Science Division, National Food Agency, Uppsala, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Science Division, National Food Agency, Uppsala, Sweden.
Water Res. 2017 Oct 1;122:503-511. doi: 10.1016/j.watres.2017.06.013. Epub 2017 Jun 5.
During recent years, knowledge gaps on drinking water-related gastrointestinal illness have been identified, especially for non-epidemic cases. Pathogen contamination of drinking water during distribution has been suggested to contribute to these cases, but the risk factors are not yet fully understood. During 2014-2015, we conducted an epidemiological study in five municipalities in Sweden, to assess whether incidents in the drinking water distribution system influence the risk of gastrointestinal illness. Telephone interviews were conducted in the affected areas and in reference areas 7-14 days after a reported incident. Symptoms of gastrointestinal illness occurring during the period were documented for each household member. The results showed a significantly elevated risk of vomiting and acute gastrointestinal illness (AGI) in the affected areas, compared to the reference areas (OR = 2.0, 95% CI: 1.2-3.3; OR = 1.9, 95% CI: 1.2-3.0). Certain conditions, or risk factors, during the incidents, such as sewage and drinking water pipelines at the same level in the trench, were associated with an elevated risk of AGI and vomiting. Safety measures taken during repair work, like flushing, were also associated with an elevated risk of AGI and vomiting. These results show that incidents in the drinking water distribution network contribute to endemic gastrointestinal illness, especially AGI and vomiting, and that external pathogen contamination of the drinking water is a likely cause of these cases of gastrointestinal illness. The results also indicate that safety measures used today may not be sufficient for eliminating the risk of gastrointestinal illness.
近年来，人们发现了一些有关饮用水相关胃肠道疾病的知识空白，特别是针对非流行病例。有人认为，饮用水在分配过程中的病原体污染可能导致了这些病例，但风险因素尚未完全了解。2014-2015 年，我们在瑞典的五个城市进行了一项流行病学研究，以评估饮用水分配系统中的事件是否会影响胃肠道疾病的风险。在报告事件后的 7-14 天，在受影响地区和参照地区进行了电话访谈。记录了每个家庭的胃肠道疾病症状。结果显示，与参照地区相比，受影响地区的呕吐和急性胃肠道疾病（AGI）风险显著升高（OR=2.0，95%CI：1.2-3.3；OR=1.9，95%CI：1.2-3.0）。事件期间的某些条件或风险因素，例如在沟渠中同一水平的污水和饮用水管道，与 AGI 和呕吐的风险升高有关。维修工作中采取的安全措施，例如冲洗，也与 AGI 和呕吐的风险升高有关。这些结果表明，饮用水分配网络中的事件会导致地方性胃肠道疾病，特别是 AGI 和呕吐，并且饮用水的外部病原体污染可能是这些胃肠道疾病病例的原因。结果还表明，目前使用的安全措施可能不足以消除胃肠道疾病的风险。
