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A time series study of gastroenteritis and tap water quality in the Nantes area, France, 2002–2007

Journal of Exposure Science & Environmental Epidemiology volume 24, pages 192–199 (2014)Cite this article

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Abstract

In the Nantes area, 410,000 inhabitants are supplied with water pumped from the Loire River. The treatment of this water is carried out through a process of complete clarification and disinfection. During the study period (2002–07), the quality of drinking water complied with European microbial standards and mean turbidity in finished water was 0.05 NTU (nephelometric turbidity units). We aimed to characterize the link between produced water turbidity and other operational data and the incidence of acute gastroenteritis (AGE) in the Nantes area. The daily number of medical prescriptions for AGE was drawn from the French national health insurance system’s drug reimbursement data. We modeled this time series using Poisson regression within the framework of a Generalized Additive Model. We showed that an interquartile range turbidity degradation (0.042–0.056 NTU) was connected to a 4.2% (CI95=(1.5%; 6.9%)) increase in the risk of AGE in children and a 2.9% (CI95=(0.5%; 5.4%)) increase in adults. The slope of the turbidity risk function was higher during both high- and low-water conditions of the river. High values of daily flow of produced water were also associated with higher endemic levels of AGE.

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Acknowledgements

The Institute for Public Health Surveillance (InVS) thanks the “Assurance Maladie”, “Météo-France” and the “Dréal des Pays de la Loire” who provided the health, weather and river flow data, respectively. We wish to thank the personnel of the water treatment plants of “Nantes Métropole” for water data and expertise. We also thank Jude Sweeney for the English revision and editing of the manuscript.

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Authors and Affiliations

  1. Institut de Veille Sanitaire, rue de Val-d’Osne, Saint-Maurice, France

    Pascal Beaudeau, Abdelkrim Zeghnoun, Magali Corso, Agnès Lefranc & Loïc Rambaud

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  1. Pascal Beaudeau
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  2. Abdelkrim Zeghnoun
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  3. Magali Corso
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  4. Agnès Lefranc
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  5. Loïc Rambaud
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Correspondence to Pascal Beaudeau.

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Beaudeau, P., Zeghnoun, A., Corso, M. et al. A time series study of gastroenteritis and tap water quality in the Nantes area, France, 2002–2007. J Expo Sci Environ Epidemiol 24, 192–199 (2014). https://doi.org/10.1038/jes.2013.5

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