Epidemiology and Health

Original Articles

Association of plain water intake with self-reported depression and suicidality among Korean adolescents: Jung Woo Lee, Yookyung Kim; Epidemiol Health. 2024;46:e2024019. Published online January 9, 2024; DOI: https://doi.org/10.4178/epih.e2024019

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Abstract Summary PDF: Abstract
OBJECTIVES
Adolescent depression and suicidality are serious health problems worldwide. Lower plain water intake has been proposed as a risk factor for depression in adults. This study investigated the association of daily plain water intake with self-reported depression and suicidality among Korean adolescents.
METHODS
We used nationwide data from 112,250 students aged 12-18 years who participated in the Korean Youth Risk Behavior Web-based Surveys in 2019 and 2020. Daily plain water intake was categorized as <1 glass, 1-2 glasses, and ≥3 glasses. The adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for self-reported depression and suicidality were calculated using multiple regression analyses.
RESULTS
The weighted prevalence rates of self-reported depression, suicidal ideation, suicide planning, and suicide attempts were 26.7%, 12.0%, 3.8%, and 2.5%, respectively. Of the participants, 3.9%, 18.5%, and 77.7% were categorized into the <1 glass/day, 1-2 glass/day, and ≥3 glass/day groups, respectively. Compared to the reference group (≥3 glass/day), the lowest level of water intake (<1 glass/day) was associated with higher odds of self-reported depression (aOR, 1.30; 95% CI, 1.20 to 1.39), suicidal ideation (aOR, 1.39; 95% CI, 1.27 to 1.55), suicide planning (aOR, 1.46; 95% CI, 1.25 to 1.69), and suicide attempts (aOR, 1.38; 95% CI, 1.15 to 1.67). Moderately lower water intake (1-2 glass/day) showed slightly increased odds of self-reported depression (aOR, 1.05; 95% CI, 1.01 to 1.10) and suicidal ideation (aOR, 1.08; 95% CI, 1.03 to 1.14).
CONCLUSIONS
Lower plain water intake was significantly associated with a higher risk of self-reported depression and suicidality among Korean adolescents. Since this cross-sectional study is unable to establish a causal relationship, it underscores the need for additional longitudinal research.; Summary

Korean summary
- 한국 청소년들에서 하루 물 섭취량이 적을수록 스스로 느끼는 우울감과 자살성향 위험이 증가하였다. - 이 연구는 하루 물 섭취량 측정이 청소년 우울증과 자살성향을 선별할 수 있음을 시사한다.

Key Message
- Lower daily plain water intake is significantly associated with a higher risk of self-reported depression and suicidality in Korean adolescents. - It suggests that daily plain water consumption could potentially serve as a screening indicator to identify depression and suicidality in adolescents.

Deprived areas and community water fluoridation in Brazil: a multilevel approach for refocusing public policy: Franklin Barbosa da Silva, José Leopoldo Ferreira Antunes, Paulo Frazão; Epidemiol Health. 2021;43:e2021031. Published online May 1, 2021; DOI: https://doi.org/10.4178/epih.e2021031

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Abstract Summary PDF: Abstract
OBJECTIVES
The aim of this study was to determine whether geographic location, socioeconomic status, infant mortality, and mortality from diarrheal disease in health regions are associated with the provision of community water fluoridation (CWF) in Brazilian municipalities.
METHODS
A multilevel ecological study was conducted based on data from the National Survey of Basic Sanitation and Human Development Atlas. A multilevel analysis was carried out considering Brazilian municipalities as the first level and health regions as the second level, comprising sanitation, demographic, socioeconomic, and health characteristics.
RESULTS
The observation units comprised 5,565 municipalities clustered in 438 health regions in Brazil. The lack of CWF provision was positively associated with the following municipal characteristics: a below-median proportion of inhabitants covered by the sewage network, medium to very low human development index, below-median per capita gross domestic product, and an above-median percentage of expenditures on sanitation. In relation to the health regions, the likelihood of a lack of CWF provision was greater in the municipalities belonging to the health regions located in the Northern and Northeastern areas of Brazil and in those where child mortality due to acute diarrheal disease and the proportion of people with low income were higher when adjusted by municipal indicators.
CONCLUSIONS
Information on the characteristics associated with CWF provision constitutes important input for refocusing public policy to reduce inequalities among Brazilian municipalities and health regions. These findings may help policy-makers to understand the challenges facing CWF expansion in low-, middle-, and high-income countries.; Summary

Key Message
Just as the challenges for CWF's expansion in Brazil's most vulnerable areas require firm leadership for refocusing public policy, expansion in low- and middle-income countries demands a continued global collaborative effort.

Epidemiologic Study for the Association between Phenol Contaminated Drinking Water and Poor Pregnancy Outcomes in Taegu City.: Jung Han Park, Ju Young Lee; Korean J Epidemiol. 2000;22(1):20-31.

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Abstract PDF: Abstract
From 14 to 17 March 1991 the Nakdong River which is a major source of drinking water for Taegu was contaminated with phenol that was spilled out of a factory in Gumi industrial park. Many people who drank the contaminated water complained of various symptoms and were apprehensive of possible adverse effect to the fetus. This study was conducted to examine the effect of drinking water contaminated with phenol on pregnancy outcome in Taegu. All of livebirths and stillbriths delivered in the 5 General Hospitals in Taegu during 1 year from 1 April 1991 were included for this study. For this duration, total number of babies delivered in the 5 General Hospitals was 21,196. Among them, 77.7%(16,468) were delivered from women living in Taegu and it accounted for 47.5% of 34,688 livbirths registered in Taegu during the same period. The babies born to the women living in Taegu were divided into phenol-exposed and unexposed groups. Exposed group was the residents of the area where contaminated water was supplied and they accounted for 81.4% of the women included for this study. Unexposed group was the residents of the area where drinking water was not contaminated with phenol and they accounted for 18.6% of the study subjects. Data were abstracted from the hospital records. All the rates were adjusted for the maternal age and parity by direct method. The abortion rates for the exposed group was 1.7 per 1,000 abortions and livebirths and 1.6 for the unexposed group. The stillbirth rate for the exposed group was 10.5 per 1,000 livebirths and stillbirths 20 weeks of gestation and 9.5 for unexposed group. The early neonatal death rate(within the 1st week after birth) for the exposed group was 7.8 per 1,000 livebirths and 5.4 for the unexposed group. The perinatal death rate for the exposed group was higher as 14.1 per 1,000 livebirths and stillbirths 28 weeks of gestation than 10.8 for the unexposed group. The proportions of intrauterine growth retardation(IUGR) were 2.7% for the exposed group and 3.3% for the unexposed group. Congenital anomaly incidence rates per 1,000 livebirths was 7.4 for the exposed group and 8.4 for the unexposed group. The low birthweight incidence rate for the exposed group was 6.6% and 6.5% for the unexposed group. These differences between two groups were not statistically significant. The premature birth rate(< 37 completed gestational week) was 6.0% for the exposed group and 4.8% for the unexposed group and the difference was statistically significant(p<0.05). Monthly variation of these indices did not show any clue that suggested concurrent change with the phenol contamination of the drinking water. There were no sufficient evidence that could support the hypothesis of adverse effects of phenol contaminated water on pregnancy outcome, such as abortion, stillbirth, premature birth, IUGR, congenital anomalies and early neonatal death.; Summary

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