Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Water Res. 2014 Jan 1;48:90-9. doi: 10.1016/j.watres.2013.09.022. Epub 2013 Sep 19.
Flooding and heavy rainfall have been associated with waterborne infectious disease outbreaks, however, it is unclear to which extent they pose a risk for public health. Here, risks of infection from exposure to urban floodwater were assessed using quantitative microbial risk assessment (QMRA). To that aim, urban floodwaters were sampled in the Netherlands during 23 events in 2011 and 2012. The water contained Campylobacter jejuni (prevalence 61%, range 14- >10(3) MPN/l), Giardia spp. (35%, 0.1-142 cysts/l), Cryptosporidium (30%, 0.1-9.8 oocysts/l), noroviruses (29%, 10(2)-10(4) pdu/l) and enteroviruses (35%, 10(3)-10(4) pdu/l). Exposure data collected by questionnaire, revealed that children swallowed 1.7 ml (mean, 95% Confidence Interval 0-4.6 ml) per exposure event and adults swallowed 0.016 ml (mean, 95% CI 0-0.068 ml) due to hand-mouth contact. The mean risk of infection per event for children, who were exposed to floodwater originating from combined sewers, storm sewers and rainfall generated surface runoff was 33%, 23% and 3.5%, respectively, and for adults it was 3.9%, 0.58% and 0.039%. The annual risk of infection was calculated to compare flooding from different urban drainage systems. An exposure frequency of once every 10 years to flooding originating from combined sewers resulted in an annual risk of infection of 8%, which was equal to the risk of infection of flooding originating from rainfall generated surface runoff 2.3 times per year. However, these annual infection risks will increase with a higher frequency of urban flooding due to heavy rainfall as foreseen in climate change projections.
洪水和暴雨与水传播传染病暴发有关，但尚不清楚其对公共健康构成的风险程度。在这里，采用定量微生物风险评估（QMRA）评估了接触城市洪水感染的风险。为此，于 2011 年和 2012 年期间在荷兰的 23 次事件中采集了城市洪水样本。水中含有空肠弯曲菌（61%的流行率，范围 14- > 10(3)MPN/l）、贾第虫属（35%，0.1-142 个囊/升）、隐孢子虫（30%，0.1-9.8 个卵囊/升）、诺如病毒（29%，10(2)-10(4)pdu/l）和肠道病毒（35%，10(3)-10(4)pdu/l）。通过问卷调查收集的暴露数据显示，儿童每次暴露事件吞下 1.7 毫升（平均值，95%置信区间 0-4.6 毫升），成人因手口接触吞下 0.016 毫升（平均值，95%置信区间 0-0.068 毫升）。暴露于源于合流污水、雨水污水和降雨产生的地表径流的洪水的儿童，每次事件的平均感染风险分别为 33%、23%和 3.5%，而成年人的感染风险分别为 3.9%、0.58%和 0.039%。计算了每年的感染风险，以比较不同城市排水系统的洪水。每年一次接触源于合流污水的洪水，其感染风险为每年 8%，与每年 2.3 次源于降雨产生的地表径流的洪水的感染风险相当。然而，随着气候变化预测中预期的暴雨导致城市洪水频率增加，这些年感染风险将会增加。
