Bylund John, Toljander Jonas, Lysén Maria, Rasti Niloofar, Engqvist Jannes, Simonsson Magnus
National Food Agency, Box 622, Uppsala SE-751 26, Sweden E-mail:
J Water Health. 2017 Jun;15(3):321-340. doi: 10.2166/wh.2017.261.
There is an increasing awareness that drinking water contributes to sporadic gastrointestinal illness (GI) in high income countries of the northern hemisphere. A literature search was conducted in order to review: (1) methods used for investigating the effects of public drinking water on GI; (2) evidence of possible dose-response relationship between sporadic GI and drinking water consumption; and (3) association between sporadic GI and factors affecting drinking water quality. Seventy-four articles were selected, key findings and information gaps were identified. In-home intervention studies have only been conducted in areas using surface water sources and intervention studies in communities supplied by ground water are therefore needed. Community-wide intervention studies may constitute a cost-effective alternative to in-home intervention studies. Proxy data that correlate with GI in the community can be used for detecting changes in the incidence of GI. Proxy data can, however, not be used for measuring the prevalence of illness. Local conditions affecting water safety may vary greatly, making direct comparisons between studies difficult unless sufficient knowledge about these conditions is acquired. Drinking water in high-income countries contributes to endemic levels of GI and there are public health benefits for further improvements of drinking water safety.
在北半球高收入国家，人们越来越意识到饮用水会导致散发性胃肠道疾病（GI）。为了进行综述，开展了一项文献检索：（1）用于调查公共饮用水对胃肠道影响的方法；（2）散发性胃肠道疾病与饮用水消费之间可能存在的剂量反应关系的证据；（3）散发性胃肠道疾病与影响饮用水质量的因素之间的关联。共筛选出74篇文章，确定了主要发现和信息空白。家庭干预研究仅在使用地表水水源的地区进行，因此需要在地下水供应社区开展干预研究。社区范围的干预研究可能是家庭干预研究的一种具有成本效益的替代方案。与社区胃肠道疾病相关的替代数据可用于检测胃肠道疾病发病率的变化。然而，替代数据不能用于衡量疾病的患病率。影响水安全的当地条件可能差异很大，除非获得有关这些条件的充分知识，否则很难在研究之间进行直接比较。高收入国家的饮用水会导致胃肠道疾病的地方性流行水平，进一步改善饮用水安全对公众健康有益。
