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ENDEMIC WATERBORNE DISEASE: BENNETT-TYPE
Impact/Purpose:
The objective is to estimate the incidence of endemic waterborne disease. This information is needed to provide estimates on disease burden rates for the country as a whole and then provide estimates on what portions are waterborne. Disease rates are needed for risk assessment and cost/benefit analysis for the Enhanced Surface Water Treatment Rule (ESWTR) and the Ground Water Disinfection Rule (GWDR).
Description:
Bennett et al. attempted to estimate national waterborne disease (endemic and epidemic) in 1985 by using both actual data and estimates by CDC experts. These investigators reported that 940,000 cases of waterborne disease and 900 associated deaths could have occurred in the U.S. The study described below is designed to develop an improved national estimate of waterborne disease using several sources of information. Three national databases, including the National Mortality Data, National Hospital Discharge Survey, and the National Ambulatory Care Survey, are being used to obtain national rates of gastrointestinal disease. The percentage of the national rates attributable to drinking water is being estimated using the Federal Reporting Data System for drinking water, pathogen occurrence data in source and finished drinking water, waterborne disease outbreak data, and infectious dose information. These sources of information will be used to estimate: 1) the proportion of U.S. served by regulated systems; 2) which of those systems use ground water, surface water, or mixed water; and 3) the potential for exposure to pathogens, based on source water quality or actual finished water pathogen occurrence information. Inferences will also be made about the extent to which specific etiologic agents, such as Cryptosporidium or hepatitis A virus, may be causing endemic illness in the community.