Water Distribution System Deficiencies and Gastrointestinal Illness: A Systematic Review and Meta-Analysis
نویسندگان
چکیده
BACKGROUND Water distribution systems are vulnerable to performance deficiencies that can cause (re)contamination of treated water and plausibly lead to increased risk of gastrointestinal illness (GII) in consumers. OBJECTIVES It is well established that large system disruptions in piped water networks can cause GII outbreaks. We hypothesized that routine network problems can also contribute to background levels of waterborne illness and conducted a systematic review and meta-analysis to assess the impact of distribution system deficiencies on endemic GII. METHODS We reviewed published studies that compared direct tap water consumption to consumption of tap water re-treated at the point of use (POU) and studies of specific system deficiencies such as breach of physical or hydraulic pipe integrity and lack of disinfectant residual. RESULTS In settings with network malfunction, consumers of tap water versus POU-treated water had increased GII [incidence density ratio (IDR) = 1.34; 95% CI: 1.00, 1.79]. The subset of nonblinded studies showed a significant association between GII and tap water versus POU-treated water consumption (IDR = 1.52; 95% CI: 1.05, 2.20), but there was no association based on studies that blinded participants to their POU water treatment status (IDR = 0.98; 95% CI: 0.90, 1.08). Among studies focusing on specific network deficiencies, GII was associated with temporary water outages (relative risk = 3.26; 95% CI: 1.48, 7.19) as well as chronic outages in intermittently operated distribution systems (odds ratio = 1.61; 95% CI: 1.26, 2.07). CONCLUSIONS Tap water consumption is associated with GII in malfunctioning distribution networks. System deficiencies such as water outages also are associated with increased GII, suggesting a potential health risk for consumers served by piped water networks.
منابع مشابه
Human papillomavirus and gastrointestinal cancer in Iranian population: A systematic review and meta-analysis
Background: Gastrointestinal (GI) malignancies are the most common cancers and account for nearly half of all cancer-related deaths in Iran. There was a strong association between human papillomavirus (HPV) infection and urogenital cancers, in particular the cervix. However, there is no clear causal relationship in all types of cancers, including gastrointestinal cancers. Therefore, the present...
متن کاملEstimating the Relationship between Serum Electrolytes and COVID-19: A systematic Review and Meta-Analysis
Background and purpose: There are controversies on the association between electrolytes and Coronavirus disease 2019 (COVID-19) and its severity. Studies on these issues may help in resolving ambiguities. The purpose of this study was to assess the association between electrolyte indices and being infected with COVID-19 and developing severe symptoms using a meta-analysis. Materials and method...
متن کاملPrevalence of Legionella Species in Water Resources of Iran: A Systematic Review and Meta-Analysis
Background: Legionella species are ubiquitous and naturally found in lakes, rivers, streams and hot springs, and other water resources. The present study aimed to investigate the prevalence of Legionella species in water resources of Iran by a systematic review and meta-analysis.Methods: In search of papers relevant to the prevalence of Legionella in water resources of Iran, the scientific info...
متن کاملPrevalence of Enuresis and its Related Factors among Children in Iran: A Systematic Review and Meta-analysis
Introduction: Enuresis is the second most common disorder among children after allergic disorders. According to the results of previous studies, different estimates of enuresis prevalence and its related factors have been reported. Combining the results of these studies is valuable. This study aims to estimate the prevalence of enuresis and its related factors among Iranian children.Materials a...
متن کامل