ArticleBMC infectious diseases2019
"Sickenin' in the rain" - increased risk of gastrointestinal and respiratory infections after urban pluvial flooding in a population-based cross-sectional study in the Netherlands.
Article in BMC infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Infectious Diseases Associated with Hydrometeorological Hazards in Europe: Disaster Risk Reduction in the Context of the Climate Crisis and the Ongoing COVID-19 Pandemic.International journal of environmental research and public health · 2022Pooled it
- Association between heavy rainfall and flooding events and infectious diseases in Europe: a rapid review, 2018 to 2025.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2026Review
- Prevalence and Spatial Distribution of Chronic Respiratory Diseases in Dar es Salaam, Tanzania: Hydrological and Household Influences.GeoHealth · 2026Article
- Climate Change and the Future of Allergies and Asthma.Current allergy and asthma reports · 2025Review
- Climate change and food safety-not just a hot topic!Sustainable microbiology · 2025Review
- Changes in Healthcare Utilization After the 2022 Seoul Metropolitan Flood: Applying a Generalized Synthetic Control Approach.GeoHealth · 2024Article
- Syndromic Surveillance in Public Health Emergencies: A Systematic Analysis of Cases Related to Exposure to 2023 Floodwaters in Romagna, Italy.Healthcare (Basel, Switzerland) · 2024Article
- Article
- Risk Factors for Respiratory Viral Infections: A Spotlight on Climate Change and Air Pollution.Journal of asthma and allergy · 2023Review
- Respiratory and Otolaryngology Symptoms Following the 2019 Spring Floods in Quebec.International journal of environmental research and public health · 2022Article
- Cholera outbreak amidst urban flooding in Karachi: An emergency condition.Annals of medicine and surgery (2012) · 2022Article
- Recurrent Home Flooding in Detroit, MI 2012-2020: Results of a Household Survey.International journal of environmental research and public health · 2021Article
- Climate Change and Childhood Respiratory Health: A Call to Action for Paediatricians.International journal of environmental research and public health · 2020Review
- The threat of a new tetanus outbreak due to urban flooding disaster requires vigilance: a narrative review.Acute medicine & surgeryReview
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClimate change is expected to increase the chance of extreme rainfall events in the Northern Hemisphere and herewith, there is an increased chance of urban pluvial flooding. Urban pluvial flooding often consists of street flooding and/or flooding of combined sewerage systems, leading to contamination of the floodwater with several gastrointestinal and/or respiratory pathogens. An increase in flooding events therefore pose a health risk to those exposed to urban floodwater. We studied the association between exposure to pluvial floodwater and acute gastroenteritis (AGE) and acute respiratory infection (ARI).
methodsWe performed a retrospective, cross-sectional survey during the summer of 2015 in 60 locations in the Netherlands with reported flooding. Two weeks after the flooding, questionnaires were sent to households in these locations, collecting data on self-reported AGE and ARI and information on floodwater exposure in the previous 2 weeks. Multivariable generalized estimating equations (GEE) regression models, accounting for the clustered data structure, were used to identify risk factors for AGE and ARI.
resultsIn total, 699 households with 1,656 participants (response rate 21%) returned the questionnaire. Contact with floodwater was significantly associated with AGE (aOR 4.2, 95%CI 2.1-8.4) and ARI (aOR 3.3, 95%CI 2.0-5.4). Risk factors for AGE were skin contact with floodwater (aOR 4.0, 95%CI 1.8-9.0), performing post-flooding cleaning operations (aOR 8.6, 95%CI 3.5-20.9) and cycling through floodwater (aOR 2.3, 95%CI 1.0-5.0). Skin contact with floodwater (aOR 3.6, 95%CI 1.9-6.9) and performing post-flooding cleaning operations (aOR 5.5, 95%CI 3.0-10.3) were identified as risk factors for ARI.
conclusionsResults suggest an association between direct exposure to pluvial floodwater and AGE and ARI. As it is predicted that the frequency of pluvial flooding events will increase in the future, there is a need for flood-proof solutions in urban development and increased awareness among stakeholders and the public about the potential health risks. Future prospective studies are recommended to confirm our results.
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