Gastrointestinal illness linked to incidents in drinking water distribution networks in Sweden

被引:24
作者
Save-Soderbergh, Meile [1 ,2 ]
Bylund, John [1 ]
Malm, Annika [3 ,4 ]
Simonsson, Magnus [1 ]
Toljander, Jonas [1 ]
机构
[1] Natl Food Agcy, Sci Div, Uppsala, Sweden
[2] Karolinska Inst, Inst Environm Med, Stockholm, Sweden
[3] RISE Res Inst Sweden, Gothenburg, Sweden
[4] Chalmers Univ Technol, Dept Civil & Environm Engn, Gothenburg, Sweden
关键词
Gastrointestinal illness; Drinking water; Water distribution; Pipe breaks; Pressure; Public health risks; RISK; ASSOCIATION; INFECTION; CONSUMPTION; INTRUSION; OUTBREAK; EVENTS; TRIAL;
D O I
10.1016/j.watres.2017.06.013
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
During recent years, knowledge gaps on drinking water-related gastrointestinal illness have been identified, especially for non-epidemic cases. Pathogen contamination of drinking water during distribution has been suggested to contribute to these cases, but the risk factors are not yet fully understood. During 2014-2015, we conducted an epidemiological study in five municipalities in Sweden, to assess whether incidents in the drinking water distribution system influence the risk of gastrointestinal illness. Telephone interviews were conducted in the affected areas and in reference areas 7-14 days after a reported incident. Symptoms of gastrointestinal illness occurring during the period were documented for each household member. The results showed a significantly elevated risk of vomiting and acute gastrointestinal illness (AGI) in the affected areas, compared to the reference areas (ORvom. = 2.0. 95% CI: 1.2-3.3; ORAGI = 1.9, 95% CI: 1.2-3.0). Certain conditions, or risk factors, during the incidents, such as sewage and drinking water pipelines at the same level in the trench, were associated with an elevated risk of AGI and vomiting. Safety measures taken during repair work, like flushing, were also associated with an elevated risk of AGI and vomiting. These results show that incidents in the drinking water distribution network contribute to endemic gastrointestinal illness, especially AGI and vomiting, and that external pathogen contamination of the drinking water is a likely cause of these cases of gastrointestinal illness. The results also indicate that safety measures used today may not be sufficient for eliminating the risk of gastrointestinal illness. (C) 2017 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
引用
收藏
页码:503 / 511
页数:9
相关论文
共 34 条
[1]  
[Anonymous], RISK ASSESSMENT CHEM
[2]   Fitting Linear Mixed-Effects Models Using lme4 [J].
Bates, Douglas ;
Maechler, Martin ;
Bolker, Benjamin M. ;
Walker, Steven C. .
JOURNAL OF STATISTICAL SOFTWARE, 2015, 67 (01) :1-48
[3]  
Besner MC, 2008, J AM WATER WORKS ASS, V100, P95
[4]   Assessing the public health risk of microbial intrusion events in distribution systems: Conceptual model, available data, and challenges [J].
Besner, Marie-Claude ;
Prevost, Michele ;
Regli, Stig .
WATER RESEARCH, 2011, 45 (03) :961-979
[5]   Water Distribution System Deficiencies and Gastrointestinal Illness: A Systematic Review and Meta-Analysis [J].
Ercumen, Ayse ;
Gruber, Joshua S. ;
Colford, John M., Jr. .
ENVIRONMENTAL HEALTH PERSPECTIVES, 2014, 122 (07) :651-660
[6]   Risk of giardiasis associated with water supply in an endemic context [J].
Gagnon, Fabien ;
Duchesne, Jean-Francois ;
Levesque, Benoit ;
Gingras, Suzanne ;
Chartrand, Josee .
INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH, 2006, 16 (05) :349-359
[7]   The incidence of acute gastrointestinal illness in Sweden [J].
Hansdotter, Frida I. ;
Magnusson, Mans ;
Kuhlmann-Berenzon, Sharon ;
Hulth, Anette ;
Sundstrom, Kristian ;
Hedlund, Kjell-Olof ;
Andersson, Yvonne .
SCANDINAVIAN JOURNAL OF PUBLIC HEALTH, 2015, 43 (05) :540-547
[8]   A randomized, blinded, controlled trial investigating the gastrointestinal health effects of drinking water quality [J].
Hellard, ME ;
Sinclair, MI ;
Forbes, AB ;
Fairley, CK .
ENVIRONMENTAL HEALTH PERSPECTIVES, 2001, 109 (08) :773-778
[9]   Self-reported diarrhea in a control group: A strong association with reporting of low-pressure events in tap water [J].
Hunter, PR ;
Chalmers, RM ;
Hughes, S ;
Syed, Q .
CLINICAL INFECTIOUS DISEASES, 2005, 40 (04) :E32-E34
[10]   A large waterborne outbreak of campylobacteriosis in Norway: The need to focus on distribution system safety [J].
Jakopanec, Irena ;
Borgen, Katrine ;
Vold, Line ;
Lund, Helge ;
Forseth, Tore ;
Hannula, Raisa ;
Nygard, Karin .
BMC INFECTIOUS DISEASES, 2008, 8 (1)