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|Title:||Emergency Department Visits for Acute Gastrointestinal Illness After a Major Water Pipe Break in 2010|
|Authors:||Lin, Cynthia J.;Richardson, David B.;Hilborn, Elizabeth D.;Weinberg, Howard;Engel, Larry S.;Wade, Timothy J.|
|Keywords:||acute gastrointestinal illness;case;crossover study;drinking water;emergency department;gastroenteritis;water|
|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, Massachusetts, 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 two weeks before and after each case. We estimated the risk of visiting the emergency department during the 0-3 and 4-7 days following 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 through 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 to referent dates selected two 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 4-7 day association was elevated (OR= 1.4; 95% CI: 1.1-1.8). CONCLUSION 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.|
|Appears in Collections:||Epidemiology 2019|
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