Gastroenteritis and Extreme Weather Events in Elderly

描述(由申请者提供)：这份题为“老年人胃肠炎和极端天气事件(GEWEL)”的申请的目标是研究胃肠道疾病(GID)的时间和空间模式如何应对国家和区域层面的极端天气事件。我们推测，老年人GID发病率的变异性对气象参数的变化很敏感。我们认为，极端天气事件的频率和强度，如热浪、干旱、暴雨和洪水，可以改变食物和水传播感染的发生率。我们预计，极端事件对健康的影响将取决于受影响人口和地理区域的脆弱性。在拟议的研究中，我们将：1)使用50,000例实验室确诊病例和6种肠道疾病的约100,000份住院记录(1992-2004年)，检验极端温度和降水对马萨诸塞州老年人食源性和水源性感染的严重性和构成的影响；2)使用全国约2,500,000份住院记录(1984-2004)的数据集，评估极端天气事件对美国不同气候区域老年人急性GID住院治疗的影响；以及3)开发、测试和实施分析模型，以评估极端事件对GID的长期、中期和短期影响。一个多学科小组完全有能力完成一个综合项目，该项目将探索健康与环境相互作用的复杂系统，并制定对环境和健康政策具有重要影响的新方法。可靠、客观和准确地估计与环境应激源有关的肠道感染发病率，更好地了解人类环境相互作用的机制，以及社会经济和人口因素对这种相互作用的影响，对于制定预防战略以减少发病率和死亡率并提高老年人的生活质量至关重要。根据所获得的知识，可以为肠道感染，包括新出现的病原体建立可靠和有效的预警系统；可以确定最脆弱的地理区域；可以在全国范围内大幅改进监测系统。

DESCRIPTION (provided by applicant): The goal of this application, entitled "Gastroenteritis and Extreme Weather Events in Elderly (GEWEL)" is to examine how temporal and spatial patterns of gastrointestinal diseases (GID) respond to extreme weather events at the national and regional levels. We postulate that variability in the GID incidence in the elderly is sensitive to a change in meteorological parameters. We assume that frequency and intensity of extreme weather events, such as heat waves, droughts, heavy rainfalls and floods, can alter the incidence of food borne and waterborne infections. We expect that the effect of extreme events on health will depend on vulnerability of the affected population and the geographical area. In the proposed study we will: 1) examine the effect of extreme temperature and precipitation on severity and composition of food borne and waterborne infections among the elderly in Massachusetts using -50,000 laboratory-confirmed cases and approximately 100,000 hospitalization records of six enteric diseases (1992-2004); 2) assess the impact of extreme weather events on hospitalizations for acute GID in the US elderly across climatic zones using nation-wide dataset of approximately 2,500,000 hospitalization records (1984-2004); and 3) develop, test and implement analytical models for assessing long-term, intermediate, and short-term effects of an extreme event on GID. A multidisciplinary team is fully capable of completing an integrated project that will explore a complex system of health and environmental interactions and develop novel methodology which will have important implications for environmental and health policy. Reliable, objective and accurate estimates of incidence of enteric infection related to environmental stressors, better understanding of mechanisms of human environmental interactions, and the impact of socio-economic and demographic factors on such interactions are crucial for the development of preventive strategies to reduce morbidity and mortality and to improve the quality of life among the elderly. Based on gained knowledge, reliable and efficient warning systems can be built for enteric infections, including emerging pathogens; the most vulnerable geographic areas can be identified; and surveillance systems can be substantially improved nation-wide.