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Drinking water source associated with Toxoplasma gondii and Helicobacter pylori infections in the United States: A cross-sectional analysis of NHANES data
Citation:
Krueger, W., E Hilborn, R. Converse, AND Tim Wade. Drinking water source associated with Toxoplasma gondii and Helicobacter pylori infections in the United States: A cross-sectional analysis of NHANES data. Presented at International Society for Environmental Epidemiology, Seattle, WA, August 24 - 28, 2014.
Impact/Purpose:
Toxoplasma gondii and Helicobacter pylori infections in the United States were associated with drinking water source in an analysis using NHANES data.
Description:
Toxoplasma gondii and Helicobacter pylori impart considerable burdens to public health. Toxoplasmosis can be life threatening in immunocompromised individuals, has been associated with psychiatric disorders, and can cause severe congenital pathologies. Infections with H. pylori are mainly acquired in early childhood and can lead to chronic disease outcomes, including peptic ulcers and gastric cancer. Both organisms can be transmitted through water, and H.pylori is on US EPA’s candidate contaminant list for regulation. We examined National Health and Nutrition Examination Survey (NHANES) data for risk factors associated with seroprevalence. Methods: We examined T. gondii serology results from survey years 1999-2004 and 2009-10; and H. pylori serology results from 1999-2000. We selected covariates a priori, including source of tap water and housing characteristics. Multivariate logistic regression was used to estimate adjusted odds ratios (AOR) and 95% confidence intervals (CI) for associations with seropositivity. Results: Persons born outside the United States were significantly more likely to be seropositive against T. gondii (AOR=4.0; CI=3.3-4.9). Among US-born participants, those with homes on well water were more likely to be seropositive against T. gondii compared to participants whose tap water was provided by a private or public water company (AOR=1.4; CI=1.1-1.9). Among younger participants (<20yrs), H. pylori seropositivity was associated with housing characteristics including having a well as the source of tap water (AOR=1.9; CI=1.2-2.8), increased family density (AOR=2.4; CI=1.7-3.6), and renting, rather than owning, the home (AOR=1.7; CI=1.1-2.7). Among adult participants (>20yrs), H. pylori infections were not associated with housing characteristics. Conclusions: The associations between well water use and other environmental factors with T. gondii and H. pylori infections warrant further research. This abstract does not reflect EPA policy.