are released into water bodies, potentially contaminating water sources. CSOs are often caused by heavy precipitation and are expected to increase with increasing extreme precipitation associated with climate change.

Objectives: The aim of this study was to assess whether the association between heavy rainfall and rate of emergency room (ER) visits for gastrointestinal (GI) illness differed in the presence of CSOs.

Methods: For the study period 2003-2007, time series of daily rate of ER visits for GI illness and meteorological data were organized for three exposure regions: a) CSOs impacting drinking water sources, b) CSOs impacting recreational waters, c) no CSOs. A distributed lag Poisson regression assessed cumulative effects for an 8-day lag period following heavy (≥ 90th and ≥ 95th percentile) and extreme (≥ 99th percentile) precipitation events, controlling for temperature and long-term time trends.

Results: The association between extreme rainfall and rate of ER visits for GI illness differed among regions. Only the region with drinking water exposed to CSOs demonstrated a significant increased cumulative risk for rate (CRR) of ER visits for GI for all ages in the 8-day period following extreme rainfall: CRR: 1.13 (95% CI: 1.00, 1.28) compared with no rainfall.

Conclusions: The rate of ER visits for GI illness was associated with extreme precipitation in the area with CSO discharges to a drinking water source. Our findings suggest an increased risk for GI illness among consumers whose drinking water source may be impacted by CSOs after extreme precipitation.

Citation: Jagai JS, Li Q, Wang S, Messier KP, Wade TJ, Hilborn ED. 2015. Extreme precipitation and emergency room visits for gastrointestinal illness in areas with and without combined sewer systems: an analysis of Massachusetts data, 2003-2007. Environ Health Perspect 123:873-879; http://dx.doi.org/10.1289/ehp.1408971.

No MeSH data available.


Related in: MedlinePlus

Time series of rate of daily ER visits for GI illness for each exposure region (per 100,000 population) indicated by dots, with days of with extreme precipitation (≥ 99th percentile) indicated by triangles.
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f2: Time series of rate of daily ER visits for GI illness for each exposure region (per 100,000 population) indicated by dots, with days of with extreme precipitation (≥ 99th percentile) indicated by triangles.

Mentions: Descriptive analysis. The three regions experienced similar rainfall patterns over the 5-year (1,826 days) study period. The exposed–drinking water region had 999 days of rain (55% of days), ranging from 0.005 to 6.76 in. The 90th, 95th, and 99th percentiles for rainfall were 0.41, 0.64, and 1.33 in, respectively. The exposed–recreational water region had 848 days of rainfall (46% of days), ranging from 0.005 to 4.32 in. The 90th, 95th, and 99th percentiles for rainfall were 0.37, 0.70, and 1.60 in, respectively. The unexposed region had 928 days of rainfall (51% of days), ranging from 0.005 to 3.61 in. The 90th, 95th, and 99th percentiles for rainfall were 0.39, 0.77, and 1.97 in, respectively. Time series for daily rate of ER visits by region with indication of days of extreme precipitation (≥ 99th percentile) are shown in Figure 2.


Extreme Precipitation and Emergency Room Visits for Gastrointestinal Illness in Areas with and without Combined Sewer Systems: An Analysis of Massachusetts Data, 2003-2007.

Jagai JS, Li Q, Wang S, Messier KP, Wade TJ, Hilborn ED - Environ. Health Perspect. (2015)

Time series of rate of daily ER visits for GI illness for each exposure region (per 100,000 population) indicated by dots, with days of with extreme precipitation (≥ 99th percentile) indicated by triangles.
© Copyright Policy - public-domain
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4559956&req=5

f2: Time series of rate of daily ER visits for GI illness for each exposure region (per 100,000 population) indicated by dots, with days of with extreme precipitation (≥ 99th percentile) indicated by triangles.
Mentions: Descriptive analysis. The three regions experienced similar rainfall patterns over the 5-year (1,826 days) study period. The exposed–drinking water region had 999 days of rain (55% of days), ranging from 0.005 to 6.76 in. The 90th, 95th, and 99th percentiles for rainfall were 0.41, 0.64, and 1.33 in, respectively. The exposed–recreational water region had 848 days of rainfall (46% of days), ranging from 0.005 to 4.32 in. The 90th, 95th, and 99th percentiles for rainfall were 0.37, 0.70, and 1.60 in, respectively. The unexposed region had 928 days of rainfall (51% of days), ranging from 0.005 to 3.61 in. The 90th, 95th, and 99th percentiles for rainfall were 0.39, 0.77, and 1.97 in, respectively. Time series for daily rate of ER visits by region with indication of days of extreme precipitation (≥ 99th percentile) are shown in Figure 2.

Bottom Line: Combined sewer overflows (CSOs) occur in combined sewer systems when sewage and stormwater runoff are released into water bodies, potentially contaminating water sources.Only the region with drinking water exposed to CSOs demonstrated a significant increased cumulative risk for rate (CRR) of ER visits for GI for all ages in the 8-day period following extreme rainfall: CRR: 1.13 (95% CI: 1.00, 1.28) compared with no rainfall.Jagai JS, Li Q, Wang S, Messier KP, Wade TJ, Hilborn ED. 2015.

View Article: PubMed Central - PubMed

Affiliation: Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois, Chicago, Illinois, USA.

ABSTRACT

Background: Combined sewer overflows (CSOs) occur in combined sewer systems when sewage and stormwater runoff are released into water bodies, potentially contaminating water sources. CSOs are often caused by heavy precipitation and are expected to increase with increasing extreme precipitation associated with climate change.

Objectives: The aim of this study was to assess whether the association between heavy rainfall and rate of emergency room (ER) visits for gastrointestinal (GI) illness differed in the presence of CSOs.

Methods: For the study period 2003-2007, time series of daily rate of ER visits for GI illness and meteorological data were organized for three exposure regions: a) CSOs impacting drinking water sources, b) CSOs impacting recreational waters, c) no CSOs. A distributed lag Poisson regression assessed cumulative effects for an 8-day lag period following heavy (≥ 90th and ≥ 95th percentile) and extreme (≥ 99th percentile) precipitation events, controlling for temperature and long-term time trends.

Results: The association between extreme rainfall and rate of ER visits for GI illness differed among regions. Only the region with drinking water exposed to CSOs demonstrated a significant increased cumulative risk for rate (CRR) of ER visits for GI for all ages in the 8-day period following extreme rainfall: CRR: 1.13 (95% CI: 1.00, 1.28) compared with no rainfall.

Conclusions: The rate of ER visits for GI illness was associated with extreme precipitation in the area with CSO discharges to a drinking water source. Our findings suggest an increased risk for GI illness among consumers whose drinking water source may be impacted by CSOs after extreme precipitation.

Citation: Jagai JS, Li Q, Wang S, Messier KP, Wade TJ, Hilborn ED. 2015. Extreme precipitation and emergency room visits for gastrointestinal illness in areas with and without combined sewer systems: an analysis of Massachusetts data, 2003-2007. Environ Health Perspect 123:873-879; http://dx.doi.org/10.1289/ehp.1408971.

No MeSH data available.


Related in: MedlinePlus