Estimated Costs of Sporadic Gastrointestinal Illness Associated with Surface Water Recreation: A Combined Analysis of Data from NEEAR and CHEERS Studies
Estimated Costs of Sporadic Gastrointestinal Illness Associated with Surface Water Recreation: A Combined Analysis of Data from NEEAR and CHEERS Studies
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DOI：
10.1289/ehp130
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发表时间：
2017-02-01
影响因子：
10.4
通讯作者：
Dorevitch, Samuel
中科院分区：
文献类型：
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作者：
DeFlorio-Barker, Stephanie;Wade, Timothy J.;Dorevitch, Samuel
背景：疾病负担可以通过解决归因于水上娱乐的发病率和疾病严重程度来描述。货币化的成本，归因于疾病负担的估计可以是有用的环境管理decisions. Adjectives：我们的特点的疾病负担归因于水娱乐使用的数据从两个队列研究使用的疾病成本（COI）的方法和估计的最大驱动程序的疾病负担的水上娱乐。S.和CHEERS评估了在芝加哥地区的水道上偶然接触娱乐（划船、划独木舟、钓鱼、划独木舟和划船）后的疾病，用于估计每例胃肠道疾病的费用和归因于水上娱乐的费用。收集有关医疗保健和药物利用以及错过工作或休闲天数的数据，并与成本数据相结合，构建COI的衡量标准。结果：根据不同的假设，水上娱乐引起的胃肠道症状的费用估计为1,220美元，（338 - 1，681美元）和游泳/涉水1，676美元（425- 2，743美元）。损失的生产力是一个主要的驱动力，估计COI，占高达90%的总costs.CONCLUSIONS：我们的估计表明，胃肠道疾病归因于地表水娱乐在城市水道，湖泊和沿海海洋海滩是负责的成本，应考虑到货币的影响，努力改善水质。COI提供了比疾病频率更多的信息，因为它考虑了疾病发生率，卫生保健利用率和生产力损失。在今后的水质和健康研究中应包括使用货币化的疾病严重程度信息。
BACKGROUND: The burden of illness can be described by addressing both incidence and illness severity attributable to water recreation. Monetized as cost, attributable disease burden estimates can be useful for environmental management decisions.OBJECTIVES: We characterize the disease burden attributable to water recreation using data from two cohort studies using a cost of illness (COI) approach and estimate the largest drivers of the disease burden of water recreation.METHODS: Data from the NEEAR study, which evaluated swimming and wading in marine and freshwater beaches in six U. S. states, and CHEERS, which evaluated illness after incidental- contact recreation (boating, canoeing, fishing, kayaking, and rowing) on waterways in the Chicago area, were used to estimate the cost per case of gastrointestinal illness and costs attributable to water recreation. Data on health care and medication utilization and missed days of work or leisure were collected and combined with cost data to construct measures of COI.RESULTS: Depending on different assumptions, the cost of gastrointestinal symptoms attributable to water recreation are estimated to be $1,220 for incidental-contact recreation (range $338-$ 1,681) and $ 1,676 for swimming/wading (range $ 425-2,743) per 1,000 recreators. Lost productivity is a major driver of the estimated COI, accounting for up to 90% of total costs.CONCLUSIONS: Our estimates suggest gastrointestinal illness attributed to surface water recreation at urban waterways, lakes, and coastal marine beaches is responsible for costs that should be accounted for when considering the monetary impact of efforts to improve water quality. The COI provides more information than the frequency of illness, as it takes into account disease incidence, health care utilization, and lost productivity. Use of monetized disease severity information should be included in future studies of water quality and health.