Colford John M, Roy Sharon, Beach Michael J, Hightower Allen, Shaw Susan E, Wade Timothy J
Division of Epidemiology, School of Public Health, University of California, Berkeley, 140 Warren Hall, MC 7360, Berkeley, CA 94720, USA.
J Water Health. 2006;4 Suppl 2:71-88. doi: 10.2166/wh.2006.018.
The incidence of acute gastrointestinal illness (AGI) attributable to public drinking water systems in the United States cannot be directly measured but must be estimated based on epidemiologic studies and other information. The randomized trial is one study design used to evaluate risks attributable to drinking water. In this paper, we review all published randomized trials of drinking water interventions in industrialized countries conducted among general immunocompetent populations. We then present an approach to estimating the incidence (number of cases) of AGI attributable annually to drinking water. To develop a national estimate, we integrate trial results with the estimated incidence of AGI using necessary assumptions about the estimated number of residents consuming different sources of drinking water and the relative quality of the water sources under different scenarios. Using this approach we estimate there to be 4.26-11.69 million cases of AGI annually attributable to public drinking water systems in the United States. We believe this preliminary estimate should be updated as new data become available.
美国公共饮用水系统导致的急性胃肠疾病（AGI）发病率无法直接测量，而必须根据流行病学研究和其他信息进行估算。随机试验是用于评估饮用水所致风险的一种研究设计。在本文中，我们回顾了在工业化国家针对一般免疫功能正常人群开展的所有已发表的饮用水干预随机试验。然后，我们提出一种方法来估算每年归因于饮用水的AGI发病率（病例数）。为得出全国性估算值，我们利用关于饮用不同水源的居民估计数量以及不同情景下水源相对质量的必要假设，将试验结果与AGI估计发病率相结合。通过这种方法，我们估计美国每年有426万至1169万例AGI病例可归因于公共饮用水系统。我们认为，随着新数据的出现，这一初步估计值应予以更新。
