Abstract：
It is well known that municipal drinking water may be the cause of gastrointestinal illness (GII) outbreaks, but it is still unclear to what extent drinking water contributes to endemic GII. To explore this, we conducted a prospective cohort study among 6,955 adults in five municipalities in Sweden, collecting monthly GII episodes and mean daily cold drinking water consumption through SMS (Short Message Service). When the association between drinking water consumption and GII (all symptoms) and acute gastrointestinal illness (AGI, vomiting and/or three loose stools during a 24-h period) were assessed, there were indications that the association departed from linearity, following a unimodal shape. Among consumers in surface water areas, the highest risk of GII and AGI was generally seen among the average consumers, while the opposite was seen among groundwater consumers. The association however also seemed to be affected by neighbouring communities. The results of the study indicate that there is indeed an association between drinking water consumption and endemic GII, but the nature of this association is complex and likely affected by multiple factors, for example, water source type in the home and degree of exposure to drinking water from additional sources.
摘要：
众所周知，市政饮用水可能是胃肠道疾病(GII)爆发的原因，但目前尚不清楚饮用水在多大程度上有助于地方性GII。为了探索这个，我们在瑞典五个城市的6,955名成年人中进行了一项前瞻性队列研究，通过SMS（短消息服务）收集每月GII发作和平均每日冷饮用水消耗量。当饮用水消耗与GII(所有症状)和急性胃肠道疾病(AGI,呕吐和/或在24小时期间的三个稀便)进行评估，有迹象表明这种关联偏离了线性，遵循单峰形状。在地表水区的消费者中，GII和AGI的最高风险通常出现在普通消费者中，而在地下水消费者中却看到了相反的情况。然而，该协会似乎也受到邻近社区的影响。研究结果表明，饮用水消耗与地方性GII之间确实存在关联，但是这种联系的性质是复杂的，可能会受到多种因素的影响，例如,家庭中的水源类型和其他来源的饮用水暴露程度。
