[背景]供水系统很容易出现性能缺陷,使得经过处理的水受到(再次)污染,从而可能增加用户罹患胃肠道疾病(GII)的风险。[目的]现在已经证实供水管网的大规模系统性破坏可能引起GII暴发。我们推测,常规供水管网故障也可能影响水源性疾病发生的背景水平,并通过系统性回顾和meta分析评估供水系统缺陷对GII流行的影响。[方法]回顾已发表的、对直接饮用自来水与饮用在饮用点(POU)进行过再处理的自来水进行比较的研究,以及有关特定系统缺陷的研究,例如物理或液压管道的完整性受损以及消毒剂余量不足等。[结果]在供水管网出现故障的情况下,饮用自来水与饮用POU处理后水的用户相比,前者GII患病率增加[发病密度比(IDR)=1.34;95%CI:1.00~1.79]。非盲法的亚组研究显示,与饮用POU处理后水的用户相比,GII与直接饮用自来水之间具有显著的关联(IDR=1.52;95%CI:1.05~2.20)。但是,在参与者不知道他们的POU水处理状态(盲法)的基础上进行的研究却显示不存在关联性(IDR=0.98;95%CI:0.90~1.08)。在针对特定供水管网缺陷的研究中,GII与临时停水相关(相对危险度=3.26;95%CI:1.48~7.19),与长期间断性供水系统停水也具有相关性(OR=1.61;95%CI:1.26~2.07)。[结论]在发生故障的供水管网中,直接饮用自来水与GII相关。系统缺陷例如停水也与GII增加相关联,提示使用供水管网的用户存在潜在的健康风险。 [Background] Water supply systems are prone to performance deficiencies that can (re-) contaminate treated water, which may increase users’ risk of gastrointestinal disease (GII). [Purpose] It has now been demonstrated that large-scale systemic damage to the water distribution network can cause GII outbreaks. We speculate that routine water supply network failures may also influence the background level of waterborne disease occurrence and systematically review and meta-analysis to assess the impact of water supply system defects on the GII pandemic. [Method] A review of published studies comparing tap water with direct drinking tap water and potable drinking water (POU) reprocessing, as well as studies of specific system deficiencies such as impaired integrity of physical or hydraulic piping and Disadvantages such as lack of disinfectant. [Results] The prevalence of GII in the drinking water system was significantly higher than that in drinking POU treated water (IDR = 1.34; 95% CI: 1.00-1.79) in the case of a water supply network failure. . A non-blinded subgroup study showed a significant association between GII and direct drinking tap water (IDR = 1.52; 95% CI: 1.05-2.20) compared with those who consumed POU-treated water. However, studies conducted on the basis that participants did not know their POU water treatment status (blinding) showed no association (IDR = 0.98; 95% CI: 0.90-1.08). GII was associated with temporary water closures (relative risk = 3.26; 95% CI: 1.48 to 7.19) in studies of defects in specific water distribution networks and was associated with no water in long-term intermittent water supply systems (OR = 1.61; 95% CI: 1.26 ~ 2.07). [Conclusion] Direct drinking tap water is related to GII in the faulty water supply network. System defects, such as water shut-off, are also associated with increased GII, suggesting that there is a potential health risk for users using the water distribution network.