Risk of Gastrointestinal Illness Associated with the Consumption of Rainwater: A Systematic Review

Dean, Jonathan and Hunter, Paul R. (2012) Risk of Gastrointestinal Illness Associated with the Consumption of Rainwater: A Systematic Review. Environmental Science & Technology, 46 (5). pp. 2501-2507. ISSN 0013-936X

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Abstract

The collection of rainwater for human consumption is a practice well established in many parts of the world. Much of the research to date regarding this inexpensive and sustainable source has focused on its microbiological or chemical quality and there have been no reviews of epidemiological evidence regarding actual health risks associated with rainwater consumption. Electronic bibliographic databases were searched for epidemiological studies that attempted to quantify the risk of gastrointestinal disease linked to the consumption of harvested rainwater. Online databases were searched from the oldest date up to January 2011. Both observational and experimental studies were included. In addition, reference sections of key articles were searched and authors of previous studies were contacted where appropriate. Studies were assessed for relevance independently and in duplicate. Searches returned a total of 764 articles, 13 met inclusion criteria, 5 of these were outbreak reports, and 9 were studies of other design types. Pooled subgroup analysis suggests that rainwater is associated with reduced risk of illness compared to unimproved supplies (relative risk 0.57 95% CI 0.42, 0.77). There was no significant difference in risk in the pooled analysis of studies that compared rainwater to improved water supplies (relative risk 0.82 95% CI 0.38, 1.73). However, there was heterogeneity with one study showing an excess risk of campylobacteriosis. Classification of outbreak reports determined that 4 reports were “strongly associated with rainwater” while 1 report was “probably associated with rainwater”. We conclude that the evidence suggests that rainwater is safer than water from unimproved water supplies. Where feasible rainwater harvesting should be encouraged as a step toward achieving millennium development targets.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: Pure Connector
Date Deposited: 22 Oct 2013 22:48
Last Modified: 23 Jan 2019 13:48
URI: https://ueaeprints.uea.ac.uk/id/eprint/43431
DOI: 10.1021/es203351n

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