ArticlePloS one2016
Associations between Self-Reported Gastrointestinal Illness and Water System Characteristics in Community Water Supplies in Rural Alabama: A Cross-Sectional Study.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Burden of disease from contaminated drinking water in countries with high access to safely managed water: A systematic review.Water research · 2023Pooled it
- Quantitative Microbial Risk Assessment ofToxics · 2025Article
- Health Effects and Water Quality Following Low Pressure Events in Drinking Water Distribution Systems in the United States.Environmental health perspectives · 2025Article
- Quantifying Temporal Dynamics ofWater · 2025Article
- Risk Factors for Enteric Pathogen Exposure among Children in Black Belt Region of Alabama, USA.Emerging infectious diseases · 2023Article
- Epidemiologic Features of Acute Pediatric Diarrhea in Managua, Nicaragua, from 2011 to 2019.The American journal of tropical medicine and hygiene · 2022Article
- Association between water source and chronic gastrointestinal diseases in Chinese: A cross-sectional and longitudinal study.Frontiers in public health · 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
- A community-engaged approach to understanding environmental health concerns and solutions in urban and rural communities.BMC public health · 2021Article
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7 authors.
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Abstract
backgroundCommunity water supplies in underserved areas of the United States may be associated with increased microbiological contamination and risk of gastrointestinal disease. Microbial and health risks affecting such systems have not been systematically characterized outside outbreak investigations. The objective of the study was to evaluate associations between self-reported gastrointestinal illnesses (GII) and household-level water supply characteristics.
methodsWe conducted a cross-sectional study of water quality, water supply characteristics, and GII in 906 households served by 14 small and medium-sized community water supplies in Alabama's underserved Black Belt region.
resultsWe identified associations between respondent-reported water supply interruption and any symptoms of GII (adjusted odds ratio (aOR): 3.01, 95% confidence interval (CI) = 1.65-5.49), as well as low water pressure and any symptoms of GII (aOR: 4.51, 95% CI = 2.55-7.97). We also identified associations between measured water quality such as lack of total chlorine and any symptoms of GII (aOR: 5.73, 95% CI = 1.09-30.1), and detection of E. coli in water samples and increased reports of vomiting (aOR: 5.01, 95% CI = 1.62-15.52) or diarrhea (aOR: 7.75, 95% CI = 2.06-29.15).
conclusionsIncreased self-reported GII was associated with key water system characteristics as measured at the point of sampling in a cross-sectional study of small and medium water systems in rural Alabama in 2012 suggesting that these water supplies can contribute to endemic gastro-intestinal disease risks. Future studies should focus on further characterizing and managing microbial risks in systems facing similar challenges.
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