SynthesisEnvironmental health perspectives2014
Water distribution system deficiencies and gastrointestinal illness: a systematic review and meta-analysis.
Synthesis in Environmental health perspectives, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Systematic Review of the Time Series Studies Addressing the Endemic Risk of Acute Gastroenteritis According to Drinking Water Operation Conditions in Urban Areas of Developed Countries.International journal of environmental research and public health · 2018Pooled it
- Measuring User Compliance and Cost Effectiveness of Safe Drinking Water Programs: A Cluster-Randomized Study of Household Ultraviolet Disinfection in Rural Mexico.The American journal of tropical medicine and hygiene · 2018Trial
- Acute Diarrheal Disease Associated With Climate Variability and Water Supply System Configuration: An Ecological Study in Brazil.Water environment research : a research publication of the Water Environment Federation · 2026Article
- Associations between Water Supply Interruptions and Water Use, Drinking Water Quality, Child Health, and Caregiver Stress in Peri-Urban Malawi.Environmental science & technology · 2026Article
- Sewage intrusion into drinking water distribution systems: implications for water resource management.Environmental monitoring and assessment · 2025Review
- Intermittent Water Supply and Beverage Consumption Patterns among Adolescents and Adults in Mexico: A Nationally Representative, Cross-Sectional Analysis.The Journal of nutrition · 2025Article
- Health Effects and Water Quality Following Low Pressure Events in Drinking Water Distribution Systems in the United States.Environmental health perspectives · 2025Article
- A multilevel analysis of basic water availability in Ethiopia using 2016 demographic health survey.Scientific reports · 2025Article
- How water intermittency and water perceptions influence household coping strategies in northwestern Ecuador.PLOS water · 2025Article
- The Impact of Rolling Blackouts on Environmental Health in South Africa.Journal of health & pollution · 2024Article
- Estimating the risk of gastrointestinal illness associated with drinking tap water in Norway: a prospective cohort study.BMC public health · 2024Article
- Association between precipitation and mortality due to diarrheal diseases by climate zone: A multi-country modeling study.Environmental epidemiology (Philadelphia, Pa.) · 2024Article
- Multiscalar Evaluation of the Water Distribution System and Diarrheal Disease Risk in Addis Ababa, Ethiopia.Environmental science & technology · 2023Article
- Racial and ethnic disparities in access to safe water and sanitation in high-income countries: a case study among the Arab-Bedouins of Southern Israel.Journal of water, sanitation, and hygiene for development : a journal of the International Water Association · 2023Article
- Sanitary sewage overflows, boil water advisories, and emergency room and urgent care visits for gastrointestinal illness: a case-crossover study in South Carolina, USA, 2013-2017.Journal of exposure science & environmental epidemiology · 2023Article
- Social Disparities in the Duration of Power and Piped Water Outages in Texas After Winter Storm Uri.American journal of public health · 2023Article
- Cascading disasters and mental health inequities: Winter Storm Uri, COVID-19 and post-traumatic stress in Texas.Social science & medicine (1982) · 2022Article
- Associations between long-term drought and diarrhea among children under five in low- and middle-income countries.Nature communications · 2022Article
- Drinking Water Quality and Public Health in the Kathmandu Valley, Nepal: Coliform Bacteria, Chemical Contaminants, and Health Status of Consumers.Journal of environmental and public health · 2022Article
- Prevalence of coliform bacterial contamination in cat drinking water in households in Thailand.Veterinary world · 2021Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWater 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.
objectivesIt 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.
methodsWe 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.
resultsIn 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).
conclusionsTap 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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.