The Relationship Between In-Home Water Service and the Risk of Respiratory Tract, Skin, and Gastrointestinal Tract Infections Among Rural Alaska Natives.
Hennessy, Thomas W MD, MPH; Ritter, Troy REHS, MPH; Holman, Robert C MS; Bruden, Dana L MS; Yorita, Krista L MPH; Bulkow, Lisa MS; Cheek, James E MD, MPH; Singleton, Rosalyn J MD, MPH; Smith, Jeff MS, RS
[Miscellaneous Article]
American Journal of Public Health.
98(11):2072-2078, November 2008.
(Format: HTML, PDF)
Objectives: We investigated the relationship between the presence of in-home piped water and wastewater services and hospitalization rates for respiratory tract, skin, and gastrointestinal tract infections in rural Alaska.
Methods: We determined in-home water service and hospitalizations for selected infectious diseases among Alaska Natives by region during 2000 to 2004. Within 1 region, infant respiratory hospitalizations and skin infections for all ages were compared by village-level water services.
Results: Regions with a lower proportion of home water service had significantly higher hospitalization rates for pneumonia and influenza (rate ratio [RR] = 2.5), skin or soft tissue infection (RR = 1.9), and respiratory syncytial virus (RR = 3.4 among those younger than 5 years) than did higher-service regions. Within 1 region, infants from villages with less than 10% of homes served had higher hospitalization rates for pneumonia (RR = 1.3) and respiratory syncytial virus (RR = 1.2) than did infants from villages with more than 80% served. Outpatient Staphylococcus aureus infections (RR = 5.1, all ages) and skin infection hospitalizations (RR = 2.7, all ages) were higher in low-service than in high-service villages.
Conclusions: Higher respiratory and skin infection rates were associated with a lack of in-home water service. This disparity should be addressed through sanitation infrastructure improvements.
Copyright (C) 2008 by the American Public Health Association, Inc.