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Yu CP, Lin IJ, Wang BL, Tsao CH, Huang SH, Huang YC, Sun CA, Chung CH, Hu JM, Chien WC. Intestinal infectious diseases increase the risk of psychiatric disorders: A nationwide population-based cohort study. Medicine (Baltimore) 2022; 101:e30959. [PMID: 36221435 PMCID: PMC9543017 DOI: 10.1097/md.0000000000030959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Intestinal infectious diseases (IIDs) are among the most common diseases and are prevalent worldwide. IIDs are also one of the major disease groups with the highest incidence worldwide, especially among children and older adults. We observed a higher probability of IIDs in patients from the psychiatric department of Tri-Service General Hospital. Therefore, our objective was to investigate if there is an association between IIDs and the risk of developing psychiatric disorders. This nationwide population-based study used the database of the National Health Insurance (NHI) program in Taiwan. The study included 150,995 patients from 2000 to 2015, comprising 30,199 patients with IIDs as the study group and 120,796 patients without IIDs as the control group. Cox proportional hazards regression analysis was performed to calculate the hazard ratio of psychiatric disorders during the 16-year follow-up. Of the patients with IIDs, 4022 (13.32%) developed psychiatric disorders compared to 8119 (6.72%) who did not (P < .001). The adjusted hazard ratio (aHR) for overall psychiatric disorders in the study group was 2.724 (95% confidence interval [CI]: 2.482-2.976; P < .001). More specifically, the study group had a higher risk of developing a psychiatric disorder, including sleep disorders, depression, anxiety, bipolar disorder, post-traumatic stress disorder (PTSD)/acute stress disorder (ASD), schizophrenia, mental retardation (MR), substance abuse, and other psychiatric disorders. Furthermore, refractory IIDs (seeking medical attention for IIDs 3 or more times) increased the risk (aHR: 3.918; 95% CI: 3.569-4.280; P < .001) of developing psychiatric disorders. There was an association between IIDs and the increased risk of developing psychiatric disorders. The novel role of etiological factors in the development of psychiatric disorders deserves more attention, and the control of pathogens that cause IIDs is of urgent public health importance.
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Affiliation(s)
- Chia-Peng Yu
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Iau-Jin Lin
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Bing-Long Wang
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chang-Huei Tsao
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Microbiology & Immunology, National Defense Medical Center, Taipei, Taiwan
| | - Shi-Hao Huang
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan
| | - Yao-Ching Huang
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
- Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
| | - Je-Ming Hu
- Division of Colorectal Surgery, Department of surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
- *Correspondence: Wu-Chien Chien, Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan and Je-Ming Hu, Division of Colorectal Surgery, Department of surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan (e-mail: (W-CC) and (J-MH))
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- *Correspondence: Wu-Chien Chien, Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan and Je-Ming Hu, Division of Colorectal Surgery, Department of surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan (e-mail: (W-CC) and (J-MH))
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Chen T, Kallawicha K. Association between sanitary toilet coverage rate and intestinal infectious disease in Jiangsu Province, China. Sci Rep 2021; 11:12805. [PMID: 34140599 PMCID: PMC8211806 DOI: 10.1038/s41598-021-92291-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/08/2021] [Indexed: 11/09/2022] Open
Abstract
Intestinal infectious disease is one of the most common diseases in China and is prevalent worldwide. The Chinese government launched a toilet improvement campaign to improve sanitation and reduce the incidence of diseases. This study determined the association between sanitary toilet use and intestinal infectious disease incidence in Jiangsu Province, China during 2011–2019. This study adopted an ecological retrospective research design. All secondary data were obtained through government websites and government information disclosure channels. Multiple linear regression was employed to analyze the association between the incidence of intestinal infectious diseases and sanitary toilet coverage rate and other potential predictors. Data suggested that the aggregate annual incidence of Type A and B intestinal infectious diseases showed a downward trend, the aggregate annual incidence of other infectious diarrhea continued to increase, and hand–foot–mouth disease occurred every other year with the highest annual incidence rate. The incidence was higher in coastal cities. Multiple regression results indicated that the usage of three types of sanitary toilets, compliance rate of water quality, and average ambient temperature have an impact on intestinal infectious diseases. The aggregate annual incidence of Type A and B intestinal infectious disease was negatively correlated with the cumulative use of sanitary toilets (β = − 0.036) and surface water quality (β = − 0.135; p < 0.05). Increase in sanitary toilet use and water quality control can reduce the number of new cases, which will be beneficial for the population in the province. Moreover, the toilet improvement interventions should continue to maintain high-quality construction.
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Affiliation(s)
- TingTing Chen
- College of Public Health Sciences, Chulalongkorn University, 11th floor (Room no. 1110) Institute Building 3, Soi Chulalongkorn 62, Phyathai Rd, Pathumwan, Bangkok, 10330, Thailand
| | - Kraiwuth Kallawicha
- College of Public Health Sciences, Chulalongkorn University, 11th floor (Room no. 1110) Institute Building 3, Soi Chulalongkorn 62, Phyathai Rd, Pathumwan, Bangkok, 10330, Thailand.
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Adams NL, Rose TC, Hawker J, Violato M, O’Brien SJ, Whitehead M, Barr B, Taylor-Robinson DC. Socioeconomic status and infectious intestinal disease in the community: a longitudinal study (IID2 study). Eur J Public Health 2018; 28:134-138. [PMID: 29016791 PMCID: PMC5965370 DOI: 10.1093/eurpub/ckx091] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Infectious intestinal diseases (IID) are common, affecting around 25% of people in UK each year at an estimated annual cost to the economy, individuals and the NHS of £1.5 billion. While there is evidence of higher IID hospital admissions in more disadvantaged groups, the association between socioeconomic status (SES) and risk of IID remains unclear. This study aims to investigate the relationship between SES and IID in a large community cohort. Methods Longitudinal analysis of a prospective community cohort in the UK following 6836 participants of all ages was undertaken. Hazard ratios for IID by SES were estimated using Cox proportional hazard, adjusting for follow-up time and potential confounding factors. Results In the fully adjusted analysis, hazard ratio of IID was significantly lower among routine/manual occupations compared with managerial/professional occupations (HR 0.74, 95% CI 0.61-0.90). Conclusion In this large community cohort, lower SES was associated with lower IID risk. This may be partially explained by the low response rate which varied by SES. However, it may be related to differences in exposure or recognition of IID symptoms by SES. Higher hospital admissions associated with lower SES observed in some studies could relate to more severe consequences, rather than increased infection risk.
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Affiliation(s)
- Natalie L Adams
- NIHR Health Protection Research Unit in Gastrointestinal Infections,
Liverpool, UK
- Department of Public Health and Policy, University of Liverpool,
Liverpool, UK
- National Infection Service, Public Health England, London/Birmingham,
UK
| | - Tanith C Rose
- NIHR Health Protection Research Unit in Gastrointestinal Infections,
Liverpool, UK
- Department of Public Health and Policy, University of Liverpool,
Liverpool, UK
| | - Jeremy Hawker
- NIHR Health Protection Research Unit in Gastrointestinal Infections,
Liverpool, UK
- National Infection Service, Public Health England, London/Birmingham,
UK
| | - Mara Violato
- NIHR Health Protection Research Unit in Gastrointestinal Infections,
Liverpool, UK
- Health Economics Research Centre, University of Oxford, Oxford, UK
| | - Sarah J O’Brien
- NIHR Health Protection Research Unit in Gastrointestinal Infections,
Liverpool, UK
- Department of Public Health and Policy, University of Liverpool,
Liverpool, UK
| | - Margaret Whitehead
- NIHR Health Protection Research Unit in Gastrointestinal Infections,
Liverpool, UK
- Department of Public Health and Policy, University of Liverpool,
Liverpool, UK
| | - Benjamin Barr
- NIHR Health Protection Research Unit in Gastrointestinal Infections,
Liverpool, UK
- Department of Public Health and Policy, University of Liverpool,
Liverpool, UK
| | - David C Taylor-Robinson
- NIHR Health Protection Research Unit in Gastrointestinal Infections,
Liverpool, UK
- Department of Public Health and Policy, University of Liverpool,
Liverpool, UK
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Rose TC, Adams NL, Barr B, Hawker J, O'Brien SJ, Violato M, Whitehead M, Taylor-Robinson DC. Socioeconomic status is associated with symptom severity and sickness absence in people with infectious intestinal disease in the UK. BMC Infect Dis 2017. [PMID: 28645256 PMCID: PMC5481911 DOI: 10.1186/s12879-017-2551-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The burden of infectious intestinal disease (IID) in the UK is substantial. Negative consequences including sickness absence are common, but little is known about the social patterning of these outcomes, or the extent to which they relate to disease severity. METHODS We performed a cross-sectional analysis using IID cases identified from a large population-based survey, to explore the association between socioeconomic status (SES) and symptom severity and sickness absence; and to assess the role of symptom severity on the relationship between SES and absence. Regression modelling was used to investigate these associations, whilst controlling for potential confounders such as age, sex and ethnicity. RESULTS Among 1164 cases, those of lower SES versus high had twice the odds of experiencing severe symptoms (OR 2.2, 95%CI;1.66-2.87). Lower SES was associated with higher odds of sickness absence (OR 1.8, 95%CI;1.26-2.69), however this association was attenuated after adjusting for symptom severity (OR 1.4, 95%CI;0.92-2.07). CONCLUSIONS In a large sample of IID cases, those of low SES versus high were more likely to report severe symptoms, and sickness absence; with greater severity largely explaining the higher absence. Public health interventions are needed to address the unequal consequences of IID identified.
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Affiliation(s)
- Tanith C Rose
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, UK. .,Department of Public Health and Policy, University of Liverpool, Liverpool, UK. .,Department of Public Health and Policy Institute of Psychology, Health and Society, University of Liverpool, Whelan Building, Liverpool, L69 3GB, UK.
| | - Natalie L Adams
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, UK.,Department of Public Health and Policy, University of Liverpool, Liverpool, UK.,National Infection Service, Public Health England, London/Birmingham, UK
| | - Benjamin Barr
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, UK.,Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Jeremy Hawker
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, UK.,National Infection Service, Public Health England, London/Birmingham, UK
| | - Sarah J O'Brien
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, UK.,Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - Mara Violato
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, UK.,Health Economics Research Centre, University of Oxford, Oxford, UK
| | - Margaret Whitehead
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, UK.,Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | - David C Taylor-Robinson
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, UK.,Department of Public Health and Policy, University of Liverpool, Liverpool, UK
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Bylund J, Toljander J, Lysén M, Rasti N, Engqvist J, Simonsson M. Measuring sporadic gastrointestinal illness associated with drinking water - an overview of methodologies. JOURNAL OF WATER AND HEALTH 2017; 15:321-340. [PMID: 28598337 DOI: 10.2166/wh.2017.261] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
There is an increasing awareness that drinking water contributes to sporadic gastrointestinal illness (GI) in high income countries of the northern hemisphere. A literature search was conducted in order to review: (1) methods used for investigating the effects of public drinking water on GI; (2) evidence of possible dose-response relationship between sporadic GI and drinking water consumption; and (3) association between sporadic GI and factors affecting drinking water quality. Seventy-four articles were selected, key findings and information gaps were identified. In-home intervention studies have only been conducted in areas using surface water sources and intervention studies in communities supplied by ground water are therefore needed. Community-wide intervention studies may constitute a cost-effective alternative to in-home intervention studies. Proxy data that correlate with GI in the community can be used for detecting changes in the incidence of GI. Proxy data can, however, not be used for measuring the prevalence of illness. Local conditions affecting water safety may vary greatly, making direct comparisons between studies difficult unless sufficient knowledge about these conditions is acquired. Drinking water in high-income countries contributes to endemic levels of GI and there are public health benefits for further improvements of drinking water safety.
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Affiliation(s)
- John Bylund
- National Food Agency, Box 622, Uppsala SE-751 26, Sweden E-mail:
| | - Jonas Toljander
- National Food Agency, Box 622, Uppsala SE-751 26, Sweden E-mail:
| | - Maria Lysén
- National Food Agency, Box 622, Uppsala SE-751 26, Sweden E-mail:
| | - Niloofar Rasti
- National Food Agency, Box 622, Uppsala SE-751 26, Sweden E-mail:
| | - Jannes Engqvist
- National Food Agency, Box 622, Uppsala SE-751 26, Sweden E-mail:
| | - Magnus Simonsson
- National Food Agency, Box 622, Uppsala SE-751 26, Sweden E-mail:
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Effect of drinking water source on associations between gastrointestinal illness and heavy rainfall in New Jersey. PLoS One 2017; 12:e0173794. [PMID: 28282467 PMCID: PMC5345866 DOI: 10.1371/journal.pone.0173794] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 02/27/2017] [Indexed: 01/17/2023] Open
Abstract
Gastrointestinal illness (GI) has been associated with heavy rainfall. Storm events and periods of heavy rainfall and runoff can result in increased microbiological contaminants in raw water. Surface water supplies are open to the environment and runoff can directly influence the presence of contaminants. A time-stratified bi-directional case-crossover study design was used to estimate associations of heavy rainfall and hospitalizations for GI. Cases of GI were identified as in-patient hospitalization with a primary diagnosis of infectious disease associated diarrhea [ICD-9 codes: specified gastrointestinal infections 001–009.9 or diarrhea 787.91] among the residents of New Jersey from 2009 to 2013 resulting in a final sample size of 47,527 cases. Two control days were selected on the same days of the week as the case day, within fixed 21-day strata. Conditional logistic regression was used to estimate odds ratios controlling for temperature and humidity. To determine potential effect modification estimates were stratified by season (warm or cold) and drinking water source (groundwater, surface water, or ‘other’ category). Stratified analyses by drinking water source and season identified positive associations of rainfall and GI hospitalizations in surface water systems during the warm season with no lag (OR = 1.12, 95% CI 1.05–1.19) and a 2-day lag (OR = 1.09, 95% CI 1.03–1.16). Positive associations in ‘Other’ water source areas (served by very small community water systems, private wells, or unknown) during the warm season with a 4-day lag were also found. However, there were no statistically significant positive associations in groundwater systems during the warm season. The results suggest that water systems with surface water sources can play an important role in preventing GI hospitalizations during and immediately following heavy rainfall. Regulators should work with water system providers to develop system specific prevention techniques to limit the impact of heavy rainfall on public health.
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Farenhorst A, Li R, Jahan M, Tun HM, Mi R, Amarakoon I, Kumar A, Khafipour E. Bacteria in drinking water sources of a First Nation reserve in Canada. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 575:813-819. [PMID: 27693149 DOI: 10.1016/j.scitotenv.2016.09.138] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/15/2016] [Accepted: 09/16/2016] [Indexed: 06/06/2023]
Abstract
Approximately 20% of the 600 First Nations reserves across Canada are under a drinking water advisory, often due to unacceptable levels of bacteria. In this study, we detected fecal bacteria at an alarmingly high frequency in drinking water sources in a fly-in First Nations community, most notably in buckets/drums of homes without running water where Escherichia coli levels ranged from 20 to 62,000CFU/100mL. The water leaving the water treatment plant was free of E. coli and its free residual chlorine concentration (0.67mg/L) was within the range typically observed for treated water in Canada. Water samples from taps in homes served by cisterns, and those sampled from the water truck and community standpipe, always showed unacceptable levels of E. coli (1 to 2100CFU/100mL) and free residual chlorine concentrations below the 0.2mg/L required to prevent bacterial regrowth. Samples from taps in homes served by piped water had lower levels of E. coli (0 to 2CFU/100mL). DNA- and RNA-based 16S rRNA Illumina sequencing demonstrated that piped and cisterns water distribution systems showed an abundance of viable cells of Alphaproteobacteria indicative of biofilm formation in pipes and cisterns. The alpha diversity, based on observed OTUs and three other indices, was lowest in water truck samples that supplied water to the cistern and the low free residual chlorine concentration (0.07mg/L) and predominance of Betaproteobacteria (63% of viable cells) that were immediately detected after the truck had filled up at the water treatment plant was indicative of contamination by particulate matter. Given these findings, First Nation residents living without running water and relying on inadequate water distribution systems are at higher risk of contracting water-born illnesses. We urge all governments in Canada to expand their investments in supporting and sustaining water as a human right in Canada's First Nations communities.
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Affiliation(s)
- Annemieke Farenhorst
- Department of Soil Science, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
| | - Ru Li
- Department of Soil Science, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Musarrat Jahan
- Department of Soil Science, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Hein Min Tun
- Department of Animal Science, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Ruidong Mi
- Department of Soil Science, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Inoka Amarakoon
- Department of Soil Science, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Ayush Kumar
- Department of Microbiology, University of Manitoba, MB R3T 2N2, Canada; Department of Medical Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Ehsan Khafipour
- Department of Animal Science, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; Department of Medical Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
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Gelormino E, Melis G, Marietta C, Costa G. From built environment to health inequalities: An explanatory framework based on evidence. Prev Med Rep 2015; 2:737-45. [PMID: 26844145 PMCID: PMC4721462 DOI: 10.1016/j.pmedr.2015.08.019] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE The Health in All Policies strategy aims to engage every policy domain in health promotion. The more socially disadvantaged groups are usually more affected by potential negative impacts of policies if they are not health oriented. The built environment represents an important policy domain and, apart from its housing component, its impact on health inequalities is seldom assessed. METHODS A scoping review of evidence on the built environment and its health equity impact was carried out, searching both urban and medical literature since 2000 analysing socio-economic inequalities in relation to different components of the built environment. RESULTS The proposed explanatory framework assumes that key features of built environment (identified as density, functional mix and public spaces and services), may influence individual health through their impact on both natural environment and social context, as well as behaviours, and that these effects may be unequally distributed according to the social position of individuals. CONCLUSION In general, the expected links proposed by the framework are well documented in the literature; however, evidence of their impact on health inequalities remains uncertain due to confounding factors, heterogeneity in study design, and difficulty to generalize evidence that is still very embedded to local contexts.
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Affiliation(s)
- Elena Gelormino
- Department of Public Health, Local Health Authority TO5, Piedmont Region, Italy
| | - Giulia Melis
- Environmental Heritage and Urban Redevelopment — SiTI Higher Institute on Territorial Systems for Innovation, Turin, via Pier Carlo Boggio 61, 10138 Torino, Italy
| | - Cristina Marietta
- Environmental Heritage and Urban Redevelopment Unit — SiTI Higher Institute on Territorial Systems for Innovation, Turin, via Pier Carlo Boggio 61, 10138 Torino, Italy
| | - Giuseppe Costa
- Department of Clinical and Biological Sciences, University of Turin, Turin, via Sabaudia 94, 10095 Grugliasco, Torino, Italy
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Guzman Herrador BR, de Blasio BF, MacDonald E, Nichols G, Sudre B, Vold L, Semenza JC, Nygård K. Analytical studies assessing the association between extreme precipitation or temperature and drinking water-related waterborne infections: a review. Environ Health 2015; 14:29. [PMID: 25885050 PMCID: PMC4391583 DOI: 10.1186/s12940-015-0014-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 03/04/2015] [Indexed: 05/20/2023]
Abstract
Determining the role of weather in waterborne infections is a priority public health research issue as climate change is predicted to increase the frequency of extreme precipitation and temperature events. To document the current knowledge on this topic, we performed a literature review of analytical research studies that have combined epidemiological and meteorological data in order to analyze associations between extreme precipitation or temperature and waterborne disease.A search of the databases Ovid MEDLINE, EMBASE, SCOPUS and Web of Science was conducted, using search terms related to waterborne infections and precipitation or temperature. Results were limited to studies published in English between January 2001 and December 2013.Twenty-four articles were included in this review, predominantly from Asia and North-America. Four articles used waterborne outbreaks as study units, while the remaining articles used number of cases of waterborne infections. Results presented in the different articles were heterogeneous. Although most of the studies identified a positive association between increased precipitation or temperature and infection, there were several in which this association was not evidenced. A number of articles also identified an association between decreased precipitation and infections. This highlights the complex relationship between precipitation or temperature driven transmission and waterborne disease. We encourage researchers to conduct studies examining potential effect modifiers, such as the specific type of microorganism, geographical region, season, type of water supply, water source or water treatment, in order to assess how they modulate the relationship between heavy rain events or temperature and waterborne disease. Addressing these gaps is of primary importance in order to identify the areas where action is needed to minimize negative impact of climate change on health in the future.
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Affiliation(s)
| | - Birgitte Freiesleben de Blasio
- Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
- Oslo Centre for Statistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
| | - Emily MacDonald
- Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden.
| | - Gordon Nichols
- European Centre for Disease Prevention and Control, Stockholm, Sweden.
- Gastrointestinal, Emerging and Zoonotic Diseases Department, Public Health England, London, UK.
- Norwich Medical School, University of East Anglia, Norwich, UK.
- Department of Hygiene & Epidemiology, University of Thessaly, Thessaly, Greece.
| | - Bertrand Sudre
- European Centre for Disease Prevention and Control, Stockholm, Sweden.
| | - Line Vold
- Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
| | - Jan C Semenza
- European Centre for Disease Prevention and Control, Stockholm, Sweden.
| | - Karin Nygård
- Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
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Hedlund C, Blomstedt Y, Schumann B. Association of climatic factors with infectious diseases in the Arctic and subarctic region--a systematic review. Glob Health Action 2014; 7:24161. [PMID: 24990685 PMCID: PMC4079933 DOI: 10.3402/gha.v7.24161] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 03/03/2014] [Accepted: 06/03/2014] [Indexed: 11/23/2022] Open
Abstract
Background The Arctic and subarctic area are likely to be highly affected by climate change, with possible impacts on human health due to effects on food security and infectious diseases. Objectives To investigate the evidence for an association between climatic factors and infectious diseases, and to identify the most climate-sensitive diseases and vulnerable populations in the Arctic and subarctic region. Methods A systematic review was conducted. A search was made in PubMed, with the last update in May 2013. Inclusion criteria included human cases of infectious disease as outcome, climate or weather factor as exposure, and Arctic or subarctic areas as study origin. Narrative reviews, case reports, and projection studies were excluded. Abstracts and selected full texts were read and evaluated by two independent readers. A data collection sheet and an adjusted version of the SIGN methodology checklist were used to assess the quality grade of each article. Results In total, 1953 abstracts were initially found, of which finally 29 articles were included. Almost half of the studies were carried out in Canada (n=14), the rest from Sweden (n=6), Finland (n=4), Norway (n=2), Russia (n=2), and Alaska, US (n=1). Articles were analyzed by disease group: food- and waterborne diseases, vector-borne diseases, airborne viral- and airborne bacterial diseases. Strong evidence was found in our review for an association between climatic factors and food- and waterborne diseases. The scientific evidence for a link between climate and specific vector- and rodent-borne diseases was weak due to that only a few diseases being addressed in more than one publication, although several articles were of very high quality. Air temperature and humidity seem to be important climatic factors to investigate further for viral- and bacterial airborne diseases, but from our results no conclusion about a causal relationship could be drawn. Conclusions More studies of high quality are needed to investigate the adverse health impacts of weather and climatic factors in the Arctic and subarctic region. No studies from Greenland or Iceland were found, and only a few from Siberia and Alaska. Disease and syndromic surveillance should be part of climate change adaptation measures in the Arctic and subarctic regions, with monitoring of extreme weather events known to pose a risk for certain infectious diseases implemented at the community level.
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Affiliation(s)
- Christina Hedlund
- Department of Public Health and Clinical Medicine, Centre for Global Health Research, Umeå University, Umeå, Sweden;
| | - Yulia Blomstedt
- Department of Public Health and Clinical Medicine, Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Barbara Schumann
- Department of Public Health and Clinical Medicine, Centre for Global Health Research, Umeå University, Umeå, Sweden
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The association between campylobacteriosis, agriculture and drinking water: a case-case study in a region of British Columbia, Canada, 2005-2009. Epidemiol Infect 2014; 142:2075-84. [PMID: 24892423 DOI: 10.1017/s095026881400123x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We studied the association between drinking water, agriculture and sporadic human campylobacteriosis in one region of British Columbia (BC), Canada. We compared 2992 cases of campylobacteriosis to 4816 cases of other reportable enteric diseases in 2005-2009 using multivariate regression. Cases were geocoded and assigned drinking water source, rural/urban environment and socioeconomic status (SES) according to the location of their residence using geographical information systems analysis methods. The odds of campylobacteriosis compared to enteric disease controls were higher for individuals serviced by private wells than municipal surface water systems (odds ratio 1·4, 95% confidence interval 1·1-1·8). In rural settings, the odds of campylobacteriosis were higher in November (P = 0·014). The odds of campylobacteriosis were higher in individuals aged ⩾15 years, especially in those with higher SES. In this region of BC, campylobacteriosis risk, compared to other enteric diseases, seems to be mediated by vulnerable drinking water sources and rural factors. Consideration should be given to further support well-water users and to further study the microbiological impact of agriculture on water.
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Uejio CK, Yale SH, Malecki K, Borchardt MA, Anderson HA, Patz JA. Drinking water systems, hydrology, and childhood gastrointestinal illness in Central and Northern Wisconsin. Am J Public Health 2014; 104:639-46. [PMID: 24524509 DOI: 10.2105/ajph.2013.301659] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study investigated if the type of drinking water source (treated municipal, untreated municipal, and private well water) modifies the effect of hydrology on childhood (aged < 5 years) gastrointestinal illness. METHODS We conducted a time series study to assess the relationship between hydrologic and weather conditions with childhood gastrointestinal illness from 1991 to 2010. The Central and Northern Wisconsin study area includes households using all 3 types of drinking water systems. Separate time series models were created for each system and half-year period (winter/spring, summer/fall). RESULTS More precipitation (summer/fall) systematically increased childhood gastrointestinal illness in municipalities accessing untreated water. The relative risk of contracting gastrointestinal illness was 1.4 in weeks with 3 centimeters of precipitation and 2.4 in very wet weeks with 12 centimeters of precipitation. By contrast, gastrointestinal illness in private well and treated municipal areas was not influenced by hydrologic conditions, although warmer winter temperatures slightly increased incidence. CONCLUSIONS Our study suggests that improved drinking water protection, treatment, and delivery infrastructure may improve public health by specifically identifying municipal water systems lacking water treatment that may transmit waterborne disease.
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Affiliation(s)
- Christopher K Uejio
- Christopher K. Uejio is with the Department of Geography and Program in Public Health, Florida State University, Tallahassee. Steven H. Yale is with the Clinical Research Center, Marshfield Clinic Research Foundation, Marshfield, WI. Kristen Malecki is with the Department of Population Health Sciences, University of Wisconsin-Madison. Mark A. Borchardt is with the US Department of Agriculture-Agricultural Research Service, Marshfield. Henry A. Anderson is with the Wisconsin Department of Health Services, Madison. Jonathan A. Patz is with the Nelson Institute Center for Sustainability and the Global Environment, University of Wisconsin-Madison
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Golberg A, Linshiz G, Kravets I, Stawski N, Hillson NJ, Yarmush ML, Marks RS, Konry T. Cloud-enabled microscopy and droplet microfluidic platform for specific detection of Escherichia coli in water. PLoS One 2014; 9:e86341. [PMID: 24475107 PMCID: PMC3903517 DOI: 10.1371/journal.pone.0086341] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Accepted: 12/12/2013] [Indexed: 12/13/2022] Open
Abstract
We report an all-in-one platform – ScanDrop – for the rapid and specific capture, detection, and identification of bacteria in drinking water. The ScanDrop platform integrates droplet microfluidics, a portable imaging system, and cloud-based control software and data storage. The cloud-based control software and data storage enables robotic image acquisition, remote image processing, and rapid data sharing. These features form a “cloud” network for water quality monitoring. We have demonstrated the capability of ScanDrop to perform water quality monitoring via the detection of an indicator coliform bacterium, Escherichia coli, in drinking water contaminated with feces. Magnetic beads conjugated with antibodies to E. coli antigen were used to selectively capture and isolate specific bacteria from water samples. The bead-captured bacteria were co-encapsulated in pico-liter droplets with fluorescently-labeled anti-E. coli antibodies, and imaged with an automated custom designed fluorescence microscope. The entire water quality diagnostic process required 8 hours from sample collection to online-accessible results compared with 2–4 days for other currently available standard detection methods.
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Affiliation(s)
- Alexander Golberg
- Centre for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Shriners Burns Institute, Boston, Massachusetts, United States of America
| | - Gregory Linshiz
- Fuels Synthesis Division, Joint BioEnergy Institute, Emeryville, California, United States of America ; Physical BioSciences Division, Lawrence Berkeley National Labs, Berkeley, California, United States of America ; DOE Joint Genome Institute, Walnut Creek, California, United States of America
| | - Ilia Kravets
- Department of Computer Science, Technion Institute of Technology, Haifa, Israel
| | - Nina Stawski
- Fuels Synthesis Division, Joint BioEnergy Institute, Emeryville, California, United States of America ; Physical BioSciences Division, Lawrence Berkeley National Labs, Berkeley, California, United States of America
| | - Nathan J Hillson
- Fuels Synthesis Division, Joint BioEnergy Institute, Emeryville, California, United States of America ; Physical BioSciences Division, Lawrence Berkeley National Labs, Berkeley, California, United States of America ; DOE Joint Genome Institute, Walnut Creek, California, United States of America
| | - Martin L Yarmush
- Centre for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Shriners Burns Institute, Boston, Massachusetts, United States of America ; Department of Biomedical Engineering, Rutgers University, New Jersey, United States of America
| | - Robert S Marks
- Department of Biotechnology Engineering, The National Institute of Biotechnology in Negev, Ben Gurion University, Beer-Sheva, Israel ; School of Materials Science and Engineering, Nanyang Technological University, Singapore ; NRF CREATE program for Nanomaterials in Energy and Water Management, Singapore
| | - Tania Konry
- Department of Pharmaceutical Sciences, School of Pharmacy Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, United States of America
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Kayser GL, Moriarty P, Fonseca C, Bartram J. Domestic water service delivery indicators and frameworks for monitoring, evaluation, policy and planning: a review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:4812-35. [PMID: 24157507 PMCID: PMC3823337 DOI: 10.3390/ijerph10104812] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 09/27/2013] [Accepted: 09/30/2013] [Indexed: 11/27/2022]
Abstract
Monitoring of water services informs policy and planning for national governments and the international community. Currently, the international monitoring system measures the type of drinking water source that households use. There have been calls for improved monitoring systems over several decades, some advocating use of multiple indicators. We review the literature on water service indicators and frameworks with a view to informing debate on their relevance to national and international monitoring. We describe the evidence concerning the relevance of each identified indicator to public health, economic development and human rights. We analyze the benefits and challenges of using these indicators separately and combined in an index as tools for planning, monitoring, and evaluating water services. We find substantial evidence on the importance of each commonly recommended indicator--service type, safety, quantity, accessibility, reliability or continuity of service, equity, and affordability. Several frameworks have been proposed that give structure to the relationships among individual indicators and some combine multiple indicator scores into a single index but few have been rigorously tested. More research is needed to understand if employing a composite metric of indicators is advantageous and how each indicator might be scored and scaled.
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Affiliation(s)
- Georgia L. Kayser
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; E-Mail:
| | - Patrick Moriarty
- IRC International Water and Sanitation Centre, Bezuidenhoutseweg 2, The Hague 2594 AV, The Netherlands; E-Mails: (P.M.); (C.F.)
| | - Catarina Fonseca
- IRC International Water and Sanitation Centre, Bezuidenhoutseweg 2, The Hague 2594 AV, The Netherlands; E-Mails: (P.M.); (C.F.)
| | - Jamie Bartram
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; E-Mail:
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Levallois P, Chevalier P, Gingras S, Déry P, Payment P, Michel P, Rodriguez M. Risk of infectious gastroenteritis in young children living in Québec rural areas with intensive animal farming: results of a case-control study (2004-2007). Zoonoses Public Health 2013; 61:28-38. [PMID: 23406420 PMCID: PMC7165781 DOI: 10.1111/zph.12039] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Indexed: 11/26/2022]
Abstract
This study was designed to evaluate the epidemiology of severe gastroenteritis in children living in Québec rural areas with intensive livestock activities. From September 2005 through June 2007, 165 cases of gastroenteritis in children aged from 6 months to 5 years, hospitalized or notified to the public health department were enrolled, and 326 eligible controls participated. The parents of cases and controls were asked questions about different gastroenteritis risk factors. The quality of the drinking water used by the participants was investigated for microbial indicators as well as for four zoonotic bacterial pathogens (Campylobacter spp, Escherichia coli, Salmonella spp and Yersinia spp) and two enteric parasites (Cryptosporidium spp and Giardia spp). From 134 stool specimen analysed, viruses were detected in 82 cases (61%), while 28 (21%) were found with at least one of the bacteria investigated, and five cases were infected by parasites. Campylobacteriosis was the main bacterial infection (n = 15), followed by Salmonella sp (n = 7) and E. coli O157:H7 (n = 5) among cases with bacterial gastroenteritis. No significant difference was found between cases and controls regarding the quality of water consumed; the frequency of faecal contamination of private wells was also similar between cases and controls. Considering the total cases (including those with a virus), no link was found between severe gastroenteritis and either being in contact with animals or living in a municipality with the highest animal density (4th quartile). However, when considering only cases with a bacterial or parasite infection (n = 32), there was a weak association with pig density that was not statistically significant after adjusting for potential confounders. Contact with domestic, zoo or farm animals were the only environmental factor associated with the disease.
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Affiliation(s)
- P Levallois
- Institut national de santé publique du Québec, Québec, QC, Canada; Axe santé publique et pratiques optimales en santé, Centre de recherche du Centre Hospitalier Universitaire de Québec, Québec, QC, Canada
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