School of Architecture, Planning & Environmental Policy, University College Dublin, Ireland.
School of Biological, Earth and Environmental Sciences, University College Cork, Cork, Ireland.
Environ Pollut. 2018 May;236:540-549. doi: 10.1016/j.envpol.2018.01.104.
Significant volumes of research over the past four decades has sought to elucidate the social, infrastructural, economic, and human health effects of climate change induced surface flooding. To date, epidemiological and public health studies of flooding events have focused on mental health effects, vector-borne diseases, and infectious enteric disease due to floodwater contact (i.e. typically low consumption rates). The inherent nature of groundwater (i.e. out of sight, out of mind) and the widely held belief that aquifers represent a pristine source of drinking water due to natural attenuation may represent the "perfect storm" causing direct consumption of relatively large volumes of surface flood-contaminated groundwater. Accordingly, the current study sought to systematically identify and synthesize all available peer-reviewed literature pertaining to the nexus between surface flooding, groundwater contamination and human gastroenteric outcomes. Just 14 relevant studies were found to have been published during the period 1980-2017, thus highlighting the fact that this potentially significant source of climate-related exposure to environmental infection has remained understudied to date. Studies differed significantly in terms of type and data reporting procedures, making it difficult to discern clear trends and patterns. Approximately 945 confirmed cases of flood-related enteric disease were examined across studies; these concurred with almost 10,000 suspected cases, equating to approximately 20 suspected cases per confirmed case. As such, no regional, national or global estimates are available for the human gastrointestinal health burden of flood-related groundwater contamination. In light of the demonstrable public health significance of the concurrent impacts of groundwater susceptibility and climate change exacerbation, strategies to increase awareness about potential sources of contamination and motivate precautionary behaviour (e.g. drinking water testing and treatment, supply interruptions) are necessary. Mainstreaming climate adaptation concerns into planning policies will also be necessary to reduce human exposure to waterborne sources of enteric infection.
在过去的四十年中，大量研究试图阐明气候变化引起的地表洪水对社会、基础设施、经济和人类健康的影响。迄今为止，洪水事件的流行病学和公共卫生研究主要集中在心理健康影响、媒介传播疾病以及由于洪水接触而引起的传染性肠道疾病（即通常的低消费水平）。地下水的固有特性（即看不见、想不到）以及含水层由于自然衰减而代表纯净饮用水源的普遍观点，可能构成导致直接大量饮用受地表洪水污染的地下水的“完美风暴”。因此，本研究旨在系统地识别和综合所有可获得的关于地表洪水、地下水污染和人类肠胃病结果之间关系的同行评议文献。在 1980 年至 2017 年期间，仅发现 14 项相关研究已发表，这突出表明，这一潜在的与气候相关的、与环境感染有关的重要暴露源迄今仍未得到充分研究。研究在类型和数据报告程序方面存在显著差异，难以辨别明确的趋势和模式。在研究中检查了大约 945 例与洪水有关的肠道疾病确诊病例；这些与近 10000 例疑似病例相符，即每例确诊病例约有 20 例疑似病例。因此，目前还没有洪水相关地下水污染对人类胃肠道健康负担的地区、国家或全球估计数。鉴于地下水易感性和气候变化加剧的并发影响具有明显的公共卫生意义，有必要采取措施提高对潜在污染来源的认识，并激励预防行为（例如饮用水测试和处理、供应中断）。还需要将适应气候变化的关切纳入规划政策的主流，以减少人类接触肠道感染水源的机会。
