Extreme precipitation events and increased risk of campylobacteriosis in Maryland, U.S.A.
Extreme precipitation events and increased risk of campylobacteriosis in Maryland, U.S.A.
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DOI：
10.1016/j.envres.2016.05.021
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发表时间：
2016-08
影响因子：
8.3
通讯作者：
Sutyajeet I. Soneja;Chengsheng Jiang;Crystal Romeo Upperman;R. Murtugudde;Clifford S Mitchell;D. Blythe;Amy R. Sapkota;A. Sapkota
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文献类型：
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作者：
Sutyajeet I. Soneja;Chengsheng Jiang;Crystal Romeo Upperman;R. Murtugudde;Clifford S Mitchell;D. Blythe;Amy R. Sapkota;A. Sapkota
食用受污染的家禽、生牛奶和水是弯曲杆菌感染的重要风险因素。以前的研究也调查了天气（温度和降水）和弯曲杆菌病风险增加之间的关系，但关于极端高温和降水事件对弯曲杆菌病风险的影响以及这种风险如何对沿海社区产生不同影响的信息有限。我们从马里兰州食源性疾病主动监测网络（FoodNet）获得了2002-2012年弯曲杆菌病例数据; n=4804）。我们使用基于30年基线（1960-1989）计算的位置和日历日特定阈值（极端高温的第95百分位数和极端降水的第90百分位数）确定了这段时间（2002-2012）的极端高温和极端降水事件。我们使用GIS将这些数据集联系起来，并使用针对人口混杂因素调整的负二项广义估计方程来计算马里兰州极端事件暴露与弯曲杆菌病风险之间的关联。我们观察到，在马里兰州沿海地区，极端降水事件暴露增加一天与弯曲杆菌病风险增加3%相关（发病率比（IRR）：1.03，95%置信区间（CI）：1.01，1.05），但在非沿海地区没有观察到这种关联。此外，在拉尼娜期间，与极端降水事件相关的风险要高得多（内部收益率：1.09，95%置信区间：1.05，1.13），而在厄尔尼诺或厄尔尼诺/南方涛动中性时期，没有证据表明风险升高。暴露于极端高温事件与弯曲杆菌病风险增加无关，拉尼娜现象期间除外（IRR：1.04，95% CI：1.01，1.08）。极端降水事件可能导致沿海地区发生洪水，这可能会使受细菌病原体污染的水（来自化粪池系统、城市污水处理厂和集中动物饲养作业等来源）与个人密切接触，接触频率可能更高。
Consumption of contaminated poultry, raw milk and water are significant risk factors for Campylobacter infection. Previous studies also have investigated the association between weather (temperature and precipitation) and increased risk of campylobacteriosis, but limited information exists regarding the impacts of extreme heat and precipitation events on campylobacteriosis risk, and how such risk may differentially impact coastal communities. We obtainedCampylobactercase data 2002–2012; n=4804) from the Maryland Foodborne Diseases Active Surveillance Network (FoodNet). We identified extreme heat and extreme precipitation events during this time (2002–2012) using location and calendar day specific thresholds (95th percentile for extreme heat and 90th percentile for extreme precipitation) that were computed based on a 30-year baseline (1960–1989). We linked these datasets using GIS and used negative binomial generalized estimating equations adjusted for demographic confounders to calculate the association between exposure to extreme events and risk of campylobacteriosis in Maryland. We observed that a one-day increase in exposure to extreme precipitation events was associated with a 3% increase in risk of campylobacteriosis in coastal areas of Maryland (Incidence Rate Ratio (IRR): 1.03, 95% confidence interval (CI): 1.01, 1.05), but such an association was not observed in noncoastal areas. Furthermore, the risk associated with extreme precipitation events was considerably higher during La Niña periods (IRR: 1.09, 95% CI: 1.05, 1.13), while there was no evidence of elevated risk during El Niño or ENSO Neutral periods. Exposure to extreme heat events was not associated with an increased risk of campylobacteriosis, except during La Niña periods (IRR: 1.04, 95% CI: 1.01, 1.08). Extreme precipitation events could result in flooding within coastal areas that may bring water contaminated with bacterial pathogens (originating from sources such as septic systems, municipal wastewater treatment plants and concentrated animal feeding operations) into close proximity with individuals, where frequency of contact may be higher.