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Marked regional variations in the prevalence of inflammatory bowel disease in a limited geographical region are not associated with compounds in the drinking water

Segerman, Fredrik LU ; Clarkson, Spencer LU and Sjöberg, Klas LU orcid (2019) In Scandinavian Journal of Gastroenterology 54(10). p.1250-1260
Abstract

Objective: The incidence of autoimmune diseases, especially inflammatory bowel disease (IBD), has increased substantially. Globally, there are vast differences varying from 0.2/105 in some Asian countries to over 80/105 in the Faroe Islands. Environmental factors have been suggested as triggers. The aim was to investigate the incidence and prevalence of IBD in the 33 municipalities in the county Scania in Southern Sweden, an area comprising 100 × 100 km with 1,274,069 inhabitants. Furthermore, we wanted to explore whether compounds in the drinking water could contribute to IBD; one report from Norway has suggested that iron in drinking water could contribute to UC. Methods: Patients with CD and UC were identified... (More)

Objective: The incidence of autoimmune diseases, especially inflammatory bowel disease (IBD), has increased substantially. Globally, there are vast differences varying from 0.2/105 in some Asian countries to over 80/105 in the Faroe Islands. Environmental factors have been suggested as triggers. The aim was to investigate the incidence and prevalence of IBD in the 33 municipalities in the county Scania in Southern Sweden, an area comprising 100 × 100 km with 1,274,069 inhabitants. Furthermore, we wanted to explore whether compounds in the drinking water could contribute to IBD; one report from Norway has suggested that iron in drinking water could contribute to UC. Methods: Patients with CD and UC were identified through the ICD-10 diagnosis database during the period 2000–2013. Water analyses for pH, alkaline, nitrate, sulphate, iron, magnesium and calcium were based on established methods and compared with the prevalence of IBD using Student’s t-test. Results: A total number of 8925 patients were identified. The incidence for CD and UC were high (mean 16.4/105, range 13.6–17.9 and 25.3/105, range 21.3–28.0, respectively). The prevalence varied substantially (p <.0001 for both; CD mean 0.30%, range 0.15–0.42 and UC mean 0.42%, range 0.32–0.56). No correlation between IBD and the chemical compounds in the drinking water could be shown. Conclusions: The incidence rates of both CD and UC were high. The prevalence varied from 200% to 300% between the municipalities, despite the limited geographical area indicating that local conditions are of importance. However, chemical compounds in the water were not associated with this variation.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Crohn’s disease, drinking water, epidemiology, prevalence, ulcerative colitis
in
Scandinavian Journal of Gastroenterology
volume
54
issue
10
pages
1250 - 1260
publisher
Taylor & Francis
external identifiers
  • pmid:31613652
  • scopus:85074575507
ISSN
0036-5521
DOI
10.1080/00365521.2019.1674374
language
English
LU publication?
yes
id
266b8326-e39d-434a-bde8-f39746a822fe
date added to LUP
2019-11-21 13:51:08
date last changed
2024-03-04 08:09:57
@article{266b8326-e39d-434a-bde8-f39746a822fe,
  abstract     = {{<p>Objective: The incidence of autoimmune diseases, especially inflammatory bowel disease (IBD), has increased substantially. Globally, there are vast differences varying from 0.2/10<sup>5</sup> in some Asian countries to over 80/10<sup>5</sup> in the Faroe Islands. Environmental factors have been suggested as triggers. The aim was to investigate the incidence and prevalence of IBD in the 33 municipalities in the county Scania in Southern Sweden, an area comprising 100 × 100 km with 1,274,069 inhabitants. Furthermore, we wanted to explore whether compounds in the drinking water could contribute to IBD; one report from Norway has suggested that iron in drinking water could contribute to UC. Methods: Patients with CD and UC were identified through the ICD-10 diagnosis database during the period 2000–2013. Water analyses for pH, alkaline, nitrate, sulphate, iron, magnesium and calcium were based on established methods and compared with the prevalence of IBD using Student’s t-test. Results: A total number of 8925 patients were identified. The incidence for CD and UC were high (mean 16.4/10<sup>5</sup>, range 13.6–17.9 and 25.3/10<sup>5</sup>, range 21.3–28.0, respectively). The prevalence varied substantially (p &lt;.0001 for both; CD mean 0.30%, range 0.15–0.42 and UC mean 0.42%, range 0.32–0.56). No correlation between IBD and the chemical compounds in the drinking water could be shown. Conclusions: The incidence rates of both CD and UC were high. The prevalence varied from 200% to 300% between the municipalities, despite the limited geographical area indicating that local conditions are of importance. However, chemical compounds in the water were not associated with this variation.</p>}},
  author       = {{Segerman, Fredrik and Clarkson, Spencer and Sjöberg, Klas}},
  issn         = {{0036-5521}},
  keywords     = {{Crohn’s disease; drinking water; epidemiology; prevalence; ulcerative colitis}},
  language     = {{eng}},
  month        = {{10}},
  number       = {{10}},
  pages        = {{1250--1260}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Gastroenterology}},
  title        = {{Marked regional variations in the prevalence of inflammatory bowel disease in a limited geographical region are not associated with compounds in the drinking water}},
  url          = {{http://dx.doi.org/10.1080/00365521.2019.1674374}},
  doi          = {{10.1080/00365521.2019.1674374}},
  volume       = {{54}},
  year         = {{2019}},
}