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Waterborne microbial risk assessment: a population-based dose-response function for Giardia spp. (E.MI.R.A study)
D Zmirou-Navier1, L Gofti-Laroche, Ph Hartemann
1INSERM-ERI 11, Nancy University Medical School, 9 av de la Forêt de Haye, BP 184, 54505 Vandoeuvre-les-Nancy Cedex, France. Denis.Zmirou@nancy.inserm.fr
BMC Public Health
|May 5, 2006
Summary
This study compared Giardia risk estimates in drinking water using clinical data and epidemiological findings. Results show consistency between models, validating dose-response parameters for public health risk assessment.
Area of Science:
- Environmental Health
- Microbiology
- Epidemiology
Background:
- Assessing protozoa health impacts in drinking water often relies on clinical dose-response parameters.
- This study compares literature-derived Giardia risk estimates with epidemiological data on acute digestive conditions (ADC).
Purpose of the Study:
- To compare Giardia risk estimates in drinking water derived from clinical dose-response parameters versus epidemiological data.
- To validate the use of dose-response parameters for assessing health impacts of Giardia in drinking water.
Main Methods:
- A panel of 544 volunteers was followed daily for digestive morbidity.
- Microbiological surveillance of tap water was conducted concurrently.
- Generalized Estimating Equations modeled the relationship between ADC incidence and Giardia cyst concentrations, adjusting for covariates.
Main Results:
- The Odds Ratio (OR = 1.76) showed consistency with literature risk assessment when a 20% abatement factor was applied to cyst counts.
- A daily intake of 2 L with 10 cysts/100 L Giardia concentration yielded an estimated relative excess risk of 11-12%.
- The abatement parameter accounts for uncertainties in germ viability, infectivity, and virulence in natural environments.
Conclusions:
- The dose-response function for waterborne Giardia risk from clinical experiments aligns with epidemiological findings.
- Further research is needed on factors influencing quantitative risk assessment for waterborne pathogens.