title: Water use and acute diarrhoeal illness in children in a United States metropolitan area.
abstract: We examined the association between water exposures and acute diarrhoeal illness (ADI) in children under non-outbreak conditions in a major US metropolitan area. We used a nested case-control study of children seen in an urban/suburban emergency department. Cases were those seen for a complaint of diarrhoea, while controls were age-matched children with a non-gastrointestinal complaint. Parents of subjects completed a validated water-use survey. Stratum-specific adjusted odds ratios (aOR) were calculated for the three main water effects: water source [surface vs. ground (well)], drinking-water type (tap vs. bottled), and use of water filters. Of 2472 subjects, 45% drank mostly or only bottled water. Well-water use was associated with increased odds of ADI compared to surface water [aOR 1·38, 95% confidence interval (CI) 1·01-1·87]. Use of bottled water did not affect the odds of ADI in well-water users, but increased the odds of ADI for surface-water users (aOR 1·27, 95% CI 1·02-1·57). We conclude that well-water use and bottled-water use are associated with increased odds of ADI in children.
authors.affiliation: Department of Paediatrics, Medical College of Wisconsin, Milwaukee, WI, USA. mgorelic@mcw.edu
authors.forename: M H
authors.initials: MH
authors.lastname: Gorelick
authors.forename: S L
authors.initials: SL
authors.lastname: McLellan
authors.forename: D
authors.initials: D
authors.lastname: Wagner
authors.forename: J
authors.initials: J
authors.lastname: Klein
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000209:etiology*; D019353:Endemic Diseases; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D014871:Water Microbiology; D014881:Water Supply; D014922:Wisconsin / Q000453:epidemiology