Modeling Spatial Risk of Diarrheal Disease Associated with Household Proximity to Untreated Wastewater Used for Irrigation in the Mezquital Valley, Mexico
Por:
Contreras, Jesse D., Trangucci, Rob, Felix-Arellano, Eunice E., Rodriguez-Dozal, Sandra, Siebe, Christina, Riojas-Rodriguez, Horacio, Meza, Rafael, Zelner, Jon, Eisenberg, Joseph N. S.
Publicada:
1 jul 2020
Resumen:
BACKGROUND: Reusing wastewater for irrigation is a longstanding practice
that enhances crop yields and improves climate resilience. Without
treatment, however, wastewater contains harmful pathogens and chemicals.
Reuse of untreated wastewater has been shown to be harmful to the health
of nearby communities, but the routes of exposure are unknown and do not
appear to be occupational. Some routes occur throughout entire
communities, such as food contamination. Other routes may be spatially
dependent, such as spread by domestic animals or through aerosolization.
OBJECTIVES: To examine whether those wastewater exposure routes with a
spatial dependency affect health, we estimated the risks of diarrheal
disease in children under age 5 associated with living near wastewater
canals, while adjusting for potential individual- and household-level
confounders.
METHODS: We conducted three surveys over 1 y in the Mezquital Valley,
Mexico, to measure diarrhea in children. The distance, between each
participating household and a wastewater canal was measured using GPS
coordinates. The association between proximity and diarrhea was
estimated with a multilevel logistic regression model accounting for
spatial autocorrelation.
RESULTS: A total of 564 households completed one to three surveys,
resulting in 1,856 survey observations of 646 children. Children living
100 m from a canal had 45% lower odds of diarrhea than those living
within 10 m of a canal, and children living 1000 m away had 70% lower
odds of diarrhea [100 m vs. 10 m adjusted odds ratio (OR) = 0.55, 95%
credible interval (CD 0.33, 0.91; 1000 m vs. 10 m adjusted OR = 0.30,
95% CI: 0.11, 0.82].
DISCUSSION: The estimated decline in diarrheal prevalence with household
distance from a canal persisted after controlling for occupational
exposure. Identifying the specific routes of exposure that drive this
relationship will help identify which interventions, such as upstream
treatment, can reduce health risks for entire communities where
wastewater exposure occurs.
Filiaciones:
Contreras, Jesse D.:
Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
Trangucci, Rob:
Univ Michigan, Dept Stat, Ann Arbor, MI 48109 USA
Felix-Arellano, Eunice E.:
Inst Nacl Salud Publ, Direcc Salud Ambiental, Cuernavaca, Morelos, Mexico
Rodriguez-Dozal, Sandra:
Inst Nacl Salud Publ, Direcc Salud Ambiental, Cuernavaca, Morelos, Mexico
Siebe, Christina:
Univ Nacl Autonoma Mexico, Inst Geol, Ciudad De Mexico, DF, Mexico
Riojas-Rodriguez, Horacio:
Inst Nacl Salud Publ, Direcc Salud Ambiental, Cuernavaca, Morelos, Mexico
Meza, Rafael:
Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
Zelner, Jon:
Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
Eisenberg, Joseph N. S.:
Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
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