Mattioli Mia C, Benedict Katharine M, Miko Shanna, Barrett Catherine E, Roundtree Alexis, Kim Sunkyung, Collier Sarah A, Adam Elizabeth, Gargano Julia W, Yoder Jonathan S, Vacs Renwick Deborah A, Rotert Kenneth, Sullivan Mike, Sweeney Sharon, Beach Michael, Hill Vincent R
Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Chenega Enterprise Systems & Solutions, LLC, Chesapeake, Virginia, USA.
Environ Health Perspect. 2025 Jun;133(6):67002. doi: 10.1289/EHP15564. Epub 2025 Jun 2.
Low pressure events (LPEs), defined as a water service disruption that presumably lowers system water pressure, can cause drinking water contamination, resulting in increased illness risk to consumers.
This study sought to examine whether LPEs increase the risk for highly credible acute gastrointestinal illness (HCGI) and acute respiratory illness (ARI) and to compare water quality in exposed and unexposed areas in the United States.
A matched cohort study was conducted during the period 2015-2019. For each LPE, household survey exposed areas were matched 1:2 with unexposed areas based on water-main size and material at the point of repair, as well as the housing type and demographic characteristics of the local population from the most recent census tract data. Water samples were collected to monitor physicochemical and microbiological water quality parameters. Households (HHs) were surveyed about water use and illness during the 2 wk after the LPE. Multivariable log-binomial models clustered on utility and LPE number were used to investigate associations between LPE exposure and HCGI and ARI.
Five water utilities reported 58 LPEs, including planned maintenance (76%) and emergency (24%) events. Controlling for livestock near home, private well presence, number of people in HH, and travel away from home, exposed HHs were at higher risk of HCGI in comparison with unexposed HHs (; 95% confidence interval: 1.05, 1.37). No associations between LPE and ARI were detected. Certain LPEs characteristics like pipe material, size, and depth were associated with an increased HH HCGI risk. HHs experiencing LPEs where low disinfectant residual, high adenosine triphosphate, or general were detected in water following an LPE repair were also at a higher risk for HCGI.
LPEs were associated with 20% higher risk of HCGI in HHs. Planned improvements to water distribution system infrastructure, adherence to industry standard distribution repair practices, and water monitoring following pipe repairs could supplement community alert systems to reduce illnesses from LPEs. https://doi.org/10.1289/EHP15564.
低压事件（LPEs）被定义为可能降低系统水压的供水服务中断，可导致饮用水污染，从而增加消费者患病风险。
本研究旨在探讨低压事件是否会增加高度可信的急性胃肠道疾病（HCGI）和急性呼吸道疾病（ARI）的风险，并比较美国暴露地区和未暴露地区的水质。
在2015年至2019年期间进行了一项匹配队列研究。对于每一次低压事件，根据维修点的水管尺寸和材料，以及最新人口普查区数据中的房屋类型和当地人口的人口特征，将暴露地区的家庭调查与未暴露地区按1:2进行匹配。采集水样以监测物理化学和微生物水质参数。在低压事件发生后的2周内，对家庭（HHs）进行用水和疾病调查。使用按公用事业和低压事件数量聚类的多变量对数二项式模型来研究低压事件暴露与HCGI和ARI之间的关联。
五家供水公司报告了58次低压事件，包括计划维护（76%）和紧急（24%）事件。在控制了家附近的牲畜、私人水井的存在、家庭人口数量和离家出行等因素后，与未暴露的家庭相比，暴露的家庭患高度可信急性胃肠道疾病的风险更高（风险比；95%置信区间：1.05，1.37）。未检测到低压事件与急性呼吸道疾病之间的关联。某些低压事件特征，如管道材料、尺寸和深度，与家庭患高度可信急性胃肠道疾病的风险增加有关。在低压事件修复后，水中检测到低消毒剂残留、高腺苷三磷酸或总体水质较差的家庭，患高度可信急性胃肠道疾病的风险也更高。
低压事件与家庭患高度可信急性胃肠道疾病的风险高20%有关。对供水系统基础设施进行计划性改善、遵守行业标准的供水维修规范以及管道维修后的水质监测，可以补充社区警报系统，以减少因低压事件导致的疾病。https://doi.org/10.1289/EHP15564
