Abstract
This research examines risk factors for sporadic cryptosporidiosis and Escherichia coli (E. coli) O157 infection in East Tennessee, using a case-control approach and spatial logistic regression models. The risk factors examined are animal density, land use, geology, surface water impairment, poverty rate and availability of private water supply. Proximity to karst geology, beef cow population density and a high percentage of both developed land and pasture land are positively associated with both diseases. The availability of private water supply is negatively associated with both diseases. Risk maps generated using the model coefficients show areas of elevated risk to identify the communities where background risk is highest, so that limited public health resources can be targeted to the risk factors and communities most at risk. These results can be used as the framework upon which to develop a comprehensive epidemiological study that focuses on risk factors important at the individual level.
Highlights
The field of medical geology assesses health problems associated with geologic materials with three areas of focus: (1) geology as a source of harmful materials; (2) movement and alteration of harmfulGeosciences 2014, 4 materials through the subsurface over time and space; and (3) exposure pathways associated with geologic materials [1]
This research has shown that environmental variables are important risk factors for cryptosporidiosis and E. coli O157 infection in the individual
Proximity to karst geology was associated with both diseases, indicating that geology, limestone and dolomite formations that are prone to karst weathering, should be incorporated as a proximity measure in waterborne disease risk models
Summary
Geosciences 2014, 4 materials through the subsurface over time and space; and (3) exposure pathways associated with geologic materials [1]. This research focuses on the third branch, on karst geology and other spatially-distributed risk factors, as pathways for exposure to waterborne diseases. The aim for epidemiologic research in general is to identify associations between exposures and outcomes to maximize health or to prevent disease [2], and the probability of human infection by pathogens depends on a number of factors, including how well the pathogen survives in the environment and the opportunities for host-pathogen interaction [3]. It is well established that karst regions are at a higher risk for groundwater contamination due to groundwater-surface water interactions and low groundwater residence times [4,5]. Contaminated groundwater supplies used for public or private water supplies can result in outbreaks of disease that are more prevalent in karst regions [8,9]
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