Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Divisions of General and Community Pediatrics and Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Sci Total Environ. 2017 Dec 31;607-608:1180-1187. doi: 10.1016/j.scitotenv.2017.07.104. Epub 2017 Jul 17.
In localities with combined sewer systems, combined sewer overflow (CSO) events frequently occur following high precipitation and can result in the release of untreated sewage and industrial wastewater into surface waters. We hypothesized that either direct contact with or proximity to aerosolized CSO effluent would increase the risk for childhood emergency department (ED) visits for asthma, gastrointestinal (GI) illnesses, and skin and soft tissue infections (SSTIs) in Cincinnati, OH, USA. ED visits for 2010-2014 due to GI diseases, asthma, and SSTIs were extracted from the Cincinnati Children's Hospital Medical Center electronic health records. The location and timing of CSO events were obtained from the Metropolitan Sewer District (MSD) of Greater Cincinnati. ED visits with a residential address within 500m of a CSO site were used in a case-control crossover study with two bi-directional control periods. Conditional logistic regression models were used to estimate the risk of an ED visit associated with a CSO event at lag periods of 0 to 7days. Statistically significant elevated risks for GI-related ED visits was observed two (OR: 1.16 [95% CI 1.04,1.30]) days after CSO events. CSO events were not significantly associated with asthma- or SSTI-related ED visits, but show similar trends. Our findings suggest an increased risk for GI-related ED visits following CSO events among children who reside near CSO sites.
在合流制排水系统的地区，强降水后经常会发生合流制污水溢流（CSO）事件，导致未经处理的污水和工业废水排入地表水中。我们假设，在美国俄亥俄州辛辛那提市，直接接触或接近雾化的 CSO 污水会增加儿童因哮喘、胃肠道（GI）疾病、皮肤和软组织感染（SSTIs）到急诊室（ED）就诊的风险。本研究从辛辛那提儿童医院医疗中心的电子健康记录中提取了 2010-2014 年因 GI 疾病、哮喘和 SSTIs 导致的 ED 就诊数据。CSO 事件的位置和时间从大辛辛那提大都市区污水区（MSD）获得。在一项病例对照交叉研究中，使用了距离 CSO 地点 500 米范围内的住宅地址的 ED 就诊数据，该研究有两个双向对照期。条件逻辑回归模型用于估计与 CSO 事件相关的 ED 就诊风险，CSO 事件的滞后时间为 0 至 7 天。CSO 事件发生两天后（OR：1.16 [95%CI 1.04,1.30]），与胃肠道相关的 ED 就诊风险显著升高。CSO 事件与哮喘或 SSTI 相关的 ED 就诊无显著相关性，但显示出类似的趋势。我们的研究结果表明，居住在 CSO 地点附近的儿童在 CSO 事件后胃肠道相关 ED 就诊的风险增加。
