Jagai Jyotsna S, Li Quanlin, Wang Shiliang, Messier Kyle P, Wade Timothy J, Hilborn Elizabeth D
Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois, Chicago, Illinois, USA.
Environ Health Perspect. 2015 Sep;123(9):873-9. doi: 10.1289/ehp.1408971. Epub 2015 Apr 9.
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.
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.
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.
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.
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.
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.
在合流制排水系统中，当污水和雨水径流被排放到水体中时，就会发生合流制溢流（CSO），这可能会污染水源。合流制溢流通常由强降水引起，并且预计随着与气候变化相关的极端降水增加而增多。
本研究的目的是评估在存在合流制溢流的情况下，强降雨与胃肠道（GI）疾病急诊就诊率之间的关联是否有所不同。
在2003 - 2007年研究期间，针对三个暴露区域整理了胃肠道疾病急诊每日就诊率的时间序列和气象数据：a）影响饮用水源的合流制溢流区域；b）影响娱乐用水的合流制溢流区域；c）无合流制溢流区域。采用分布滞后泊松回归分析了强降雨（≥第90百分位数和≥第95百分位数）和极端降雨（≥第99百分位数）事件后8天滞后期的累积影响，并对温度和长期时间趋势进行了控制。
不同区域极端降雨与胃肠道疾病急诊就诊率之间的关联有所不同。只有饮用水源受合流制溢流影响的区域在极端降雨后的8天内，各年龄段胃肠道疾病急诊就诊率（CRR）的累积风险显著增加：与无降雨情况相比，CRR为1.13（95%可信区间：1.00, 1.28）。
在合流制溢流排放到饮用水源的地区，胃肠道疾病急诊就诊率与极端降水有关。我们的研究结果表明，极端降水后，饮用水源可能受合流制溢流影响的消费者患胃肠道疾病的风险增加。
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.
