title: Extreme precipitation and beach closures in the great lakes region: evaluating risk among the elderly.
abstract: As a result of climate change, extreme precipitation events are expected to increase in frequency and intensity. Runoff from these extreme events poses threats to water quality and human health. We investigated the impact of extreme precipitation and beach closings on the risk of gastrointestinal illness (GI)-related hospital admissions among individuals 65 and older in 12 Great Lakes cities from 2000 to 2006. Poisson regression models were fit in each city, controlling for temperature and long-term time trends. City-specific estimates were combined to form an overall regional risk estimate. Approximately 40,000 GI-related hospital admissions and over 100 beach closure days were recorded from May through September during the study period. Extreme precipitation (≥90th percentile) occurring the previous day (lag 1) is significantly associated with beach closures in 8 of the 12 cities (p < 0.05). However, no association was observed between beach closures and GI-related hospital admissions. These results support previous work linking extreme precipitation to compromised recreational water quality.
authors.affiliation: Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA. kathleenfbush@gmail.com.
authors.forename: Kathleen F
authors.initials: KF
authors.lastname: Bush
authors.affiliation: Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA. cheryl.fossani@gmail.com.
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Fossani
authors.affiliation: Department of Biostatistics, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA. shili@umich.edu.
authors.forename: Shi
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Biostatistics, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA. bhramar@umich.edu.
authors.forename: Bhramar
authors.initials: B
authors.lastname: Mukherjee
authors.affiliation: Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA. gronlund@umich.edu.
authors.forename: Carina J
authors.initials: CJ
authors.lastname: Gronlund
authors.affiliation: Department of Environmental Health Sciences, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA. cheryl.fossani@gmail.com.
authors.forename: Marie S
authors.initials: MS
authors.lastname: O'Neill
mesh_terms: D000368:Aged; D001493:Bathing Beaches / Q000592:standards / Q000706:statistics & numerical data*; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology; D006114:Great Lakes Region / Q000453:epidemiology; D006801:Humans; D011891:Rain; D018570:Risk Assessment; D014876:Water Pollution / Q000009:adverse effects*; D060753:Water Quality