Extreme Precipitation and Emergency Room Visits for Gastrointestinal Illness in Areas with and without Combined Sewer Systems: An Analysis of Massachusetts Data, 2003–2007

• DOI: 10.1289/ehp.1408971
• Publication Date: 2015-04-09T12:58:19Z
• Authors: Jyotsna S. Jagai; Quanlin Li; Shiliang Wang; Kyle P. Messier; Timothy J. Wade; Elizabeth D. Hilborn
• Keywords: Combined sewer; Distributed lag; Waterborne diseases

Combined sewer overflows (CSOs) occur in combined systems when sewage and stormwater runoff are released into water bodies, potentially contaminating sources. CSOs often caused by heavy precipitation expected to increase with increasing extreme associated climate change.The aim of this study was assess whether the association between rainfall rate emergency room (ER) visits for gastrointestinal (GI) illness differed presence CSOs.For period 2003-2007, time series daily ER GI meteorological data were organized three exposure regions: a) impacting drinking sources, b) recreational waters, c) no CSOs. A distributed lag Poisson regression assessed cumulative effects an 8-day following (≥ 90th ≥ 95th percentile) 99th events, controlling temperature long-term trends.The among regions. Only region exposed demonstrated a significant increased risk (CRR) all ages rainfall: CRR: 1.13 (95% CI: 1.00, 1.28) compared rainfall.The area CSO discharges source. Our findings suggest consumers whose source may be impacted after precipitation.Jagai JS, Li Q, Wang S, Messier KP, Wade TJ, Hilborn ED. 2015. Extreme areas without systems: analysis Massachusetts data, 2003-2007. Environ Health Perspect 123:873-879; http://dx.doi.org/10.1289/ehp.1408971.