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Putting Regulatory Data to Work at the Service of Public Health: Utilizing Data Collected Under the Clean Water Act

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Abstract

Under the Clean Water Act, the US Environmental Protection Agency (EPA) collects information from states on intended use and impairment of each water body. We explore the feasibility of using these data, collected for regulatory purposes, for public health analyses. Combining EPA impairment data and stream hydrology information we estimated the percent of stream length impaired for any use, recreational use, or drinking water use per county in the US as exposure variables. For health outcomes we abstracted county-level hospitalization rates of gastrointestinal infections, GI (ICD-9CM 001-009 excluding 008.45) and gastrointestinal symptoms, GS (ICD-9CM 558.9, 787) among US adults aged 65 years and older from the Center for Medicare and Medicaid Services (1991–2004). Linear mixed-effects models were used to assess county-level associations between percent impaired waters and hospitalization rates adjusted for population density, a proxy for person-to-person transmission. Contrary to expectation, both GI and GS were negatively associated with any water impairment in adjusted models (GI: −0.052, 95 % CI: −0.077, −0.028; GS: −0.438, 95 % CI: −0.702, −0.174). GI was also negatively associated with recreational water impairment (−0.079, 95 % CI: −0.123, −0.036 after adjustment). Neither outcome was associated with drinking water impairment. Limited state data were reported to the EPA for specific recreational (27 states) and drinking (13 states) water impairment, thus limiting the power of the study. Though limited, this analysis demonstrates the feasibility of utilizing regulatory data for public health analyses.

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References

  • Bell EM, Hertz-Picciotto I, Beaumont JJ (2001a) Case-cohort analysis of agricultural pesticide applications near maternal residence and selected causes of fetal death. Am J Epidemiol 154(8):702–710

    Article  CAS  Google Scholar 

  • Bell EM, Hertz-Picciotto I, Beaumont JJ (2001b) A case-control study of pesticides and fetal death due to congenital anomalies. Epidemiology 12(2):148–156

    Article  CAS  Google Scholar 

  • California Department of Pesticide Regulation (2011) Pesticide use reporting

  • Castronovo DA, Chui KKH, Naumova EN (2009) Dynamic maps: a visual-analytic methodology for exploring spatio-temporal disease patterns. Environ Health 8:61

    Article  Google Scholar 

  • Choi HS, Shim YK, Kaye WE, Ryan PB (2006) Potential residential exposure to toxics release inventory chemicals during pregnancy and childhood brain cancer. Environ Health Perspect 114(7):1113–1118

    CAS  Google Scholar 

  • Cohen SA, Egorov AI, Jagai JS, Matyas BT, DeMaria A Jr., Chui KK, Griffiths JK, Naumova EN (2008) The SEEDs of two gastrointestinal diseases: socioeconomic, environmental, and demographic factors related to cryptosporidiosis and giardiasis in Massachusetts. Environ Res 108(2):185–191

    Article  CAS  Google Scholar 

  • Cohen SA, Naumova EN (2007) Population dynamics in the elderly: the need for age-adjustment in national BioSurveillance systems. In: Zeng D, Gotham I, Komatsu K et al. (eds) Intelligence and security informatics: biosurveillance: second NSF workshop, BioSurveillance 2007, vol 1, New Brunswick, NJ, USA, May 22, 2007. Lecture notes in computer science, vol 4506. Springer, Berlin, pp 47–58.

    Google Scholar 

  • Craun GF, Brunkard JM, Yoder JS, Roberts VA, Carpenter J, Wade T, Calderon RL, Roberts JM, Beach MJ, Roy SL (2010) Causes of outbreaks associated with drinking water in the United States from 1971 to 2006. Clin Microbiol Rev 23(3):507–528

    Article  CAS  Google Scholar 

  • De Roos AJ, Davis S, Colt JS, Blair A, Airola M, Severson RK, Cozen W, Cerhan JR, Hartge P, Nuckols JR, Ward MH (2010) Residential proximity to industrial facilities and risk of non-Hodgkin lymphoma. Environ Res 110(1):70–78

    Article  Google Scholar 

  • Dockery DW, Pope CA 3rd, Xu X, Spengler JD, Ware JH, Fay ME, Ferris BG Jr, Speizer FE (1993) An association between air pollution and mortality in six US cities. N Engl J Med 329(24):1753–1759

    Article  CAS  Google Scholar 

  • Egorov AI, Naumova EN, Tereschenko AA, Kislitsin VA, Ford TE (2003) Daily variations in effluent water turbidity and diarrhoeal illness in a Russian city. Int J Environ Health Res 13(1):81–94

    Article  CAS  Google Scholar 

  • Fisher ES, Baron JA, Malenka DJ, Barrett J, Bubolz TA (1990) Overcoming potential pitfalls in the use of Medicare data for epidemiologic research. Am J Publ Health 80(12):1487–1490

    Article  CAS  Google Scholar 

  • Hlavsa MC, Roberts VA, Anderson AR, Hill VR, Kahler AM, Orr M, Garrison LE, Hicks LA, Newton A, Hilborn ED, Wade TJ, Beach MJ, Yoder JS (2011) Surveillance for waterborne disease outbreaks and other health events associated with recreational water—United States, 2007–2008. MMWR Surveill Summ 60(12):1–32

    Google Scholar 

  • Kelsall JE, Samet JM, Zeger SL, Xu J (1997) Air pollution and mortality in Philadelphia, 1974–1988. Am J Epidemiol 146(9):750–762

    Article  CAS  Google Scholar 

  • Kim BM, Lee BE, Hong YC, Park H, Ha M, Kim YJ, Kim Y, Chang N, Kim BN, Oh SY, Yoo M, Ha EH (2011) Mercury levels in maternal and cord blood and attained weight through the 24 months of life. Sci Total Environ 410(411):26–33

    Article  Google Scholar 

  • Lim G, Aramini J, Fleury M, Ibarra R, Meyers R (2002) Investigating the relationships between drinking water and gastroenteritis in Edmonton: 1993–1998. Health, Canada

    Google Scholar 

  • Majidi NE, Bouchard M, Gosselin NH, Carrier G (2012) Relationship between prenatal exposure to polychlorinated biphenyls and birth weight: a systematic analysis of published epidemiological studies through a standardization of biomonitoring data. Regul Toxicol Pharmacol 64(1):161–176

    Article  Google Scholar 

  • McFee RB (2009a) Clostridium difficile: emerging public health threat and other nosocomial or hospital acquired infections. Introduction Dis Mon 55(7):419–421

    Article  Google Scholar 

  • McFee RB (2009b) Nosocomial or hospital-acquired infections: an overview. Dis Mon 55(7):422–438

    Article  Google Scholar 

  • Messner M, Shaw S, Regli S, Rotert K, Blank V, Soller J (2006) An approach for developing a national estimate of waterborne disease due to drinking water and a national estimate model application. J Water Health 4 Suppl(2):201–240

    Article  Google Scholar 

  • Morris RD, Naumova EN, Levin R, Munasinghe RL (1996) Temporal variation in drinking water turbidity and diagnosed gastroenteritis in Milwaukee. Am J Publ Health 86(2):237–239

    Article  CAS  Google Scholar 

  • Pruss A (1998) Review of epidemiological studies on health effects from exposure to recreational water. Int J Epidemiol 27(1):1–9

    CAS  Google Scholar 

  • Roberts EM, English PB, Grether JK, Windham GC, Somberg L, Wolff C (2007) Maternal residence near agricultural pesticide applications and autism spectrum disorders among children in the California Central Valley. Environ Health Perspect 115(10):1482–1489

    Google Scholar 

  • Rotkin-Ellman M, Quirindongo M, Sass J, Solomon G (2008) Deepest cuts: repairing health monitoring programs slashed under the Bush Administration

  • Schwartz J, Levin R, Goldstein R (2000) Drinking water turbidity and gastrointestinal illness in the elderly of Philadelphia. J Epidemiol Community Health 54(1):45–51

    Article  CAS  Google Scholar 

  • Schwartz J, Levin R, Hodge K (1997) Drinking water turbidity and pediatric hospital use for gastrointestinal illness in Philadelphia. Epidemiology 8(6):615–620

    CAS  Google Scholar 

  • Sinclair MI, Fairley CK (2000) Drinking water and endemic gastrointestinal illness. J Epidemiol Community Health 54(10):728

    Article  CAS  Google Scholar 

  • Tinker SC, Moe CL, Klein M, Flanders WD, Uber J, Amirtharajah A, Singer P, Tolbert PE (2010) Drinking water turbidity and emergency department visits for gastrointestinal illness in Atlanta, 1993–2004. J Expo Sci Env Epid 20(1):19–28

    Article  Google Scholar 

  • US Environmental Protection Agency (2002) Clean water act, vol 33 USC 1251 et seq. Washington DC

  • US Environmental Protection Agency (2011a) Air pollution monitoring. http://www.epa.gov/airquality/montring.html#montypes

  • US Environmental Protection Agency (2011b) National summary of impaired waters and TMDL information. http://iaspub.epa.gov/waters10/attains_nation_cy.control?p_report_type=T#status_of_data

  • US Environmental Protection Agency (2011c) Overview of impaired waters and total maximum daily loads program. http://water.epa.gov/lawsregs/lawsguidance/cwa/tmdl/intro.cfm

  • US Environmental Protection Agency (2011d) What is the toxics release inventory program? http://www.epa.gov/tri/triprogram/whatis.htm

  • Wade TJ, Pai N, Eisenberg JN, Colford JM Jr (2003) Do US environmental protection agency water quality guidelines for recreational waters prevent gastrointestinal illness? A systematic review and meta-analysis. Environ Health Perspect 111(8):1102–1109

    Article  Google Scholar 

  • Zanobetti A, Schwartz J (2009) The effect of fine and coarse particulate air pollution on mortality: a national analysis. Environ Health Perspect 117(6):898–903

    Article  Google Scholar 

Download references

Acknowledgements

The Office of Research and Development (ORD), US Environmental Protection Agency (EPA), partially funded the research with Innovate!, Inc. and L.C. Messer (Contracts WCF DP26H0001 and EP09D000003) and under EPA Cooperative Agreement with the University of North Carolina at Chapel Hill (CR83323601) and an appointment to the Research Participation Program for the US Environmental Protection Agency, Office of Research and Development, administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and EPA. The authors would also like to thank Joel Hansel, EPA Region 4, and Andrey Egorov, World Health Organization, for their help in the initial phases of this project.

Conflict of interest

The authors have no conflict of interest to declare.

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Authors and Affiliations

  1. National Health and Environmental Effects Research Laboratory, Office of Research and Development, US Environmental Protection Agency, MD 58A, Research Triangle Park, NC, USA

    Jyotsna S. Jagai & Danelle T. Lobdell

  2. Innovate!, Inc., Alexandria, VA, USA

    Barbara J. Rosenbaum & Suzanne M. Pierson

  3. Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA

    Lynne C. Messer

  4. Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

    Kristen Rappazzo

  5. Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, MA, USA

    Elena N. Naumova

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  1. Jyotsna S. Jagai
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  2. Barbara J. Rosenbaum
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  3. Suzanne M. Pierson
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  4. Lynne C. Messer
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  5. Kristen Rappazzo
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  6. Elena N. Naumova
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  7. Danelle T. Lobdell
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Correspondence to Jyotsna S. Jagai or Danelle T. Lobdell.

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The views expressed in this article are those of the authors and do not necessarily reflect the views or policies of the US Environmental Protection Agency. Mention of trade names or commercial products does not constitute endorsement or recommendation for use.

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Jagai, J.S., Rosenbaum, B.J., Pierson, S.M. et al. Putting Regulatory Data to Work at the Service of Public Health: Utilizing Data Collected Under the Clean Water Act. Water Qual Expo Health 5, 117–125 (2013). https://doi.org/10.1007/s12403-013-0095-1

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  • DOI: https://doi.org/10.1007/s12403-013-0095-1

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