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ESTIMATES OF ENDEMIC WATERBORNE ILLNESS FROM COMMUNITY INTERVENTION STUDIES
Citation:
CRAUN, G. AND R. L. CALDERON. ESTIMATES OF ENDEMIC WATERBORNE ILLNESS FROM COMMUNITY INTERVENTION STUDIES. JOURNAL OF WATER AND HEALTH. IWA Publishing, London, Uk, 4(2):89-99, (2006).
Impact/Purpose:
In this paper, we review the community-intervention studies that have assessed changes in waterborne gastroenteritis risks among immunocompetent populations in industrialized counties
Description:
The nature and magnitude of endemic waterborne disease are not well characterized in the
United States. Epidemiologic studies of various designs can provide an estimate of the
waterborne attributable risk along with other types of information. Community drinking water
systems frequently improve their operations and may change drinking water treatment and their
major source of water. In the United States, many of these treatment changes are the result of
regulations promulgated under the Safe Drinking Water Act. A community-intervention study
design takes advantage of these 'natural' experiments to assess changes in health risks. In this
paper, we review the community-intervention studies that have assessed changes in waterborne
gastroenteritis risks among immunocompetent populations in industrialized countries. Published
results are available from two studies in Australia, one study in the United Kingdom, and one
study in the United States. Preliminary results from two other US studies are also available.
Although the current information is limited, the risks reported in these community-intervention
studies can help inform the national estimate of endemic waterborne gastroenteritis. Information
is provided about endemic waterborne risks for unfiltered surface water sources and a
groundwater under the influence of surface water. Community-intervention studies with
recommended study modifications should be conducted to better estimate the benefits
associated with improved drinking water treatment.