You are here:
WATER QUALITY AND ASSOCIATIONS WITH GASTROINTESTINAL CONDITIONS
Citation:
Jagai, J., B. Rosenbaum, S. Pierson, L. Messer, K. Rappazzo, AND D. Lobdell. WATER QUALITY AND ASSOCIATIONS WITH GASTROINTESTINAL CONDITIONS. Presented at Society for Epidemiologic Research, Boston, MA, June 18 - 21, 2013.
Impact/Purpose:
Water quality is quantified using several measures, available from various data sources. These can be combined to create a single index of overall water quality which can be used for health research. We developed a water quality index for all United States counties and assessed associations with gastrointestinal infections (GI) and gastrointestinal symptoms (GS).
Description:
Water quality is quantified using several measures, available from various data sources. These can be combined to create a single index of overall water quality which can be used for health research. We developed a water quality index for all United States counties and assessed associations with gastrointestinal infections (GI) and gastrointestinal symptoms (GS). Data representing water quality were identified. For all counties (n=3141), variables were constructed and principal components analysis (PCA) used to construct the index. Four categories of rural-urban continuum codes (RUCC1 (most urban) – RUCC4 (most rural)) were used to group counties for multilevel analyses. GI- and GS- (defined per ICD-9CM 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 the water quality index and hospitalization rates. Neither GI (beta coefficient (B): -0.030; 95% Confidence Interval (95% CI): -0.623, 0.563) nor GS (B: -1.558; 95% CI: -6.114, 2.999) hospitalization rates were associated with the water quality index. Low GI case counts and low GS outcome specificity may partially account for the lack of association with overall water quality. Additionally, the elderly may not be the population most at risk for the water quality parameters considered. National level water quality data is limited both spatially and temporally. Though limited, this analysis demonstrates the utility of developing a water quality index for public health research. (This abstract does not necessarily reflect EPA policy.)