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Emergency room visits for acute gastrointestinal illness following flooding: A case-crossover study
Citation:
WADE, T. J., J. S. JAGAI, AND E. D. HILBORN. Emergency room visits for acute gastrointestinal illness following flooding: A case-crossover study. Presented at International Society of Environmental Epidemiology (ISEE) Annual Meeting, Columbia, SC, August 26 - 30, 2012.
Impact/Purpose:
Objectives: Evaluate the association between flood events and emergency room (ER) visits for AGI.
Description:
Climate change may alter the frequency of precipitation and flooding which can increase fecal-oral transmission of acute gastrointestinal illness (AGI) through contact with contaminated items or water. Few studies have quantified the risk associated with flood events in the United States. Objectives: Evaluate the association between flood events and emergency room (ER) visits for AGI. Methods: ER visits for AGI (n = 156,172) were obtained from State of Massachusetts for years 20032007. Flood events (n=124) were obtained from National Oceanic & Atmospheric Administration, Storm Events Database. A case-crossover approach was used with each case (ER visit) representing their own controls. Three controls, matched by date and county of residence, were selected per case for each of the remaining years in the study period. For example, an ER visit on June 1, 2004, would be matched to controls for June 1, 2003, 2005 and 2007. Cases and controls were exposed if a flood occurred in the county of residence during the defined risk period, and unexposed if there was no flood event. Data were analyzed using conditional logistic regression. Results: 8.8% of cases and 8.6% of controls occurred within 15 days a flood. The odds of an ER visit were 1.02 times greater within the 15 days following the start of a flood event (OR=1.02, 95% CI 1.00, 1.04, p=0.036). Similar associations were seen for risk periods of 20 and 30 days. Conclusions: ER visits for AGI increased 2% following floods in Massachusetts