DeFlorio-Barker Stephanie, Wade Timothy J, Jones Rachael M, Friedman Lee S, Wing Coady, Dorevitch Samuel
Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois, Chicago, Illinois, USA.
Environ Health Perspect. 2017 Feb;125(2):215-222. doi: 10.1289/EHP130. Epub 2016 Jul 26.
The burden of illness can be described by addressing both incidence and illness severity attributable to water recreation. Monetized as cost, attributable disease burden estimates can be useful for environmental management decisions.
We characterize the disease burden attributable to water recreation using data from two cohort studies using a cost of illness (COI) approach and estimate the largest drivers of the disease burden of water recreation.
Data from the NEEAR study, which evaluated swimming and wading in marine and freshwater beaches in six U.S. states, and CHEERS, which evaluated illness after incidental-contact recreation (boating, canoeing, fishing, kayaking, and rowing) on waterways in the Chicago area, were used to estimate the cost per case of gastrointestinal illness and costs attributable to water recreation. Data on health care and medication utilization and missed days of work or leisure were collected and combined with cost data to construct measures of COI.
Depending on different assumptions, the cost of gastrointestinal symptoms attributable to water recreation are estimated to be $1,220 for incidental-contact recreation (range $338-$1,681) and $1,676 for swimming/wading (range $425-2,743) per 1,000 recreators. Lost productivity is a major driver of the estimated COI, accounting for up to 90% of total costs.
Our estimates suggest gastrointestinal illness attributed to surface water recreation at urban waterways, lakes, and coastal marine beaches is responsible for costs that should be accounted for when considering the monetary impact of efforts to improve water quality. The COI provides more information than the frequency of illness, as it takes into account disease incidence, health care utilization, and lost productivity. Use of monetized disease severity information should be included in future studies of water quality and health. Citation: DeFlorio-Barker S, Wade TJ, Jones RM, Friedman LS, Wing C, Dorevitch S. 2017. Estimated costs of sporadic gastrointestinal illness associated with surface water recreation: a combined analysis of data from NEEAR and CHEERS Studies. Environ Health Perspect 125:215-222; http://dx.doi.org/10.1289/EHP130.
疾病负担可以通过探讨水上娱乐活动导致的发病率和疾病严重程度来描述。以成本形式货币化后，可归因疾病负担估计值对环境管理决策可能有用。
我们使用疾病成本（COI）方法，利用两项队列研究的数据来描述水上娱乐活动导致的疾病负担，并估计水上娱乐活动疾病负担的最大驱动因素。
来自NEEAR研究（评估美国六个州的海洋和淡水海滩游泳和涉水情况）以及CHEERS研究（评估芝加哥地区水道上的偶然接触性娱乐活动（划船、独木舟、钓鱼、皮划艇和赛艇）后的疾病情况）的数据，用于估计每例胃肠道疾病的成本以及水上娱乐活动导致的成本。收集了医疗保健和药物使用数据以及工作或休闲时间的缺勤天数，并与成本数据相结合，以构建COI指标。
根据不同假设，每1000名参与者中，偶然接触性娱乐活动导致的胃肠道症状成本估计为1220美元（范围为338 - 1681美元），游泳/涉水导致的成本为1676美元（范围为425 - 2743美元）。生产力损失是估计COI的主要驱动因素，占总成本的比例高达90%。
我们的估计表明，城市水道、湖泊和沿海海滩的地表水娱乐活动导致的胃肠道疾病会产生相应成本，在考虑改善水质措施的货币影响时应予以考虑。COI提供的信息比疾病发生频率更多，因为它考虑了疾病发病率、医疗保健利用情况和生产力损失。货币化的疾病严重程度信息的使用应纳入未来水质与健康的研究中。引文：DeFlorio - Barker S, Wade TJ, Jones RM, Friedman LS, Wing C, Dorevitch S. 2017. 与地表水娱乐活动相关的散发性胃肠道疾病的估计成本：NEEAR和CHEERS研究数据的综合分析。环境健康展望125:215 - 222; http://dx.doi.org/10.1289/EHP130
