DE Man H, Mughini Gras L, Schimmer B, Friesema I H M, DE Roda Husman A M, VAN Pelt W
Institute for Risk Assessment Sciences,Utrecht University,Utrecht,The Netherlands.
Center for Infectious Disease Control,National Institute for Public Health and the Environment,Bilthoven,The Netherlands.
Epidemiol Infect. 2016 May;144(7):1445-54. doi: 10.1017/S0950268815002654. Epub 2015 Nov 11.
Extreme rainfall events may cause pluvial flooding, increasing the transmission of several waterborne pathogens. However, the risk of experiencing clinically overt infections following exposure to pluvial floodwater is poorly estimated. A retrospective cross-sectional survey was performed to quantify the occurrence of self-reported gastrointestinal, influenza-like illness (ILI) and dermatological complaints, and the frequency of visits to the general practitioner (GP), during a 4-week observation period following pluvial flooding at seven locations in The Netherlands. Questionnaires were sent to 817 flooded households, 149 (17%) of which returned the questionnaire reporting information for 199 participants. Contact with floodwater was significantly associated with increased occurrence of gastrointestinal [odds ratio (OR 4·44)], ILI (OR 2·75) and dermatological (OR 6·67) complaints, and GP visits (OR 2·72). Having hand contact with floodwater was associated with gastrointestinal and dermatological complaints, whereas ILI complaints were associated with being engaged in post-flooding cleaning operations and having walked/cycled through floodwater. This study shows that floodwater-associated diseases occur in urban settings following extreme rainfall events in a high-income country. As pluvial floods are expected to escalate in the future due to global climate change, further research is warranted to determine the disease burden of pluvial flooding and to assess the effect of different interventions, including raising awareness among stakeholders.
极端降雨事件可能导致内涝，增加多种水源性病原体的传播。然而，接触内涝洪水后出现临床显性感染的风险却鲜有评估。在荷兰七个地点发生内涝洪水后的4周观察期内，开展了一项回顾性横断面调查，以量化自我报告的胃肠道疾病、流感样疾病（ILI）和皮肤病主诉的发生率，以及看全科医生（GP）的频率。向817户受灾家庭发放了调查问卷，其中149户（17%）返回问卷，报告了199名参与者的信息。接触洪水与胃肠道疾病（优势比[OR] 4.44）、ILI（OR 2.75）和皮肤病（OR 6.67）主诉以及看全科医生（OR 2.72）的发生率增加显著相关。手部接触洪水与胃肠道和皮肤病主诉相关，而ILI主诉与参与洪水后清洁作业以及步行/骑车穿过洪水有关。这项研究表明，在高收入国家，极端降雨事件后城市地区会出现与洪水相关的疾病。由于全球气候变化，预计未来内涝洪水将加剧，因此有必要进一步开展研究，以确定内涝洪水的疾病负担，并评估包括提高利益相关者认识在内的不同干预措施的效果。
