ArticleInternational journal of environmental research and public health2015
Flooding and Clostridium difficile Infection: A Case-Crossover Analysis.
Article in International journal of environmental research and public health, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 23 citations in OpenAlex.
- US Emergency Department Use and Operations Amid Natural Disasters: A Narrative Review.The western journal of emergency medicine · 2026Review
- Hurricanes, industrial animal operations, and acute gastrointestinal illness in North Carolina, USA.Environmental research, health : ERH · 2025Article
- The Impact of Climate Change, Pollution, and Biodiversity Loss on Digestive Health and Disease.Gastro hep advances · 2024Review
- 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
- Flooding and emergency department visits: Effect modification by the CDC/ATSDR Social Vulnerability Index.International journal of disaster risk reduction : IJDRR · 2022Article
- Hurricane flooding and acute gastrointestinal illness in North Carolina.The Science of the total environment · 2022Article
- Monitoring the evolution of individuals' flood-related adaptive behaviors over time: two cross-sectional surveys conducted in the Province of Quebec, Canada.BMC public health · 2020Article
- Development and validation of five behavioral indices of flood adaptation.BMC public health · 2019Article
- Infectious Diseases After Hydrologic Disasters.Emergency medicine clinics of North America · 2018Review
- Sanitary Sewer Overflows and Emergency Room Visits for Gastrointestinal Illness: Analysis of Massachusetts Data, 2006-2007.Environmental health perspectives · 2017Article
- Risk of Flood-Related Diseases of Eyes, Skin and Gastrointestinal Tract in Taiwan: A Retrospective Cohort Study.PloS one · 2016Article
- Health Effects of Waterborne Contaminants: A Focus on Emerging Concerns.International journal of environmental research and public health · 2015Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clostridium difficile is a bacterium that can spread by water. It often causes acute gastrointestinal illness in older adults who are hospitalized and/or receiving antibiotics; however, community-associated infections affecting otherwise healthy individuals have become more commonly reported. A case-crossover study was used to assess emergency room (ER) and outpatient visits for C. difficile infection following flood events in Massachusetts from 2003 through 2007. Exposure status was based on whether or not a flood occurred prior to the case/control date during the following risk periods: 0-6 days, 7-13 days, 14-20 days, and 21-27 days. Fixed-effects logistic regression was used to estimate the risk of diagnosis with C. difficile infection following a flood. There were 129 flood events and 1575 diagnoses of C. difficile infection. Among working age adults (19-64 years), ER and outpatient visits for C. difficile infection were elevated during the 7-13 days following a flood (Odds Ratio, OR = 1.69; 95% Confidence Interval, CI: 0.84, 3.37). This association was more substantial among males (OR = 3.21; 95% CI: 1.01-10.19). Associations during other risk periods were not observed (p < 0.05). Although we were unable to differentiate community-associated versus nosocomial infections, a potential increase in C. difficile infections should be considered as more flooding is projected due to climate change.
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