The association between extreme precipitation and waterborne disease outbreaks in the United States, 1948-1994
The association between extreme precipitation and waterborne disease outbreaks in the United States, 1948-1994
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DOI：
10.2105/ajph.91.8.1194
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发表时间：
2001-08-01
影响因子：
12.7
通讯作者：
Lele, S
中科院分区：
文献类型：
--
作者：
Curriero, FC;Patz, JA;Lele, S
目标.降雨和径流与特定地点的水媒疾病爆发有关。由于美国强降水的上升趋势预计将随着气候变化而增加，因此本研究试图量化降水与疾病爆发之间的关系。方法.利用美国环境保护署水传播疾病数据库，从1948年到1994年共报告了548起疫情，以及国家气候数据中心的降水数据，分析降水与水传播疾病之间的关系。分析是在流域一级，分层的地下水和地表水污染和控制的影响，由于季节和水文区域。使用Fisher精确检验的Monte Carlo版本来检验统计学显著性。51%的水传播疾病爆发之前，降水事件高于第90百分位数（P =.002），68%的事件高于第80百分位数（P=.001）。地表水污染导致的疫情与疫情发生当月的极端降水量关联最强;地下水污染事件滞后2个月。结论.在美国发现的降雨和疾病之间的统计学显著关联对于水管理人员，公共卫生官员和未来气候变化的风险评估人员非常重要。
Objectives. Rainfall and runoff have been implicated in site-specific waterborne disease outbreaks. Because upward trends in heavy precipitation in the United States are projected to increase with climate change, this study sought to quantify the relationship between precipitation and disease outbreaks. Methods. The US Environmental Protection Agency waterborne disease database, totaling 548 reported outbreaks from 1948 through 1994, and precipitation data of the National Climatic Data Center were used to analyze the relationship between precipitation and waterborne diseases. Analyses were at the watershed level, stratified by groundwater and surface water contamination and controlled for effects due to season and hydrologic region. A Monte Carlo version of the Fisher exact test was used to test for statistical significance.Results. Fifty-one percent of waterborne disease outbreaks were preceded by precipitation events above the 90th percentile (P =.002), and 68% by events above the 80th percentile (P=.001). Outbreaks due to surface water contamination showed the strongest association with extreme precipitation during the month of the outbreak; a 2-month lag applied to groundwater contamination events. Conclusions. The statistically significant association found between rainfall and disease in the United States is important for water managers, public health officials, and risk assessors of future climate change.