Pirard P, Goria S, Nguengang Wakap S, Galey C, Motreff Y, Guillet A, Le Tertre A, Corso M, Beaudeau P
Département santé environnement, Institut de Veille Sanitaire, 12 rue du Val d'Osne, Saint-Maurice Cedex 94415, France E-mail
J Water Health. 2015 Sep;13(3):737-45. doi: 10.2166/wh.2015.188.
During the night of 23-24 January 2009, Storm Klaus hit south-western France and caused power outages affecting 1,700,000 homes and stopping numerous pumping and drinking water disinfection systems. In France, medicalized acute gastroenteritis (MAGE) outbreaks are monitored by analysing the daily amount of reimbursements of medical prescriptions, registered in the French National Health Insurance database, at the 'commune' administrative level. As AGE is suspected to be associated with perturbations to water supply systems as well as power outages, Storm Klaus provided an opportunity to test its influence on the incidence of MAGE in the communes of three affected French departments (administrative areas larger than communes). The geographical exposure indicator was built by using the mapping of the water distribution zones, the reported distribution/production stoppages and their duration. Irrespective of exposure class, a relative risk of MAGE of 0.86 (95% confidence 0.84-0.88) was estimated compared with the 'unexposed' reference level. Although these results must be considered with caution because of a potential marked decrease in global medical consultation probably due to impassable roads, they do not suggest a major public health impact of Klaus in terms of increased MAGE incidence.
2009年1月23日至24日夜间,克劳斯风暴袭击了法国西南部,导致停电,影响了170万户家庭,并使众多抽水和饮用水消毒系统停止运行。在法国,通过分析法国国家健康保险数据库中在“市镇”行政级别登记的医疗处方每日报销金额,对医疗化急性胃肠炎(MAGE)疫情进行监测。由于怀疑急性胃肠炎与供水系统扰动以及停电有关,克劳斯风暴提供了一个机会,来测试其对法国三个受影响省份(比市镇大的行政区)市镇中MAGE发病率的影响。地理暴露指标是通过绘制配水区域图、报告的配送/生产停工情况及其持续时间构建的。与“未暴露”参考水平相比,无论暴露类别如何,估计MAGE的相对风险为0.86(95%置信区间0.84 - 0.88)。尽管由于可能因道路无法通行导致全球医疗咨询显著减少,这些结果必须谨慎看待,但它们并未表明克劳斯风暴在增加MAGE发病率方面对公共卫生有重大影响。