Evidence map›Paper›PMID 27441862›Full record

ArticleJournal of water and health2016

Refined assessment of associations between drinking water residence time and emergency department visits for gastrointestinal illness in Metro Atlanta, Georgia.

Karen Levy, Mitchel Klein, Stefanie Ebelt Sarnat, Samina Panwhar, Alexandra Huttinger, Paige Tolbert, Christine Moe

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of water and health, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Karen LevyDepartment of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA E-mail: karen.levy@emory.edu; Center for Global Safe Water, Sanitation and Hygiene at Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA.
Mitchel KleinDepartment of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA E-mail: karen.levy@emory.edu.
Stefanie Ebelt SarnatDepartment of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA E-mail: karen.levy@emory.edu.
Samina PanwharCenter for Global Safe Water, Sanitation and Hygiene at Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA; Present address: Oregon Health Authority, 500 Summer St. NE, E52, Salem, OR 97301, USA.
Alexandra HuttingerCenter for Global Safe Water, Sanitation and Hygiene at Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA.
Paige TolbertDepartment of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA E-mail: karen.levy@emory.edu.
Christine MoeCenter for Global Safe Water, Sanitation and Hygiene at Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA.

Funding

Multiple Pollutants and Cardiorespiratory OutcomesR01ES011294 · NIEHS · EMORY UNIVERSITY · PI TOLBERT, PAIGE E · 2002 to 2005
$1.1M
Impacts of Human Movement on Regional Strain Distribution of Diarrheagenic E.coliK01AI103544 · NIAID · EMORY UNIVERSITY · PI LEVY, KAREN · 2013 to 2017
$655k
NIAID NIH HHS K01 AI103544NIEHS NIH HHS R01 ES011294
6 · The paper itself

Abstract

Recent outbreak investigations suggest that a substantial proportion of waterborne disease outbreaks are attributable to water distribution system issues. In this analysis, we examine the relationship between modeled water residence time (WRT), a proxy for probability of microorganism intrusion into the distribution system, and emergency department visits for gastrointestinal (GI) illness for two water utilities in Metro Atlanta, USA during 1993-2004. We also examine the association between proximity to the nearest distribution system node, based on patients' residential address, and GI illness using logistic regression models. Comparing long (≥90th percentile) with intermediate WRTs (11th to 89th percentile), we observed a modestly increased risk for GI illness for Utility 1 (OR = 1.07, 95% CI: 1.02-1.13), which had substantially higher average WRT than Utility 2, for which we found no increased risk (OR = 0.98, 95% CI: 0.94-1.02). Examining finer, 12-hour increments of WRT, we found that exposures >48 h were associated with increased risk of GI illness, and exposures of >96 h had the strongest associations, although none of these associations was statistically significant. Our results suggest that utilities might consider reducing WRTs to <2-3 days or adding booster disinfection in areas with longer WRT, to minimize risk of GI illness from water consumption.

Indexed as

Emergency Service, HospitalWater SupplyDrinking WaterGastrointestinal DiseasesGeorgiaWater MovementsDrinking Water

Identifiers

PMID27441862
PMCPMC5468164

What OpenQuestion holds

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Registered trials

None linked

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.