Drinking Water Quality at Industrial Supply Points and Its Association with Gastrointestinal Morbidity in Adjacent Communities

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Background: Unsafe drinking water remains an important environmental and public health concern, particularly in communities located near industrial areas where microbiological and chemical contamination may coexist. Objective: To assess the microbiological, physicochemical, and selected chemical quality of drinking water from industrial-area supply points in Multan, Pakistan, and examine its association with recent gastrointestinal morbidity among adjacent communities. Methods: A community-based analytical cross-sectional study was conducted from January to June 2026 among 300 adult residents. Sixty drinking-water samples were assessed for total coliforms, Escherichia coli, physicochemical parameters, nitrate, lead, and arsenic. Gastrointestinal symptoms during the preceding 14 days were collected using a structured interviewer-administered questionnaire. Descriptive statistics, chi-square testing, and logistic regression were used for analysis. Results: Total coliforms were detected in 35/60 samples (58.3%) and E. coli in 25/60 (41.7%). High turbidity and TDS occurred in 30.0% and 36.7% of samples, respectively; nitrate, lead, and arsenic exceeded reported limits in 15.0%, 13.3%, and 8.3%. Gastrointestinal morbidity was reported by 96/300 participants (32.0%), with diarrhea reported by 21.3%. Reported morbidity among participants classified as exposed to E. coli-contaminated water was 47.1% (p<0.001). Conclusion: Microbiological contamination was common in sampled industrial-area water supplies and was associated with greater reported gastrointestinal morbidity. The cross-sectional findings support strengthened water-safety surveillance but do not establish causality

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