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A NOVEL USE FOR DATA COLLECTED UNDER THE CLEAN WATER ACT FOR PUBLIC HEALTH ANALYSIS
Citation:
JAGAI, J. S., B. J. Rosenbaum, S. M. Pierson, L. C. Messer, K. Rapazzo, D. T. LOBDELL, AND E. N. Naumova. A NOVEL USE FOR DATA COLLECTED UNDER THE CLEAN WATER ACT FOR PUBLIC HEALTH ANALYSIS. Presented at 3rd North American Congress of Epidemiology, Montreal, QC, CANADA, June 21 - 24, 2011.
Impact/Purpose:
We hypothesized that counties with impaired drinking water environments will also have higher rates of gastrointestinal infections (01) and gastrointestinal symptoms (OS). Impairment data were obtained and merged with stream length data to estimate the percent of drinking-water-impaired stream-length per county in the 13 states that report these data.
Description:
Under the Clean Water Act, the U.S. Environmental Protection Agency (EPA) collects information on intended stream use and impairment. We hypothesized that counties with impaired drinking water environments will also have higher rates of gastrointestinal infections (01) and gastrointestinal symptoms (OS). Impairment data were obtained and merged with stream length data to estimate the percent of drinking-water-impaired stream-length per county in the 13 states that report these data. 01-and OS-(defined per ICD-9 codes) related hospitalizations (1991-2004) were abstracted from the Center for Medicare and Medicaid Services (CMS), the only comprehensive national hospitalization dataset. Data were aggregated by county of residence; annual hospitalization rates in the elderly (65+years) per county were calculated. A linear random effects model assessed county-level associations between percent impaired waters and hospitalization rates, adjusted for percent of population on public water supply and population density. Neither 01 (unadjusted: beta coefficient (B): -0.064; 95% Confidence Interval (95% CI): -0.292,0.164; adjusted: B: -0.014; 95% CI: -0.224,0.196) nor OS (unadjusted: B: 0.561; 950/0 CI: -0.929,2.050; adjusted: B: 0.677; 950/0 CI: -0.808,2.162) hospitalization rates were associated with drinking water impairment. Low 01 case counts and low OS outcome specificity may partially account for the lack of association with drinking water impairment. Impairment data from omitted states would possibly confirm these results. Though limited, this analysis demonstrates the feasibility of utilizing data collected for policy in environmental public health research. (This abstract does not necessarily reflect EPA policy.)