Aging water infrastructure is increasing stressed by heavy rainfall events which are expected to increase with climate change. Combined sewer overflows (CSOs) and sanitary sewer overflows (SSOs) are infrastructure issues that are impacted by heavy rainfall events. We assessed whether CSOs and SSOs are associated with increased rates of emergency room (ER) visits for gastrointestinal (GI) illness. Using hospitalization data from Massachusetts we considered a time-series of daily rate of ER visits for GI illness and meteorological data for three exposure regions. A distributed lag Poisson regression assessed cumulative effects for an 8-day lag period following heavy precipitation events. Only the region with drinking waters exposed to CSOs demonstrated a significant increased cumulative risk for rate of ER visits for GI for all ages in the 8-day period following extreme rainfall, CRR: 1.13 (95% CI: 1.00, 1.28) compared to no rainfall. Additionally, case-crossover study design was used to investigate association between SSOs and ER visits for GI. ER visits were considered exposed if an SSO occurred in the county of residence within three hazard periods, 0–4, 5–9, or 10–14 days, before the visit. Fixed effect logistic regression models were used to estimate risk of ER visits following the SSO event. The overall odds ratio (OR) for ER visits for GI illness was 1.09 (95% CI: 1.03, 1.16) in the 10-14 day period following a SSO event, with positive ORs for all age groups. We demonstrated the rate of ER visits for GI illness was associated with extreme precipitation in the area with CSO discharges to a drinking water source and an association between SSOs and ER visits for GI. In light of aging water infrastructure in the U.S. and expected increase in heavy rainfall events, our findings suggest a potential health impact associated with sewage overflows.

Impact of climatic events on water quality and related health outcomes

2019 Fall National Meeting

The official archive and repository for all ACS Meetings & Expositions abstracts and select posters or presentations.