Emergency Department Visits for Acute Gastrointestinal Illness After a Major Water Pipe Break in 2010. Issue 6 (November 2019)

• Record Type: Journal Article
• Authors: Lin, Cynthia J.; Richardson, David B.; Hilborn, Elizabeth D.; Weinberg, Howard; Engel, Larry S.; Wade, Timothy J.
• Is Part Of: Epidemiology. Volume 30:Issue 6(2019)
• Publication Date: 2019-11
• Subjects: Acute gastrointestinal illness -- Case–crossover study -- Drinking water -- Emergency department -- Gastroenteritis -- Water supply; Epidemiology -- Periodicals; Epidemiology -- Environmental aspects -- Periodicals; Epidemiology -- Periodicals; 614.405
• DOI: 10.1097/EDE.0000000000001083
• Languages: English
• ISSNs: 1044-3983

Abstract

Abstract : Background: When a water pipe breaks, contaminants can enter the drinking water system and cause waterborne illnesses such as acute gastrointestinal illness. In May 2010, a major water pipe broke near Boston, MA, and a boil water order was issued to nearly two million residents. Methods: Using a case-crossover study design, we examined the association between the water pipe break and subsequent emergency department visits for acute gastrointestinal illness. We identified cases of illness according to ICD-9-CM diagnosis codes and selected control dates 2 weeks before and after each case. We estimated the risk of visiting the emergency department during the 0–3 and 4–7 days after the water pipe break using conditional logistic regression models. Results: Our analysis included 5, 726 emergency department visits for acute gastrointestinal illness from 3 April 2010 to 5 June 2010. Overall, there was a 1.3-fold increased odds for visiting the emergency department for acute gastrointestinal illness during the 0–3 days after the water pipe break (odds ratio [OR] = 1.3; 95% confidence interval [CI] = 1.1, 1.4) compared with referent dates selected 2 weeks before and after. During the 4–7 days after the break, the association diminished overall (OR = 1.1; 95% CI = 0.96, 1.2). However, in communities over 12 miles from the break, the 4- to 7-day association was elevated (OR = 1.4; 95% CI = 1.1, 1.8). Conclusions: This study suggests that a major water pipe break was associated with emergency department visits for acute gastrointestinal illness, particularly during the 0–3 days after the break, when a boil water order was in effect. Abstract : Supplemental Digital Content is available in the text.