ArticleEnvironmental health perspectives2015
Extreme Precipitation and Emergency Room Visits for Gastrointestinal Illness in Areas with and without Combined Sewer Systems: An Analysis of Massachusetts Data, 2003-2007.
Article in Environmental health perspectives, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 3 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Rainfall and Temperature Influences on Childhood Diarrhea and the Effect Modification Role of Water and Sanitation Conditions: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2024Pooled it
- Understanding the Impact of Rainfall on Diarrhea: Testing the Concentration-Dilution Hypothesis Using a Systematic Review and Meta-Analysis.Environmental health perspectives · 2020Pooled 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
- Waterborne diseases and climate change.Nature reviews. Microbiology · 2026Review
- Article
- A Review of Combined Sewer Overflows and Gastrointestinal Illness in a Changing Climate.Current epidemiology reports · 2025Article
- Incorporating Incubation Period Distributions to Precisely Estimate the Association Between Rainfall and Legionella Infection.The Journal of infectious diseases · 2025Article
- New York State Climate Impacts Assessment Chapter 07: Human Health and Safety.Annals of the New York Academy of Sciences · 2024Review
- Invited Perspective: Toward Resilience-Community-Based Approaches to Managing Combined Sewer Overflows in a Changing Climate.Environmental health perspectives · 2024Article
- Association between Combined Sewer Overflow Events and Gastrointestinal Illness in Massachusetts Municipalities with and without River-Sourced Drinking Water, 2014-2019.Environmental health perspectives · 2024Article
- Relationship between extreme precipitation and acute gastrointestinal illness in Toronto, Ontario, 2012-2022.Epidemiology and infection · 2024Article
- Hydrometeorology and geography affect hospitalizations for waterborne infectious diseases in the United States: A retrospective analysis.PLOS water · 2024Article
- Article
- 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
- The Association Between Rainfall, Temperature, and Reported Drinking Water Source: A Multi-Country Analysis.GeoHealth · 2022Article
- Projecting the Impacts of a Changing Climate: Tropical Cyclones and Flooding.Current environmental health reports · 2022Review
- Combined Sewer Overflows and Gastrointestinal Illness in Atlanta, 2002-2013: Evaluating the Impact of Infrastructure Improvements.Environmental health perspectives · 2022Article
- Exposure Assessment for Tropical Cyclone Epidemiology.Current environmental health reports · 2022Review
- Effects of extreme precipitation on hospitalization risk and disease burden of schizophrenia in urban and rural Lu'an, China, from 2010 to 2019.Environmental science and pollution research international · 2022Article
- Hurricane flooding and acute gastrointestinal illness in North Carolina.The Science of the total environment · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCombined sewer overflows (CSOs) occur in combined sewer systems when sewage and stormwater runoff are released into water bodies, potentially contaminating water sources. CSOs are often caused by heavy precipitation and are expected to increase with increasing extreme precipitation associated with climate change.
objectivesThe aim of this study was to assess whether the association between heavy rainfall and rate of emergency room (ER) visits for gastrointestinal (GI) illness differed in the presence of CSOs.
methodsFor the study period 2003-2007, time series of daily rate of ER visits for GI illness and meteorological data were organized for three exposure regions: a) CSOs impacting drinking water sources, b) CSOs impacting recreational waters, c) no CSOs. A distributed lag Poisson regression assessed cumulative effects for an 8-day lag period following heavy (≥ 90th and ≥ 95th percentile) and extreme (≥ 99th percentile) precipitation events, controlling for temperature and long-term time trends.
resultsThe association between extreme rainfall and rate of ER visits for GI illness differed among regions. Only the region with drinking water exposed to CSOs demonstrated a significant increased cumulative risk for rate (CRR) of ER visits for GI for all ages in the 8-day period following extreme rainfall: CRR: 1.13 (95% CI: 1.00, 1.28) compared with no rainfall.
conclusionsThe rate of ER visits for GI illness was associated with extreme precipitation in the area with CSO discharges to a drinking water source. Our findings suggest an increased risk for GI illness among consumers whose drinking water source may be impacted by CSOs after extreme precipitation. CITATION: Jagai JS, Li Q, Wang S, Messier KP, Wade TJ, Hilborn ED. 2015. Extreme precipitation and emergency room visits for gastrointestinal illness in areas with and without combined sewer systems: an analysis of Massachusetts data, 2003-2007. Environ Health Perspect 123:873-879; http://dx.doi.org/10.1289/ehp.1408971.
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