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Seasonal Patterns of Gastrointestinal Illness and Streamflow along the Ohio River
U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
Tufts University School of Medicine, Boston, MA 02111, USA
Institute for the Study of Earth, Oceans, and Space, University of New Hampshire, Durham, NH 03824, USA
Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
Tufts University School of Engineering, Medford, MA 02155, USA
* Author to whom correspondence should be addressed.
Received: 30 March 2012; in revised form: 12 April 2012 / Accepted: 20 April 2012 / Published: 7 May 2012
Abstract: Waterborne gastrointestinal (GI) illnesses demonstrate seasonal increases associated with water quality and meteorological characteristics. However, few studies have been conducted on the association of hydrological parameters, such as streamflow, and seasonality of GI illnesses. Streamflow is correlated with biological contamination and can be used as proxy for drinking water contamination. We compare seasonal patterns of GI illnesses in the elderly (65 years and older) along the Ohio River for a 14-year period (1991–2004) to seasonal patterns of streamflow. Focusing on six counties in close proximity to the river, we compiled weekly time series of hospitalizations for GI illnesses and streamflow data. Seasonal patterns were explored using Poisson annual harmonic regression with and without adjustment for streamflow. GI illnesses demonstrated significant seasonal patterns with peak timing preceding peak timing of streamflow for all six counties. Seasonal patterns of illness remain consistent after adjusting for streamflow. This study found that the time of peak GI illness precedes the peak of streamflow, suggesting either an indirect relationship or a more direct path whereby pathogens enter water supplies prior to the peak in streamflow. Such findings call for interdisciplinary research to better understand associations among streamflow, pathogen loading, and rates of gastrointestinal illnesses.
Keywords: drinking water quality; gastrointestinal infections; hydrology; pathogens; seasonality; streamflow
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MDPI and ACS Style
Jagai, J.S.; Griffiths, J.K.; Kirshen, P.K.; Webb, P.; Naumova, E.N. Seasonal Patterns of Gastrointestinal Illness and Streamflow along the Ohio River. Int. J. Environ. Res. Public Health 2012, 9, 1771-1790.
Jagai JS, Griffiths JK, Kirshen PK, Webb P, Naumova EN. Seasonal Patterns of Gastrointestinal Illness and Streamflow along the Ohio River. International Journal of Environmental Research and Public Health. 2012; 9(5):1771-1790.
Jagai, Jyotsna S.; Griffiths, Jeffrey K.; Kirshen, Paul K.; Webb, Patrick; Naumova, Elena N. 2012. "Seasonal Patterns of Gastrointestinal Illness and Streamflow along the Ohio River." Int. J. Environ. Res. Public Health 9, no. 5: 1771-1790.