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Association between Gastrointestinal Illness and Precipitation in Areas Impacted by Combined Sewer Facilities: Analysis of Massachusetts Data, 2003-2007
Citation:
JAGAI, J. S., L. C. Messer, T. J. WADE, AND E. D. HILBORN. Association between Gastrointestinal Illness and Precipitation in Areas Impacted by Combined Sewer Facilities: Analysis of Massachusetts Data, 2003-2007. Presented at International Society for Environmental Epidemiology (ISEE) Annual Meeting, Columbia, SC, August 26 - 30, 2012.
Impact/Purpose:
Objective: Evaluate associations between heavy precipitation and emergency room (ER) visits for gastrointestinal illness (GI) in areas with and without CSS in Massachusetts (MA).
Description:
Background: Combined sewer systems (CSS) collect rainwater runoff, sewage, and industrial wastewater for transit to treatment facilities. With heavy precipitation, volumes can exceed capacity of treatment facilities, and wastewater discharges directly to receiving waters. These combined sewer overflows (CSOs) are a source of episodic pollution for downstream water users. Climate change is expected to increase frequency of heavy precipitation and resultant CSO events. Objective: Evaluate associations between heavy precipitation and emergency room (ER) visits for gastrointestinal illness (GI) in areas with and without CSS in Massachusetts (MA). Methods: MA towns were grouped into CSS exposed and unexposed areas. We considered the most populous exposed and unexposed town groups. ER visits during 2003-2007 for GI diagnoses were aggregated by town of residence and date of admission. Precipitation was abstracted from National Climatic Data Center for town groups and heavy precipitation events defined (daily precipitation ~ ss" percentile). We fit group specific Poisson regressions for ER visits with predictors for natural spline for temporal trend and heavy precipitation events up to an 8 day lag. Results: In the exposed group, heavy precipitation events were associated with a 6.68% (95%CI:0.04%, 13.77%) increase in ER visits for GI eight days later. The unexposed region did not demonstrate an association between heavy precipitation events and ER visits. Conclusions: With expected increases in episodic precipitation due to climate change and aging infrastructure the U.S. it is important to understand the human health impact of heavy precipitation events. This abstract does not necessarily reflect EPA policy. Word count: