Journal article
Review of Epidemiological Studies of Drinking-Water Turbidity in Relation to Acute Gastrointestinal Illness
Environmental health perspectives, v 125(8), 086003
01 Aug 2017
PMID: 28886603
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND: Turbidity has been used as an indicator of microbiological contamination of drinking water in time-series studies attempting to discern the presence of waterborne gastrointestinal illness; however, the utility of turbidity as a proxy exposure measure has been questioned.
OBJECTIVES: We conducted a review of epidemiological studies of the association between turbidity of chinking-water supplies and incidence of acute gastrointestinal illness (AGI), including a synthesis of the overall weight of evidence. Our goal was to evaluate the potential for causal inference from the studies.
METHODS: We identified 14 studies on the topic (distinct by region, time period and/or population). We evaluated each study with regard to modeling approaches, potential biases, and the strength of evidence. We also considered consistencies and differences in the collective results.
DISCUSSION: Positive associations between drinking-water turbidity and AGI incidence were found in different cities and time periods, and with both unfiltered and filtered supplies. There was some evidence for a stronger association at higher turbidity levels. The studies appeared to adequately adjust for confounding. There was fair consistency in the notable lags between turbidity measurement and AGI identification, which fell between 6 and 10 d in many studies.
CONCLUSIONS: The observed associations suggest a detectable incidence of waterborne AGI from drinking water in the systems and time periods studied. However, some discrepant results indicate that the association may be context specific. Combining turbidity with seasonal and climatic factors, additional water quality measures, and treatment data may enhance predictive modeling in future studies.
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Details
- Title
- Review of Epidemiological Studies of Drinking-Water Turbidity in Relation to Acute Gastrointestinal Illness
- Creators
- Anneclaire J. De Roos - Drexel University, Environmental and Occupational HealthPatrick L. Gurian - Drexel UniversityLucy F. Robinson - Drexel UniversityArjita Rai - Drexel University, Environmental and Occupational HealthIssa Zakeri - Drexel UniversityMichelle C. Kondo - US Forest Service
- Publication Details
- Environmental health perspectives, v 125(8), 086003
- Publisher
- Us Dept Health Human Sciences Public Health Science
- Number of pages
- 19
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Civil, Architectural, and Environmental Engineering; Epidemiology and Biostatistics; Environmental and Occupational Health
- Web of Science ID
- WOS:000413790600009
- Scopus ID
- 2-s2.0-85030994457
- Other Identifier
- 991019168102704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Environmental Sciences
- Public, Environmental & Occupational Health
- Toxicology