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Int J Environ Res Public Health. 2018 Apr 26;15(5). pii: E867. doi: 10.3390/ijerph15050867.

A Systematic Review of the Time Series Studies Addressing the Endemic Risk of Acute Gastroenteritis According to Drinking Water Operation Conditions in Urban Areas of Developed Countries.

Author information

1
Santé Publique France, 14 rue du Val-d'Osne, 94415 Saint-Maurice CEDEX, France. pascal.beaudeau@santepubliquefrance.fr.

Abstract

Time series studies (TSS) can be viewed as an inexpensive way to tackle the non-epidemic health risk from fecal pathogens in tap water in urban areas. Following the PRISMA recommendations, I reviewed TSS addressing the endemic risk of acute gastroenteritis risk according to drinking water operation conditions in urban areas of developed countries. Eighteen studies were included, covering 17 urban sites (seven in North-America and 10 in Europe) with study populations ranging from 50,000 to 9 million people. Most studies used general practitioner consultations or visits to hospitals for acute gastroenteritis (AGE) as health outcomes. In 11 of the 17 sites, a significant and plausible association was found between turbidity (or particle count) in finished water and the AGE indicator. When provided and significant, the interquartile excess of relative risk estimates ranged from 3⁻13%. When examined, water temperature, river flow, and produced flow were strongly associated with the AGE indicator. The potential of TSS for the study of the health risk from fecal pathogens in tap water is limited by the lack of specificity of turbidity and its site-sensitive value as an exposure proxy. Nevertheless, at the DWS level, TSS could help water operators to identify operational conditions most at risk, almost if considering other water operation indicators, in addition to turbidity, as possible relevant proxies for exposure.

KEYWORDS:

acute gastroenteritis; risk; tap water; time series study; turbidity; urban area; water operation data

PMID:
29701701
PMCID:
PMC5981906
DOI:
10.3390/ijerph15050867
[Indexed for MEDLINE]
Free PMC Article

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