Date of Award

Fall 12-2018

Degree Name

Master of Science (MS)



Second Advisor


Third Advisor



Extreme precipitation has been implicated in more than 51% of the waterborne disease outbreaks in the United States between 1948-1994. With increased incidence of extreme precipitation projected to be more likely due to ongoing climate change, the burden of waterborne disease is expected to rise even in the United States where drinking water is considered to be one of the safest in the world. In this study we aim to quantify the risk of extreme precipitation on gastrointestinal (GI) related hospital admissions by using meteorological and emergency hospital data from twelve major metropolitan statistical areas (MSA) of Texas from year 2004 to 2013. We used distributed lag non-linear model with quasi Poisson regression to estimate the relative risk of GI-related hospital admission occurring at the certain value of precipitation (90th, 95th and 99th percentile) following 15-day period to the probability of the event occurring at the reference value of no precipitation (0 mm). The results showed that the cumulative risk of GI-related hospital admission following days with extreme precipitation was consistently elevated in overall as well as age stratified population in most of the MSAs. The relative risks were significantly higher in children under 6 years and elderly above 65 years compared to adults between 6 to 65 years. The largest effect was observed in Corpus Christi with an estimated relative risk of 2.19 [95% CI: 1.35,3.54] among children under 6 years and 1.65 [95% CI: 1.33, 2.05] among elderly population above 65 years.The results from casue specific analysis showed diarrheal specific causes were responsible for most of the risks observed compared to pathogen or other/ill-defined causes. The findings underscore the need for development of policies and infrastructures to address the effects of extreme precipitation on global/local disease burden given the projected increase in such inclement weather events in the future.