Association between rainfall and pediatric emergency department visits for acute gastrointestinal illness. Environ Health Perspect 2010 Oct;118(10):1439-43
Date
06/03/2010Pubmed ID
20515725Pubmed Central ID
PMC2957926DOI
10.1289/ehp.0901671Scopus ID
2-s2.0-77957927197 (requires institutional sign-in at Scopus site) 107 CitationsAbstract
BACKGROUND: Microbial water contamination after periods of heavy rainfall is well described, but its link to acute gastrointestinal illness (AGI) in children is not well known.
OBJECTIVES: We hypothesize an association between rainfall and pediatric emergency department (ED) visits for AGI that may represent an unrecognized, endemic burden of pediatric disease in a major U.S. metropolitan area served by municipal drinking water systems.
METHODS: We conducted a retrospective time series analysis of visits to the Children's Hospital of Wisconsin ED in Wauwatosa, Wisconsin. Daily visit totals of discharge International Classification of Diseases, 9th Revision codes of gastroenteritis or diarrhea were collected along with daily rainfall totals during the study period from 2002 to 2007. We used an autoregressive moving average model, adjusting for confounding variables such as sewage release events and season, to look for an association between daily visits and rainfall after a lag of 1-7 days.
RESULTS: A total of 17,357 AGI visits were identified (mean daily total, 7.9; range, 0-56). Any rainfall 4 days prior was significantly associated with an 11% increase in AGI visits. Expected seasonal effects were also seen, with increased AGI visits in winter months.
CONCLUSIONS: We observed a significant association between rainfall and pediatric ED visits for AGI, suggesting a waterborne component of disease transmission in this population. The observed increase in ED visits for AGI occurred in the absence of any disease outbreaks reported to public health officials in our region, suggesting that rainfall-associated illness may be underestimated. Further study is warranted to better address this association.
Author List
Drayna P, McLellan SL, Simpson P, Li SH, Gorelick MHAuthors
Patrick C. Drayna MD Associate Professor in the Pediatrics department at Medical College of WisconsinPippa M. Simpson PhD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Acute DiseaseChild
Emergency Service, Hospital
Gastrointestinal Diseases
Humans
Pediatrics
Rain
Regression Analysis
Retrospective Studies
Wisconsin
