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Journal of Water and Health Vol 08 No 1 pp 192–203 © IWA Publishing 2010 doi:10.2166/wh.2009.040 The association of drinking water quality and sewage disposal with Helicobacter pylori incidence in infants: the potential role of water-borne transmissionPenny B. Travis, Karen J. Goodman, Kathleen M. O'Rourke, Frank D. Groves, Debajyoti Sinha, Joyce S. Nicholas, Jim VanDerslice, Daniel Lackland and Kristina D. MenaMedical University of South Carolina, PO Box 1158, Folly Beach South Carolina, 29439, USA E-mail: pennybtravis@yahoo.comUniversity of Alberta, 130 University Campus, Edmonton Alberta, Canada T6G2X8 University of South Florida, 4202 E. Fowler, Tampa Florida, 33620, USA University of Louisville, PO Box 3801, Louisville Kentucky, 40202, USA Florida State University, Tallahassee Florida, 32306, USA Medical University of South Carolina, PO Box 250835, Charleston South Carolina, 29439, USA University of Utah, 375 Chipeta Way, Suite A, Salt Lake City Utah, 84108, USA University of Texas Health Science Center at Houston, 1100 N. Stanton Street, Suite 110, El Paso Texas, 79902, USA ABSTRACT The mode of transmission of Helicobacter pylori, a bacterium causing gastric cancer and peptic ulcer disease, is unknown although waterborne transmission is a likely pathway. This study investigated the hypothesis that access to treated water and a sanitary sewerage system reduces the H. pylori incidence rate, using data from 472 participants in a cohort study that followed children in Juarez, Mexico, and El Paso, Texas, from April 1998, with caretaker interviews and the urea breath test for detecting H. pylori infection at target intervals of six months from birth through 24 months of age. The unadjusted hazard ratio comparing bottled/vending machine water to a municipal water supply was 0.71 (95% confidence interval (CI): 0.50, 1.01) and comparing a municipal sewer connection to a septic tank or cesspool, 0.85 (95% CI: 0.60, 1.20). After adjustment for maternal education and country, the hazard ratios decreased slightly to 0.70 (95% confidence interval: 0.49, 1.00) and 0.77 (95% confidence interval: 0.50, 1.21), respectively. These results provide moderate support for potential waterborne transmission of H. pylori. Keywords: child; cohort studies; Helicobacter pylori; infant; infection; Mexican Americans; sewer; water eProduct: Buy this article for £24.00 (IWA MEMBER PRICE: £18.00) All prices include VAT. For customers where VAT should not be applied, the VAT amount will be removed upon payment |
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