Associations Between Extreme Precipitation and Gastrointestinal-related Hospital Admissions in Chennai, India

Overview

Journal Environ Health Perspect

Date 2013 Dec 19

PMID 24345350

Citations 19

Authors

Kathleen F Bush

Marie S ONeill

Shi Li

Bhramar Mukherjee

Howard Hu

Santu Ghosh

Kalpana Balakrishnan

Affiliations

Soon will be listed here.

Abstract

Background: Understanding the potential links between extreme weather events and human health in India is important in the context of vulnerability and adaptation to climate change. Research exploring such linkages in India is sparse.

Objectives: We evaluated the association between extreme precipitation and gastrointestinal (GI) illness-related hospital admissions in Chennai, India, from 2004 to 2007.

Methods: Daily hospital admissions were extracted from two government hospitals in Chennai, India, and meteorological data were retrieved from the Chennai International Airport. We evaluated the association between extreme precipitation (≥ 90th percentile) and hospital admissions using generalized additive models. Both single-day and distributed lag models were explored over a 15-day period, controlling for apparent temperature, day of week, and long-term time trends. We used a stratified analysis to explore the association across age and season.

Results: Extreme precipitation was consistently associated with GI-related hospital admissions. The cumulative summary of risk ratios estimated for a 15-day period corresponding to an extreme event (relative to no precipitation) was 1.60 (95% CI: 1.29, 1.98) among all ages, 2.72 (95% CI: 1.25, 5.92) among the young (≤ 5 years of age), and 1.62 (95% CI: 0.97, 2.70) among the old (≥ 65 years of age). The association was stronger during the pre-monsoon season (March-May), with a cumulative risk ratio of 6.50 (95% CI: 2.22, 19.04) for all ages combined compared with other seasons.

Conclusions: Hospital admissions related to GI illness were positively associated with extreme precipitation in Chennai, India, with positive cumulative risk ratios for a 15-day period following an extreme event in all age groups. Projected changes in precipitation and extreme weather events suggest that climate change will have important implications for human health in India, where health disparities already exist.

Citation: Bush KF, O'Neill MS, Li S, Mukherjee B, Hu H, Ghosh S, Balakrishnan K. 2014. Associations between extreme precipitation and gastrointestinal-related hospital admissions in Chennai, India. Environ Health Perspect 122:249-254; http://dx.doi.org/10.1289/ehp.1306807.

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References

Bramer G . International statistical classification of diseases and related health problems. Tenth revision. World Health Stat Q. 1988; 41(1):32-6. View

Thomas K, Charron D, Waltner-Toews D, Schuster C, Maarouf A, Holt J . A role of high impact weather events in waterborne disease outbreaks in Canada, 1975 - 2001. Int J Environ Health Res. 2006; 16(3):167-80. DOI: 10.1080/09603120600641326. View

Hastie T, Tibshirani R . Generalized additive models for medical research. Stat Methods Med Res. 1995; 4(3):187-96. DOI: 10.1177/096228029500400302. View

Olago D, Marshall M, Wandiga S, Opondo M, Yanda P, Kanalawe R . Climatic, socio-economic, and health factors affecting human vulnerability to cholera in the Lake Victoria basin, East Africa. Ambio. 2007; 36(4):350-8. DOI: 10.1579/0044-7447(2007)36[350:csahfa]2.0.co;2. View

Singh R, Hales S, De Wet N, Raj R, Hearnden M, Weinstein P . The influence of climate variation and change on diarrheal disease in the Pacific Islands. Environ Health Perspect. 2001; 109(2):155-9. PMC: 1240636. DOI: 10.1289/ehp.01109155. View

Naumova E, Jagai J, Matyas B, Demaria Jr A, Macneill I, Griffiths J . Seasonality in six enterically transmitted diseases and ambient temperature. Epidemiol Infect. 2007; 135(2):281-92. PMC: 2870561. DOI: 10.1017/S0950268806006698. View

Gasparrini A, Armstrong B, Kenward M . Distributed lag non-linear models. Stat Med. 2010; 29(21):2224-34. PMC: 2998707. DOI: 10.1002/sim.3940. View

Balakrishnan K, Ganguli B, Ghosh S, Sankar S, Thanasekaraan V, Rayudu V . Part 1. Short-term effects of air pollution on mortality: results from a time-series analysis in Chennai, India. Res Rep Health Eff Inst. 2011; (157):7-44. View

Chen M, Lin C, Wu Y, Wu P, Lung S, Su H . Effects of extreme precipitation to the distribution of infectious diseases in Taiwan, 1994-2008. PLoS One. 2012; 7(6):e34651. PMC: 3380951. DOI: 10.1371/journal.pone.0034651. View

10.

Ford T, Colwell R, Rose J, Morse S, Rogers D, Yates T . Using satellite images of environmental changes to predict infectious disease outbreaks. Emerg Infect Dis. 2009; 15(9):1341-6. PMC: 2819876. DOI: 10.3201/eid1509.081334. View

11.

Ebi K, Paulson J . Climate change and child health in the United States. Curr Probl Pediatr Adolesc Health Care. 2010; 40(1):2-18. DOI: 10.1016/j.cppeds.2009.12.001. View

12.

Pascual M, Rodo X, Ellner S, Colwell R, Bouma M . Cholera dynamics and El Niño-Southern Oscillation. Science. 2000; 289(5485):1766-9. DOI: 10.1126/science.289.5485.1766. View

13.

Jagai J, Castronovo D, Monchak J, Naumova E . Seasonality of cryptosporidiosis: A meta-analysis approach. Environ Res. 2009; 109(4):465-78. PMC: 2732192. DOI: 10.1016/j.envres.2009.02.008. View

14.

Zanobetti A, Wand M, Schwartz J, Ryan L . Generalized additive distributed lag models: quantifying mortality displacement. Biostatistics. 2003; 1(3):279-92. DOI: 10.1093/biostatistics/1.3.279. View

15.

Aramini J, McLean M, Wilson J, Holt J, Copes R, Allen B . Drinking water quality and health-care utilization for gastrointestinal illness in greater Vancouver. Can Commun Dis Rep. 2001; 26(24):211-4. View

16.

Patz J, Vavrus S, Uejio C, McLellan S . Climate change and waterborne disease risk in the Great Lakes region of the U.S. Am J Prev Med. 2008; 35(5):451-8. DOI: 10.1016/j.amepre.2008.08.026. View

17.

Morris R, Naumova E, Levin R, Munasinghe R . Temporal variation in drinking water turbidity and diagnosed gastroenteritis in Milwaukee. Am J Public Health. 1996; 86(2):237-9. PMC: 1380334. DOI: 10.2105/ajph.86.2.237. View

18.

Nichols G, Lane C, Asgari N, Verlander N, Charlett A . Rainfall and outbreaks of drinking water related disease and in England and Wales. J Water Health. 2008; 7(1):1-8. DOI: 10.2166/wh.2009.143. View

19.

Haley B, Cole D, Lipp E . Distribution, diversity, and seasonality of waterborne salmonellae in a rural watershed. Appl Environ Microbiol. 2009; 75(5):1248-55. PMC: 2648171. DOI: 10.1128/AEM.01648-08. View

20.

Fleury M, Charron D, Holt J, Allen O, Maarouf A . A time series analysis of the relationship of ambient temperature and common bacterial enteric infections in two Canadian provinces. Int J Biometeorol. 2006; 50(6):385-91. DOI: 10.1007/s00484-006-0028-9. View