title: Impact of providing in-home water service on the rates of infectious diseases: results from four communities in Western Alaska.
abstract: Approximately 20% of rural Alaskan homes lack in-home piped water; residents haul water to their homes. The limited quantity of water impacts the ability to meet basic hygiene needs. We assessed rates of infections impacted by water quality (waterborne, e.g. gastrointestinal infections) and quantity (water-washed, e.g. skin and respiratory infections) in communities transitioning to in-home piped water. Residents of four communities consented to a review of medical records 3 years before and after their community received piped water. We selected health encounters with ICD-9CM codes for respiratory, skin and gastrointestinal infections. We calculated annual illness episodes for each infection category after adjusting for age. We obtained 5,477 person-years of observation from 1032 individuals. There were 9,840 illness episodes with at least one ICD-9CM code of interest; 8,155 (83%) respiratory, 1,666 (17%) skin, 241 (2%) gastrointestinal. Water use increased from an average 1.5 gallons/capita/day (g/c/d) to 25.7 g/c/d. There were significant (P-value < 0.05) declines in respiratory (16, 95% confidence interval (CI): 11-21%), skin (20, 95%CI: 10-30%), and gastrointestinal infections (38, 95%CI: 13-55%). We demonstrated significant declines in respiratory, skin and gastrointestinal infections among individuals who received in-home piped water. This study reinforces the importance of adequate quantities of water for health.
authors.affiliation: Alaska Native Tribal Health Consortium, 3900 Ambassador Drive, Anchorage, Alaska, 99508, USA E-mail: tkthomas@anthc.org.
authors.forename: T K
authors.initials: TK
authors.lastname: Thomas
authors.affiliation: Alaska Native Tribal Health Consortium, 3900 Ambassador Drive, Anchorage, Alaska, 99508, USA E-mail: tkthomas@anthc.org.
authors.forename: T
authors.initials: T
authors.lastname: Ritter
authors.affiliation: Centers for Disease Control and Prevention, Arctic Investigation Program, 4055 Tudor Center Drive, Anchorage, Alaska, 99508, USA.
authors.forename: D
authors.initials: D
authors.lastname: Bruden
authors.affiliation: Centers for Disease Control and Prevention, Arctic Investigation Program, 4055 Tudor Center Drive, Anchorage, Alaska, 99508, USA.
authors.forename: M
authors.initials: M
authors.lastname: Bruce
authors.affiliation: Centers for Disease Control and Prevention, Arctic Investigation Program, 4055 Tudor Center Drive, Anchorage, Alaska, 99508, USA.
authors.forename: K
authors.initials: K
authors.lastname: Byrd
authors.affiliation: Alaska Native Tribal Health Consortium, 3900 Ambassador Drive, Anchorage, Alaska, 99508, USA E-mail: tkthomas@anthc.org.
authors.forename: R
authors.initials: R
authors.lastname: Goldberger
authors.affiliation: Yukon Kuskokwim Health Corporation, P.O. Box 528, Bethel, Alaska, 99559, USA.
authors.forename: J
authors.initials: J
authors.lastname: Dobson
authors.affiliation: Alaska Native Tribal Health Consortium, 3900 Ambassador Drive, Anchorage, Alaska, 99508, USA E-mail: tkthomas@anthc.org.
authors.forename: K
authors.initials: K
authors.lastname: Hickel
authors.affiliation: Alaska Native Tribal Health Consortium, 3900 Ambassador Drive, Anchorage, Alaska, 99508, USA E-mail: tkthomas@anthc.org.
authors.forename: J
authors.initials: J
authors.lastname: Smith
authors.affiliation: Centers for Disease Control and Prevention, Arctic Investigation Program, 4055 Tudor Center Drive, Anchorage, Alaska, 99508, USA.
authors.forename: T
authors.initials: T
authors.lastname: Hennessy
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000413:Alaska / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D006920:Hygiene / Q000193:education*; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000209:etiology; D012424:Rural Population; D012871:Skin Diseases / Q000453:epidemiology* / Q000209:etiology; D014881:Water Supply; D055815:Young Adult
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