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This paper explores the complex relationships between changes in the state of a coral reef, rapid economic growth, and mental wellbeing for residents of Tân Hiệp commune (Vietnam). With its designation as a UNESCO Biosphere reserve status 10 years previously, the Tân Hiệp coral reef offers an important example of an ecosystem that remains central to the coastal community, but whose associated ecosystem services have largely transferred from provisioning (fishing) to cultural (tourism). Using the 'ecosystems enriched' Driver, Pressure, State, Exposure, Effect, Action framework (eDPSEEA), to help develop a theoretical model of the relationships between changes to the coral ecosystem, it's capacity to provide ecosystem services and the impacts on human wellbeing using the Cù Lao Chàm UNESCO biosphere reserve as a case study site. Mediation analysis found that when examined through the pathways of the eDPSEEA framework, the social and environmental pressures associated with the rapid economic development of the island over the last 10 years have a significant negative association with resident mental wellbeing. Using the eDPSEEA framework to examine the pathways in which ecosystem change impacts human wellbeing, this analysis demonstrates the complexity of our dependence on coastal ecosystems, and the nuance required to develop and sustain effective 'actions' to manage human and ecosystems health in the future. • eDPSSEA framework used to explore the role of rapid economic growth and ecosystem change on mental wellbeing. • Drivers of rapid economic growth have a positive but insignificant association with mental wellbeing. • Mediation analysis used to examine the impact of these drivers through a pressures pathway. • Drivers' positive association with mental wellbeing was fully mediated when examined via a pressure's pathway. [ABSTRACT FROM AUTHOR]

• Meteorological conditions and daylight hours affect recreational physical activity. • Research has not explored how these affect physical activity in different environments. • Park-based physical activity associated with temperature, wind speed, and daylight. • Unique associations for physical activity at woodlands, inland waters, and coasts. • Implications for 'green prescriptions' and future climate change are discussed. Meteorological conditions affect people's outdoor physical activity. However, we know of no previous research into how these conditions affect physical activity in different types of natural environments – key settings for recreational physical activity, but ones which are particularly impacted by meteorological conditions. Using responses from four waves (2009–2013) of a survey of leisure visits to natural environments in England (n = 47,613), visit dates and locations were ascribed estimates of energy expenditure (MET-minutes) and assigned meteorological data. We explored relationships between MET-minutes in natural environments (in particular, parks, woodlands, inland waters, and coasts) and the hourly maxima of air temperature and wind speed, levels of rainfall, and daylight hours using generalised additive models. Overall, we found a positive linear relationship between MET-minutes and air temperature; a negative linear relationship with wind speed; no relation with categories of rainfall; and a positive, but non-linear relationship with daylight hours. These same trends were observed for park-based energy expenditure, but differed for visits to other natural environments: only daylight hours were related to energy expenditure at woodlands; wind speed and daylight hours affected energy expenditure at inland waters; and only air temperature was related to energy expenditure at coasts. Natural environments support recreational physical activity under a range of meteorological conditions. However, distinct conditions do differentially affect the amount of energy expenditure accumulated in a range of natural environments. The findings have implications for reducing commonly-reported meteorological barriers to both recreational physical activity and visiting natural environments for leisure, and begin to indicate how recreational energy expenditure in these environments could be affected by future climate change. [ABSTRACT FROM AUTHOR]

Abstract Health and economic benefits may accrue from marine and coastal recreation. In England, few national-level descriptive analyses exist which examine predictors of recreation in these environments. Data from seven waves (2009–2016) of a representative survey of the English population (n = 326,756) were analysed to investigate how many recreational visits were made annually to coastal environments in England, which activities were undertaken on these visits, and which demographic, motivational, temporal, and regional factors predict them. Inland environments are presented for comparison. Approximately 271 million recreational visits were made to coastal environments in England annually, the majority involving land-based activities such as walking. Separately, there were around 59 million instances of water-based recreation undertaken on recreational visits (e.g. swimming, water sports). Visits to the coast involving walking were undertaken by a wide spectrum of the population: compared to woodland walks, for instance, coastal walks were more likely to be made by females, older adults, and individuals from lower socioeconomic classifications, suggesting the coast may support reducing activity inequalities. Motivational and temporal variables showed distinct patterns between visits to coastal and inland comparator environments. Regional variations existed too with more visits to coastal environments made by people living in the south-west and north-east compared to London, where more visits were made to urban open spaces. The results provide a reference for current patterns of coastal recreation in England, and could be considered when making policy-level decisions with regard to coastal accessibility and marine plans. Implications for future public health and marine plans are discussed. [ABSTRACT FROM AUTHOR]

The rise in greenhouse gas emissions from air travel could be reduced by individuals voluntarily abstaining from, or reducing, flights for leisure and recreational purposes. In theory, we might expect that people with pro-environmental value orientations and concerns about the risks of climate change, and those who engage in more pro-environmental household behaviours, would also be more likely to abstain from such voluntary air travel, or at least to fly less far. Analysis of two large datasets from the United Kingdom, weighted to be representative of the whole population, tested these associations. Using zero-inflated Poisson regression models, we found that, after accounting for potential confounders, there was no association between individuals’ environmental attitudes, concern over climate change, or their routine pro-environmental household behaviours, and either their propensity to take non-work related flights, or the distances flown by those who do so. These findings contrasted with those for pro-environmental household behaviours, where associations with environmental attitudes and concern were observed. Our results offer little encouragement for policies aiming to reduce discretionary air travel through pro-environmental advocacy, or through ‘spill-over’ from interventions to improve environmental impacts of household routines. [ABSTRACT FROM AUTHOR]

Human health protection at recreational beaches requires accurate and timely information on microbiological conditions to issue advisories. The objective of this study was to develop a new numerical mass balance model for enterococci levels on nonpoint source beaches. The significant advantage of this model is its easy implementation, and it provides a detailed description of the cross-shore distribution of enterococci that is useful for beach management purposes. The performance of the balance model was evaluated by comparing predicted exceedances of a beach advisory threshold value to field data, and to a traditional regression model. Both the balance model and regression equation predicted approximately 70% the advisories correctly at the knee depth and over 90% at the waist depth. The balance model has the advantage over the regression equation in its ability to simulate spatiotemporal variations of microbial levels, and it is recommended for making more informed management decisions. [ABSTRACT FROM AUTHOR]

• A novel and transdisciplinary eco-thriller podcast series was produced by the BBC. • An integrated experiment explored appraisals of changing natural soundscapes. • Participants responded differently to soundscapes with and without audible wildlife. • Lived experience moderated both restorative potential and preservation motivation. • Perceived therapeutic qualities partly mediated desires to preserve natural sounds. Extensive ecosystem degradation and increasing urbanization are altering human relationships with nature. To explore these trends, we created a transdisciplinary, narrative-led podcast series produced by the BBC, called Forest 404. The series explored the implications of a world without nature. An online experimental component mobilized audience participation (n = 7,596) to assess responses to natural soundscapes with and without abiotic, biotic, and poetic elements across five biomes. Conditions featuring the sounds of wildlife, such as bird song, were perceived to be more psychologically restorative than those without. Participants' personal lived experiences were strongly related to these outcomes; those who had memories triggered by the sounds were more likely to find them psychologically restorative and exhibited a greater motivation to preserve them. Moreover, the effects of both soundscape composition and memories on preservation behavior were partially mediated by restorative potential; respondents were more likely to want to protect the sounds they heard if they thought they might offer therapeutic outcomes. Our findings highlight the value of art-science collaborations and demonstrate how maintaining contact with the natural world can promote wellbeing and foster behaviors that protect planetary health. [ABSTRACT FROM AUTHOR]

Abstract: Interdisciplinary research is increasingly promoted in a wide range of fields, especially so in the study of relationships between the environment and human health. However, many projects and research teams struggle to address exactly how researchers from a multitude of disciplinary and methodological backgrounds can best work together to maximize the value of this approach to research. In this paper, we briefly review the role of interdisciplinary research, and emphasise that it is not only our discipline and methods, but our research paradigms, that shape the way that we work. We summarise three key research paradigms – positivism, postpositivism and interpretivism – with an example of how each might approach a given environment-health research issue. In turn, we argue that understanding the paradigm from which each researcher operates is fundamental to enabling and optimizing the integration of research disciplines, now argued by many to be necessary for our understanding of the complexities of the interconnections between human health and our environment as well as their impacts in the policy arena. We recognise that a comprehensive interrogation of research approaches and philosophies would require far greater length than is available in a journal paper. However, our intention is to instigate debate, recognition, and appreciation of the different worlds inhabited by the multitude of researchers involved in this rapidly expanding field. [Copyright &y& Elsevier]

Abstract: Having demonstrated significant and persistent adverse changes in pulmonary function for asthmatics after 1h exposure to brevetoxins in Florida red tide (Karenia brevis bloom) aerosols, we assessed the possible longer term health effects in asthmatics from intermittent environmental exposure to brevetoxins over 7 years. 125 asthmatic subjects were assessed for their pulmonary function and reported symptoms before and after 1h of environmental exposure to Florida red tide aerosols for up to 11 studies over seven years. As a group, the asthmatics came to the studies with normal standardized percent predicted pulmonary function values. The 38 asthmatics who participated in only one exposure study were more reactive compared to the 36 asthmatics who participated in ≥4 exposure studies. The 36 asthmatics participating in ≥4 exposure studies demonstrated no significant change in their standardized percent predicted pre-exposure pulmonary function over the 7 years of the study. These results indicate that stable asthmatics living in areas with intermittent Florida red tides do not exhibit chronic respiratory effects from intermittent environmental exposure to aerosolized brevetoxins over a 7 year period. [Copyright &y& Elsevier]

Abstract: This paper reviews the literature describing research performed over the past decade on the known and possible exposures and human health effects associated with Florida red tides. These harmful algal blooms are caused by the dinoflagellate, Karenia brevis, and similar organisms, all of which produce a suite of natural toxins known as brevetoxins. Florida red tide research has benefited from a consistently funded, long-term research program, that has allowed an interdisciplinary team of researchers to focus their attention on this specific environmental issue—one that is critically important to Gulf of Mexico and other coastal communities. This long-term interdisciplinary approach has allowed the team to engage the local community, identify measures to protect public health, take emerging technologies into the field, forge advances in natural products chemistry, and develop a valuable pharmaceutical product. The review includes a brief discussion of the Florida red tide organisms and their toxins, and then focuses on the effects of these toxins on animals and humans, including how these effects predict what we might expect to see in exposed people. [Copyright &y& Elsevier]

Abstract: Blooms of the toxic dinoflagellate, Karenia brevis, produce potent neurotoxins in marine aerosols. Recent studies have demonstrated acute changes in both symptoms and pulmonary function in asthmatics after only 1h of beach exposure to these aerosols. This study investigated if there were latent and/or sustained effects in asthmatics in the days following the initial beach exposure during periods with and without an active Florida red tide. Symptom data and spirometry data were collected before and after 1h of beach exposure. Subjects kept daily symptom diaries and measured their peak flow each morning for 5 days following beach exposure. During non-exposure periods, there were no significant changes in symptoms or pulmonary function either acutely or over 5 days of follow-up. After the beach exposure during an active Florida red tide, subjects had elevated mean symptoms which did not return to the pre-exposure baseline for at least 4 days. The peak flow measurements decreased after the initial beach exposure, decreased further within 24h, and continued to be suppressed even after 5 days. Asthmatics may continue to have increased symptoms and delayed respiratory function suppression for several days after 1h of exposure to the Florida red tide toxin aerosols. [Copyright &y& Elsevier]

Abstract: Enterococci, are used nationwide as a water quality indicator of marine recreational beaches. Prior research has demonstrated that enterococci inputs to the study beach site (located in Miami, FL) are dominated by non-point sources (including humans and animals). We have estimated their respective source functions by developing a counting methodology for individuals to better understand their non-point source load impacts. The method utilizes camera images of the beach taken at regular time intervals to determine the number of people and animal visitors. The developed method translates raw image counts for week days and weekend days into daily and monthly visitation rates. Enterococci source functions were computed from the observed number of unique individuals for average days of each month of the year, and from average load contributions for humans and for animals. Results indicate that dogs represent the larger source of enterococci relative to humans and birds. [ABSTRACT FROM AUTHOR]

Abstract: The goal of this study was to quantify the microbial load (enterococci) contributed by the different animals that frequent a beach site. The highest enterococci concentrations were observed in dog feces with average levels of 3.9×107 CFU/g; the next highest enterococci levels were observed in birds averaging 3.3×105 CFU/g. The lowest measured levels of enterococci were observed in material collected from shrimp fecal mounds (2.0CFU/g). A comparison of the microbial loads showed that 1 dog fecal event was equivalent to 6940 bird fecal events or 3.2×108 shrimp fecal mounds. Comparing animal contributions to previously published numbers for human bather shedding indicates that one adult human swimmer contributes approximately the same microbial load as one bird fecal event. Given the abundance of animals observed on the beach, this study suggests that dogs are the largest contributing animal source of enterococci to the beach site. [Copyright &y& Elsevier]

The intensive growth of cruise tourism worldwide during recent decades is leading to growing concerns over the sector's global environmental and health impacts. This review combines for the first time various sources of information to estimate the magnitude of the cruise industry's environmental and public health footprints. This research shows that cruising, despite technical advances and some surveillance programmes, remains a major source of air, water (fresh and marine) and land pollution affecting fragile habitats, areas and species, and a potential source of physical and mental human health risks. Health risks impact both the people on board (crew and passengers) and on land (workers of shipyards where cruise ships are dismantled and citizens inhabiting cities with cruise ports and shipyards). In this context, we argue that the cruise industry should be held accountable with more monitoring and regulation to prevent or minimize the growing negative environmental and human health impacts. [Display omitted] • Environmental and human health impacts of cruise tourism are increasing. • Air, water, soil, fragile habitats and areas and wildlife are affected by cruises. • The health of passengers, crew, residents living near cruise ports and workers of shipyards is compromised. • The cruise industry's impacts provide an example of interconnections between human and environmental health. • Cruises should be more closely monitored and regulated to prevent or minimize all impacts. [ABSTRACT FROM AUTHOR]

Background: Early detection of skin cancer by skin examination may reduce its associated morbidity and mortality, in particular for workers routinely exposed to sun. Objectives: We sought to describe the proportion of US workers reporting skin cancer screening examination in a representative sample of the US worker population in the National Health Interview Survey. Methods: Report of skin cancer examination in the 2000 and 2005 National Health Interview Survey cancer control supplements were examined by a range of variables. Results: Lifetime and 12-month reported clinical skin examination prevalence was 15% and 8%, respectively. Workers with elevated occupational exposure to ultraviolet light were less likely to have ever received a skin examination than the average US worker. Logistic regression analysis identified occupational category and age, sex, race, education level, health insurance, and sun-protective behavior as significant independent correlates of skin cancer examination. Limitations: A limitation is potential healthy worker effect and underestimation of skin cancer screening with self-reported data. Conclusions: Routine examination by primary care physicians frequently does not include a thorough skin examination. Physicians should be even more vigilant with patients at increased risk of excessive occupational sun exposure, as early detection of skin cancer by periodic skin examination decreases morbidity and can improve survival. [Copyright &y& Elsevier]

Abstract: Human exposure to Florida red tides formed by Karenia brevis, occurs from eating contaminated shellfish and inhaling aerosolized brevetoxins. Recent studies have documented acute symptom changes and pulmonary function responses after inhalation of the toxic aerosols, particularly among asthmatics. These findings suggest that there are increases in medical care facility visits for respiratory complaints and for exacerbations of underlying respiratory diseases associated with the occurrence of Florida red tides. This study examined whether the presence of a Florida red tide affected the rates of admission with a respiratory diagnosis to a hospital emergency room in Sarasota, FL. The rate of respiratory diagnoses admissions were compared for a 3-month time period when there was an onshore red tide in 2001 (red tide period) and during the same 3-month period in 2002 when no red tide bloom occurred (non-red tide period). There was no significant increase in the total number of respiratory admissions between the two time periods. However, there was a 19% increase in the rate of pneumonia cases diagnosed during the red tide period compared with the non-red tide period. We categorized home residence zip codes as coastal (within 1.6km from the shore) or inland (>1.6km from shore). Compared with the non-red tide period, the coastal residents had a significantly higher (54%) rate of respiratory diagnoses admissions than during the red tide period. We then divided the diagnoses into subcategories (i.e. pneumonia, bronchitis, asthma, and upper airway disease). When compared with the non-red tide period, the coastal zip codes had increases in the rates of admission of each of the subcategories during the red tide period (i.e. 31, 56, 44, and 64%, respectively). This increase was not observed seen in the inland zip codes. These results suggest that the healthcare community has a significant burden from patients, particularly those who live along the coast, needing emergency medical care for both acute and potentially chronic respiratory illnesses during red tide blooms. [Copyright &y& Elsevier]

Florida red tides are a natural phenomenon caused by dense aggregations of single cell or several species of unicellular organisms. Patches of discolored water, dead or dying fish, and respiratory irritants in the air often characterize these algal blooms. In humans, two distinct clinical entities, depending on the route of exposure, are associated with exposure to the Florida red tide toxins (particularly the brevetoxins). With the ingestion of brevetoxin-contaminated shellfish, neurotoxic shellfish poisoning (NSP) presents as a milder gastroenteritis with neurologic symptoms compared with other marine toxin diseases such as paralytic shellfish poisoning (PSP) or ciguatera fish poisoning. With the inhalation of the aerosolized red tide toxins (especially the brevetoxins) from the sea spray, respiratory irritation and possibly other health effects are reported in both humans and other mammals [Nat. Toxins Drugs (1995) 141; Fleming, L.E., Baden, D.G., 1988. Neurotoxic shellfish poisoning: public health and human health effects. White Paper for the Proceedings of the Texas Conference on Neurotoxic Shellfish Poisoning. In: Proceedings of the Texas NSP Conference, Corpus Christi, TX, pp. 27–34; Travel Med, 2 (10) (1998b) 1; Travel Med. 3 (10) (1999a) 1; Toxins Pathol. 26 (2) (1998) 276; J. Allergy Clin. Immunol. 69 (1982) 418; Arch. Intern. Med. 149 (1989) 1735; Toxicon 24 (1986) 955; Florida Med. J. 60 (11) (1773) 27; J. Nat. Toxins 4 (1995) 181; J. Nat. Toxins 4 (1995) 181; Sci. Am. 271 (4) (1994) 62].This paper reviews the literature on the known and possible human health effects of exposure to the Florida red tides and their toxins. The review includes discussion of the red tide organisms and their toxins, as well as the effects of these toxins on both wild and laboratory animals as they relate to possible human health effects and exposures. [Copyright &y& Elsevier]

During two separate Karenia brevis red tide events, we measured the levels of brevetoxins in air and water samples, conducted personal interviews, and performed pulmonary function tests on people before and after they visited one of two Florida beaches. One hundred and twenty-nine people participated in the study, which we conducted during red tide events in Sarasota and Jacksonville, FL, USA. Exposure was categorized into three levels: low/no exposure, moderate exposure, and high exposure. Lower respiratory symptoms (e.g. wheezing) were reported by 8% of unexposed people, 11% of the moderately exposed people, and 28% of the highly exposed people. We performed nasal–pharyngeal swabs on people who experienced moderate or high exposure, and we found an inflammatory response in over 33% of these participants. We did not find any clinically significant changes in pulmonary function test results; however, the study population was small. In future epidemiologic studies, we plan to further investigate the human health impact of inhaled brevetoxins. [Copyright &y& Elsevier]

The blue green algae or cyanobacteria represent a diverse group of organisms that produce potent natural toxins. There have been case reports of severe morbidity and mortality in domestic animals through drinking water contaminated by these toxins. Microcystins, in particular, have been associated with acute liver damage and possibly liver cancer in laboratory animals. Although, there has been little epidemiologic research on toxin effects in humans, a study by found an association between primary liver cancer and surface water. Surface water drinking supplies are particularly vulnerable to the growth of these organisms; current US drinking water treatment practices do not monitor or actively treat for blue green algal toxins including the microcystins.After a monitoring survey in Florida found organisms and microcystins (among other cyanobacterial toxins) in surface water drinking sources, a pilot ecological study was performed using a Geographic Information System (GIS) to evaluate the risk of primary hepatocellular carcinoma (HCC) and proximity to a surface water treatment plant at cancer diagnosis. The study linked all HCC cancers diagnosed in Florida from 1981 to 1998 with environmental databases.A significantly increased risk for HCC with residence within the service area of a surface water treatment plant was found compared to persons living in areas contiguous to the surface water treatment plants. However, this increased risk was not seen in comparison to persons living in randomly selected ground water treatment service areas or compared to the Florida cumulative incidence rate for the study period, using various comparison and GIS methodologies. Furthermore, these findings must be interpreted in light of significant issues of latency, high population mobility, and the lack of individual exposure information. Nevertheless, the issue of acute and chronic human health effects associated with the consumption of surface waters possibly contaminated by blue green algal toxins merits further investigation. [Copyright &y& Elsevier]

• 15-country survey of health-related perceptions of marine plastic pollution. • Public extremely concerned over human health impacts of marine plastic pollution. • Strong public support for research into marine plastic pollution and human health. • Socio-political and personality factors predict public concern and research support. • Public concern is positively associated with support for research. Marine plastic pollution is caused by humans and has become ubiquitous in the marine environment. Despite the widely acknowledged ecological consequences, the scientific evidence regarding detrimental human health impacts is currently debated, and there is no substantive evidence surrounding public opinion with respect to marine plastic pollution and human health. Results from a 15-country survey (n = 15,179) found that both the European and Australian public were highly concerned about the potential human health impacts of marine plastic pollution, and strongly supported the funding of research which aims to better understand its health/wellbeing implications. Multi-level modelling revealed that these perceptions varied across socio-demographic factors (e.g. gender), political orientation, marine contact factors (e.g. marine occupation and engagement in coastal recreation activities) and personality traits (e.g. openness, conscientiousness and agreeableness). Quantifying attitudes, as well as understanding how individual-level differences shape risk perception will enable policy makers and communicators to develop more targeted communications and initiatives that target a reduction in marine plastic pollution. [ABSTRACT FROM AUTHOR]

• In 2019, 22 million adults in England visited natural environments at least weekly. • Physical activity on these visits prevented 12,763 cases of non-communicable disease. • Annual societal costs of the disease avoided were estimated at £108.7 million. • Strategies increasing visitor activity or volume may prevent more cases of disease. Physical activity (PA) reduces the risk of several non-communicable diseases (NCDs). Natural environments support recreational PA. Using data including a representative cross-sectional survey of the English population, we estimated the annual value of nature-based PA conducted in England in 2019 in terms of avoided healthcare and societal costs of disease. Population-representative data from the Monitor of Engagement with the Natural Environment (MENE) survey (n = 47,580; representing 44,386,756) were used to estimate the weekly volume of nature-based recreational PA by adults in England in 2019. We used epidemiological dose–response data to calculate incident cases of six NCDs (ischaemic heart disease (IHD), ischaemic stroke (IS), type 2 diabetes (T2D), colon cancer (CC), breast cancer (BC) and major depressive disorder (MDD)) prevented through nature-based PA, and estimated associated savings using published costs of healthcare, informal care and productivity losses. We investigated additional savings resulting from hypothetical increases in: (a) visitor PA and (b) visitor numbers. In 2019, 22 million adults > 16 years of age in England visited natural environments at least weekly. At reported volumes of nature-based PA, we estimated that 550 cases of IHD, 168 cases of IS, 1,410 cases of T2D, 41 cases of CC, 37 cases of BC and 10,552 cases of MDD were prevented, creating annual savings of £108.7million (95 % uncertainty interval: £70.3million; £150.3million). Nature-based recreational PA in England results in reduced burden of disease and considerable annual savings through prevention of priority NCDs. Strategies that increase nature-based PA could lead to further reductions in the societal burden of NCDs. [ABSTRACT FROM AUTHOR]

Abstract: To enhance information sharing and garner increased support from the public for scientific research, funding agencies now typically require that research groups receiving support convey their work to stakeholders. The National Institute of Environmental Health Sciences (NIEHS) funded Aerosolized Florida Red Tide P01 research group (Florida Red Tide Research Group) has employed a variety of outreach strategies to meet this requirement. Messages developed from this project began a decade ago and have evolved from basic print material (fliers and posters) to an interactive website, to the use of video and social networking technologies, such as Facebook and Twitter. The group was able to track dissemination of these information products; however, evaluation of their effectiveness presented much larger challenges. The primary lesson learned by the Florida Red Tide Research Group is that the best ways to reach specific stakeholders are to develop unique products or services to address specific stakeholders’ needs, such as the Beach Conditions Reporting System. Based on the experience of the Group, the most productive messaging products result when scientific community engages potential stakeholders and outreach experts during the very initial phases of a project. [Copyright &y& Elsevier]

Abstract: The west coast of Florida has annual blooms of the toxin-producing dinoflagellate, Karenia brevis with Sarasota, FL considered the epicenter for these blooms. Numerous outreach materials, including Frequently Asked Question (FAQ) cards, exhibits for local museums and aquaria, public beach signs, and numerous websites have been developed to disseminate information to the public about this natural hazard. In addition, during intense onshore blooms, a great deal of media attention, primarily via newspaper (print and web) and television, is focused on red tide. However to date, the only measure of effectiveness of these outreach methods has been counts of the number of people exposed to the information, e.g., visits to a website or number of FAQ cards distributed. No formal assessment has been conducted to determine if these materials meet their goal of informing the public about Florida red tide. Also, although local residents have the opinion that they are very knowledgeable about Florida red tide, this has not been verified empirically. This study addressed these issues by creating and administering an evaluation tool for the assessment of public knowledge about Florida red tide. A focus group of Florida red tide outreach developers assisted in the creation of the evaluation tool. The location of the evaluation was the west coast of Florida, in Sarasota County. The objective was to assess the knowledge of the general public about Florida red tide. This assessment identified gaps in public knowledge regarding Florida red tides and also identified what information sources people want to use to obtain information on Florida red tide. The results from this study can be used to develop more effective outreach materials on Florida red tide. [ABSTRACT FROM AUTHOR]

Abstract: In a continuing effort to develop suitable methods for the surveillance of harmful algal blooms (HABs) of Karenia brevis using satellite radiometers, a new multi-algorithm method was developed to explore whether improvements in the remote-sensing detection of the Florida Red Tide was possible. A Hybrid Scheme was introduced that sequentially applies the optimized versions of two pre-existing satellite-based algorithms: an Empirical Approach (using water-leaving radiance as a function of chlorophyll concentration) and a Bio-optical Technique (using particulate backscatter along with chlorophyll concentration). The long-term evaluation of the new multi-algorithm method was performed using a multi-year MODIS dataset (2002–2006; during the boreal Summer–Fall periods – July–December) along the Central West Florida Shelf between 25.75°N and 28.25°N. Algorithm validation was done with in situ measurements of the abundances of K. brevis; cell counts ≥1.5×104 cellsl−1 defined a detectable HAB. Encouraging statistical results were derived when either or both algorithms correctly flagged known samples. The majority of the valid match-ups were correctly identified (∼80% of both HABs and non-blooming conditions) and few false negatives or false positives were produced (∼20% of each). Additionally, most of the HAB-positive identifications in the satellite data were indeed HAB samples (positive predictive value: ∼70%) and those classified as HAB-negative were almost all non-bloom cases (negative predictive value: ∼86%). These results demonstrate an excellent detection capability, on average ∼10% more accurate than the individual algorithms used separately. Thus, the new Hybrid Scheme could become a powerful tool for environmental monitoring of K. brevis blooms, with valuable consequences including leading to the more rapid and efficient use of ships to make in situ measurements of HABs. [Copyright &y& Elsevier]

Abstract: Human exposure to brevetoxins during Florida red tide blooms formed by Karenia brevis has been documented to cause acute gastrointestinal, neurologic, and respiratory health effects. Traditionally, the routes of brevetoxin exposure have been through the consumption of contaminated bivalve shellfish and the inhalation of contaminated aerosols. However, recent studies using more sensitive methods have demonstrated the presence of brevetoxins in many components of the aquatic food web which may indicate potential alternative routes for human exposure. This study examined whether the presence of a Florida red tide bloom affected the rates of admission for a gastrointestinal diagnosis to a hospital emergency room in Sarasota, FL. The rates of gastrointestinal diagnoses admissions were compared for a 3-month time period in 2001 when Florida red tide bloom was present onshore to the same 3-month period in 2002 when no Florida red tide bloom occurred. A significant 40% increase in the total number of gastrointestinal emergency room admissions for the Florida red tide bloom period was found compared to the non-red tide period. These results suggest that the healthcare community may experience a significant and unrecognized impact from patients needing emergency medical care for gastrointestinal illnesses during Florida red tide blooms. Thus, additional studies characterizing the potential sources of exposure to the toxins, as well as the dose/effect relationship of brevetoxin exposure, should be undertaken. [Copyright &y& Elsevier]

Many existing residential wood structures, such as playsets and decks, have been treated with chromated copper arsenate (CCA). This preservative chemical can be released from these structures incrementally over time through contact with rainfall. The objective of this study was to evaluate the levels of arsenic and chromium leached from an in-service CCA-treated deck exposed to rainfall, as well as their possible impacts on soils and shallow groundwater. Two monitoring stations, one containing a CCA-treated deck and the other containing an untreated deck as a control, were constructed outside for this study. Rainfall, runoff water from the decks, soils below the decks, and infiltrated water through 0. 7-m depth of soil were monitored for arsenic and chromium over a period of 3 years. The concentration of the CCA-treated deck runoff for arsenic (0. 114–4. 66 mg/L) and chromium (0. 008–0. 470 mg/L) were significantly (p <0. 001) higher than the untreated deck runoff (≤0. 002 mg/L for both). During the 3-year monitoring period, 13% of the arsenic and 1. 4% of the chromium were leached from the amount initially present in the CCA-treated wood. Arsenic levels (<0. 1–46 mg/kg) in soils under the CCA-treated deck were significantly (p <0. 001) higher than under the untreated deck (<0. 1–2. 7 mg/kg), while chromium levels were statistically the same below the two decks (2. 4–9. 6 mg/kg). Approximately 94% of the arsenic from the runoff was absorbed in the soils below the CCA-treated deck; the upper 2. 5 cm of the soils captured 42% of the total. The infiltrated water concentrations for arsenic (<0. 001–0. 085 mg/L) and chromium (<0. 001–0. 010 mg/L) below the CCA-treated deck were both significantly (p <0. 001) higher than below the untreated deck (≤0. 006 mg/L). The amounts of arsenic found in the infiltrated water below the CCA-treated deck represented 6% of total arsenic leached and less than 0. 7% of the initial mass in the wood. The study demonstrated that exposure of a CCA-treated deck to rainfall resulted in elevated arsenic concentrations in both runoff and soil. Although only a relatively small fraction of the initial arsenic from the wood was found to infiltrate through the soil, these impacts were significant and caused the infiltrated water to exceed drinking water standards. The study suggests that potential exposures to arsenic exist indirectly through an environment that is contaminated with arsenic leached from in-service CCA-treated wood. [Copyright &y& Elsevier]

The microbial water quality at two beaches, Hobie Beach and Crandon Beach, in Miami-Dade County, Florida, USA was measured using multiple microbial indicators for the purpose of evaluating correlations between microbes and for identifying possible sources of contamination. The indicator microbes chosen for this study (enterococci, Escherichia coli, fecal coliform, total coliform and C. perfringens) were evaluated through three different sampling efforts. These efforts included daily measurements at four locations during a wet season month and a dry season month, spatially intensive water sampling during low- and high-tide periods, and a sand sampling effort. Results indicated that concentrations did not vary in a consistent fashion between one indicator microbe and another. Daily water quality frequently exceeded guideline levels at Hobie Beach for all indicator microbes except for fecal coliform, which never exceeded the guideline. Except for total coliform, the concentrations of microbes did not change significantly between seasons in spite of the fact that the physical–chemical parameters (rainfall, temperature, pH, and salinity) changed significantly between the two monitoring periods. Spatially intense water sampling showed that the concentrations of microbes were significantly different with distance from the shoreline. The highest concentrations were observed at shoreline points and decreased at offshore points. Furthermore, the highest concentrations of indicator microbe concentrations were observed at high tide, when the wash zone area of the beach was submerged. Beach sands within the wash zone tested positive for all indicator microbes, thereby suggesting that this zone may serve as the source of indicator microbes. Ultimate sources of indicator microbes to this zone may include humans, animals, and possibly the survival and regrowth of indicator microbes due to the unique environmental conditions found within this zone. Overall, the results of this study indicated that the concentrations of indicator microbes do not necessarily correlate with one another. Exceedence of water quality guidelines, and thus the frequency of beach advisories, depends upon which indicator microbe is chosen. [Copyright &y& Elsevier]

There is growing evidence that ecosystem services and especially the exposure to the natural world (blue-green spaces) have potential benefits for mental health and well-being. The COVID-19 pandemic and the measures adopted to control it provide a natural experiment to investigate the links between nature exposure and mental health under extreme conditions. Using a survey distributed online, we tested the following hypotheses: 1) People will show greater symptoms of depression and anxiety under lockdown conditions that did not allow contact with outdoor nature spaces; 2) Where access to public outdoor nature spaces was strictly restricted, (2a) those with green/blue nature view or (2b) access to private outdoor spaces such as a garden or balcony will show fewer symptoms of depression and anxiety, and a more positive mood. Based on 5218 responses from 9 countries, we found that lockdown severity significantly affected mental health, while contact with nature helped people to cope with these impacts, especially for those under strict lockdown. People under strict lockdown in Spain (3403 responses), perceived that nature helped them to cope with lockdown measures; and emotions were more positive among individuals with accessible outdoor spaces and blue-green elements in their views. These findings can help decision-makers in developing potential future lockdown measures to mitigate the negative impacts, helping people to be more resilient and maintain better mental health, using the benefits that ecosystem services are providing us. Unlabelled Image • Lockdown severity is positively associated with poor mental health. • Nature contact 'buffers' the negative effect of lockdown on mental health. • People perceived that nature helped them to cope better with lockdown measures. • Access to outdoor spaces and nature views associated with more positive emotions. [ABSTRACT FROM AUTHOR]

Highlights • Brevetoxins are produced by the marine harmful alga, Karenia brevis (K. brevis); and humans can be exposed to these toxins through a variety of pathways, including inhalation of aerosols and consumption of toxin-contaminated seafood; • Neurological illnesses may also be associated with human exposures to brevetoxins, but to date there has been little research on this specific effect; • During K. brevis blooms in nearby coastal waters, significant increases in visits to emergency departments by older coastal residents (≥55 years) were found specifically for the primary diagnosis of headache (ICD-9 784.0); • In previous studies, older coastal residents were also at increased risk for respiratory illnesses associated with K. brevis blooms; • Preventive measures designed to reduce and limit human exposures to brevetoxins are recommended; and healthcare providers should be instructed to consider brevetoxin exposures and resultant neurological illness as possible diagnoses. Abstract Human respiratory and gastrointestinal illnesses can result from exposures to brevetoxins originating from coastal Florida red tide blooms, comprising the marine alga Karenia brevis (K. brevis). Only limited research on the extent of human health risks and illness costs due to K. brevis blooms has been undertaken to date. Because brevetoxins are known neurotoxins that are able to cross the blood-brain barrier, it is possible that exposure to brevetoxins may be associated with neurological illnesses. This study explored whether K. brevis blooms may be associated with increases in the numbers of emergency department visits for neurological illness. An exposure-response framework was applied to test the effects of K. brevis blooms on human health, using secondary data from diverse sources. After controlling for resident population, seasonal and annual effects, significant increases in emergency department visits were found specifically for headache (ICD-9 784.0) as a primary diagnosis during proximate coastal K. brevis blooms. In particular, an increased risk for older residents (≥55 years) was identified in the coastal communities of six southwest Florida counties during K. brevis bloom events. The incidence of headache associated with K. brevis blooms showed a small but increasing association with K. brevis cell densities. Rough estimates of the costs of this illness were developed for hypothetical bloom occurrences. [ABSTRACT FROM AUTHOR]

The role of neighbourhood nature in promoting good health is increasingly recognised in policy and practice, but consistent evidence for the underlying mechanisms is lacking. Heterogeneity in exposure methods, outcome measures, and population characteristics, little exploration of recreational use or the role of different types of green or blue space, and multiple separate mediation models in previous studies have limited our ability to synthesise findings and draw clear conclusions. We examined multiple pathways linking different types of neighbourhood nature with general health using a harmonised international sample of adults. Using cross-sectional survey data from 18 countries (n = 15,917), we developed a multigroup path model to test theorised pathways, controlling for sociodemographic variables. We tested the possibility that neighbourhood nature (e.g. greenspace, inland bluespace, and coastal bluespace) would be associated with general health through lower air pollution exposure, greater physical activity attainment, more social contact, and higher subjective well-being. However, our central prediction was that associations between different types of neighbourhood nature and general health would largely be serially mediated by recent visit frequency to corresponding environment types, and, subsequently, physical activity, social contact, and subjective well-being associated with these frequencies. Several subsidiary analyses assessed the robustness of the results to alternative model specifications as well as effect modification by sociodemographics. Consistent with this prediction, there was statistical support for eight of nine potential serial mediation pathways via visit frequency which held for a range of alternative model specifications. Effect modification by financial strain, sex, age, and urbanicity altered some associations but did not necessarily support the idea that nature reduced health inequalities. The results demonstrate that across countries, theorised nature-health linkages operate primarily through recreational contact with natural environments. This provides arguments for greater efforts to support use of local green/blue spaces for health promotion and disease prevention. [ABSTRACT FROM AUTHOR]

Despite growing interest in the relationships between natural environments and subjective wellbeing (SWB), previous studies have various methodological and theoretical limitations. Focusing on urban/peri-urban residents (n=7272) from a nationally representative survey of the English population, we explored the relationships between three types of exposure: i) 'neighbourhood exposure', ii) 'visit frequency', and iii) 'specific visit'; and four components of SWB: i) evaluative, ii) eudaimonic, iii) positive experiential and iv) negative experiential. Controlling for area and individual level socio-demographics and other aspects of SWB, visit frequency was associated with eudaimonic wellbeing and a specific visit with positive experiential wellbeing. People who visited nature regularly felt their lives were more worthwhile, and those who visited nature yesterday were happier. The magnitude of the association between weekly nature visits and eudaimonic wellbeing was similar to that between eudaimonic wellbeing and life circumstances such as marital status. Findings are relevant for policies to protect and promote public access to natural environments. [ABSTRACT FROM AUTHOR]

Background Improved data linkages between diverse environment and health datasets have the potential to provide new insights into the health impacts of environmental exposures, including complex climate change processes. Initiatives that link and explore big data in the environment and health arenas are now being established. Objectives To encourage advances in this nascent field, this article documents the development of a web browser application to facilitate such future research, the challenges encountered to date, and how they were addressed. Methods A ‘storyboard approach’ was used to aid the initial design and development of the application. The application followed a 3-tier architecture: a spatial database server for storing and querying data, server-side code for processing and running models, and client-side browser code for user interaction and for displaying data and results. The browser was validated by reproducing previously published results from a regression analysis of time-series datasets of daily mortality, air pollution and temperature in London. Results Data visualisation and analysis options of the application are presented. The main factors that shaped the development of the browser were: accessibility, open-source software, flexibility, efficiency, user-friendliness, licensing restrictions and data confidentiality, visualisation limitations, cost-effectiveness, and sustainability. Conclusions Creating dedicated data and analysis resources, such as the one described here, will become an increasingly vital step in improving understanding of the complex interconnections between the environment and human health and wellbeing, whilst still ensuring appropriate confidentiality safeguards. The issues raised in this paper can inform the future development of similar tools by other researchers working in this field. [ABSTRACT FROM AUTHOR]

Purpose: Cancer affects a growing proportion of US workers. Factors contributing to whether they continue or return to work after cancer diagnosis include: age, physical and mental health, health insurance, education, and cancer site. The purpose of this study was to assess the complex relationships between health indicators and employment status for adult cancer survivors.Methods: We analyzed pooled data from the 1997-2012 US National Health Interview Survey (NHIS). Our sample included adults with a self-reported physician diagnosis of cancer (n = 24,810) and adults with no cancer history (n = 382,837). Using structural equation modeling (SEM), we evaluated the relationship between sociodemographic factors, cancer site, and physical and mental health indicators on the overall health and employment status among adults with a cancer history.Results: The overall model for cancer survivors fit the data well (χ(2) (374) = 3654.7, P < .001; comparative fit index = 0.98; root mean square error of approximation = 0.04). Although black cancer survivors were less likely to report good-to-excellent health, along with Hispanic survivors, they were more likely to continue to work after diagnosis compared with their white counterparts. Health insurance status and educational level were strongly and positively associated with health status and current employment. Age and time since diagnosis were not significantly associated with health status or employment, but there were significant differences by cancer site.Conclusions: A proportion of cancer survivors may continue to work because of employment-based health insurance despite reporting poor health and significant physical and mental health limitations. Acute and long-term health and social support are essential for the continued productive employment and quality of life of all cancer survivors. [ABSTRACT FROM AUTHOR]

Neurotoxic shellfish poisoning (NSP) is caused by the consumption of molluscan shellfish meat contaminated with brevetoxins produced by the dinoflagellate, Karenia brevis ( K. brevis ). During a prolonged and intermittent K. brevis bloom starting in 2005 lasting through early 2007 in the Gulf of Mexico off southwest Florida coast, there were 24 confirmed cases of NSP linked to the consumption of clams recreationally harvested in, or in close proximity to, regulated shellfish harvesting areas; these shellfish beds had already been officially closed to harvesting due to the presence of the K. brevis bloom. The majority of NSP cases (78%) were in “visitors,” either non-Florida residents or Florida residents living outside the county of harvest. The number of confirmed NSP cases was likely an underestimate of the actual number of cases. Current management strategy appears to be effective in limiting the number of NSP cases associated with shellfish harvested commercially during red tide events. In contrast, public notification that shellfish beds are closed to harvest, due to red tides or pathogens, is not reaching all recreational shellfish harvesters and consumers, particularly visitors from outside the county or state. The constantly changing closure status of shellfish harvesting areas in combination with overlooked notifications may lead to an apparent disregard of harvesting restrictions. It is important, therefore, to provide the general public, including visitors and those with language barriers, with improved access to up-to-date information concerning the daily openings and closings of shellfish harvesting areas. Furthermore, the risks of consuming potentially toxic shellfish should be disseminated more broadly. [ABSTRACT FROM AUTHOR]

To mitigate the damages of natural hazards, policy responses can be beneficial only if they are effective. Using a self-administered survey approach, this paper focuses on the adherence to local fertilizer ordinances (i.e., county or municipal rules regulating the application of fertilizer to private lawns or facilities such as golf courses) implemented in jurisdictions along the Southwest Florida coast in response to hazardous blooms of Florida red tides (Karenia brevis). These ordinances play a role in the context of evolving programs of water pollution control at federal, state, water basin, and local levels. With respect to policy effectiveness, while the strength of physical linkages is of critical importance, the extent to which humans affected are aware of and adhere to the relevant rules, is equally critical. We sought to understand the public's depth of understanding about the rationales for local fertilizer ordinances. Respondents in Sarasota, Florida, were asked about their fertilizer practices in an area that has experienced several major blooms of Florida red tides over the past two decades. A highly educated, older population of 305 residents and "snowbirds" reported relatively little knowledge about a local fertilizer ordinance, its purpose, or whether it would change the frequency, size, or duration of red tides. This finding held true even among subpopulations that were expected to have more interest in or to be more knowledgeable about harmful algal blooms. In the face of uncertain science and environmental outcomes, and with individual motivations at odds with evolving public policies, the effectiveness of local community efforts to decrease the impacts of red tides may be compromised. Targeted social-science research on human perceptions about the risks of Florida red tides and education about the rationales for potential policy responses are warranted. [ABSTRACT FROM AUTHOR]

Abstract: Human respiratory and digestive illnesses can be caused by exposures to brevetoxins from blooms of the marine alga Karenia brevis, also known as Florida red tide (FRT). K. brevis requires macro-nutrients to grow; although the sources of these nutrients have not been resolved completely, they are thought to originate both naturally and anthropogenically. The latter sources comprise atmospheric depositions, industrial effluents, land runoffs, or submerged groundwater discharges. To date, there has been only limited research on the extent of human health risks and economic impacts due to FRT. We hypothesized that FRT blooms were associated with increases in the numbers of emergency room visits and hospital inpatient admissions for both respiratory and digestive illnesses. We sought to estimate these relationships and to calculate the costs of associated adverse health impacts. We developed environmental exposure–response models to test the effects of FRT blooms on human health, using data from diverse sources. We estimated the FRT bloom-associated illness costs, using extant data and parameters from the literature. When controlling for resident population, a proxy for tourism, and seasonal and annual effects, we found that increases in respiratory and digestive illnesses can be explained by FRT blooms. Specifically, FRT blooms were associated with human health and economic effects in older cohorts (≥55years of age) in six southwest Florida counties. Annual costs of illness ranged from $60,000 to $700,000 annually, but these costs could exceed $1.0million per year for severe, long-lasting FRT blooms, such as the one that occurred during 2005. Assuming that the average annual illness costs of FRT blooms persist into the future, using a discount rate of 3%, the capitalized costs of future illnesses would range between $2 and 24million. [Copyright &y& Elsevier]

Abstract: The debate over the suitability of molecular biological methods for the enumeration of regulatory microbial parameters (e.g. Faecal Indicator Organisms [FIOs]) in bathing waters versus the use of traditional culture-based methods is of current interest to regulators and the science community. Culture-based methods require a 24–48hour turn-around time from receipt at the laboratory to reporting, whilst quantitative molecular tools provide a more rapid assay (approximately 2–3h). Traditional culturing methods are therefore often viewed as slow and ‘out-dated’, although they still deliver an internationally ‘accepted’ evidence-base. In contrast, molecular tools have the potential for rapid analysis and their operational utility and associated limitations and uncertainties should be assessed in light of their use for regulatory monitoring. Here we report on the recommendations from a series of international workshops, chaired by a UK Working Group (WG) comprised of scientists, regulators, policy makers and other stakeholders, which explored and interrogated both molecular (principally quantitative polymerase chain reaction [qPCR]) and culture-based tools for FIO monitoring under the European Bathing Water Directive. Through detailed analysis of policy implications, regulatory barriers, stakeholder engagement, and the needs of the end-user, the WG identified a series of key concerns that require critical appraisal before a potential shift from culture-based approaches to the employment of molecular biological methods for bathing water regulation could be justified. [Copyright &y& Elsevier]

Abstract: Introduction: While alcohol use has traditionally been thought to decrease with age, several recent studies have shown an increase in heavy drinking among retirees. Florida''s unique population distribution that includes a higher proportion of elderly residents warrants an in-depth look at the drinking patterns in the elderly and how they may differ from those in other areas of the country. However, state-level comparisons of excessive alcohol consumption are limited. Methods: We compared risky drinking (defined as ten or more drinks/week in men and seven or more drinks/week in women; or five or more drinks at one sitting, one or more times/year for both men and women) in Florida to the rest of the US. We used pooled data from the 1997–2010 National Health Interview Survey (NHIS). Results: The prevalence of risky drinking for those aged ≥65 in Florida and the rest of the US was 24.1%, and 21.8%, respectively, compared to 31.9% and 37.4% for all ages in Florida and the rest of the US, respectively. In multivariable analyses of those aged ≥65years, risky drinking was significantly associated with male gender, younger age, non-Hispanic White race/ethnicity, more than a high school education, unemployment (including retirement), lower BMI, and current or former smoking. Floridians aged ≥65 were significantly more likely to report risky drinking than their counterparts in the rest of the US (Odds ratio=1.13; 95% CI: 1.04–1.21), in contrast to analyses of all ages where Floridians were less likely to report risky drinking compared to the rest of the US (0.77; 0.67–0.86). Discussion: Excessive alcohol consumption is an important modifiable risk factor for cancer, cardiovascular disease, and liver disease; a reduction among the elderly has great potential to reduce disease burden. Although Floridians overall were less likely to be risky drinkers than the rest of the US, almost a third of the Florida population reported this behavior. It is, therefore, an important public health concern, particularly in Florida''s older population who are more likely to engage in this behavior than their counterparts in the rest of the US. [Copyright &y& Elsevier]

Abstract: A model study was conducted to understand the influence of non-point sources including bather shedding, animal fecal sources, and near shore sand, as well as the impact of the environmental conditions, on the fate and transport of the indicator microbe, enterococci, at a subtropical recreational marine beach in South Florida. The model was based on an existing finite element hydrodynamic and transport model, with the addition of a first order microbe deactivation function due to solar radiation. Results showed that dog fecal events had a major transient impact (hundreds of Colony Forming Units/100 ml [CFU/100 ml]) on the enterococci concentration in a limited area within several hours, and could partially explain the high concentrations observed at the study beach. Enterococci released from beach sand during high tide caused mildly elevated concentration for a short period of time (ten to twenty of CFU/100 ml initially, reduced to 2 CFU/100 ml within 4 h during sunny weather) similar to the average baseline numbers observed at the beach. Bather shedding resulted in minimal impacts (less than 1 CFU/100 ml), even during crowded holiday weekends. In addition, weak current velocity near the beach shoreline was found to cause longer dwelling times for the elevated concentrations of enterococci, while solar deactivation was found to be a strong factor in reducing these microbial concentrations. [Copyright &y& Elsevier]

Abstract: The marine dinoflagellate, Karenia brevis, is responsible for Florida red tides. Brevetoxins, the neurotoxins produced by K. brevis blooms, can cause fish kills, contaminate shellfish, and lead to respiratory illness in humans. Although several studies have assessed different economic impacts from Florida red tide blooms, no studies to date have considered the impact on beach lifeguard work performance. Sarasota County experiences frequent Florida red tides and staffs lifeguards at its beaches 365 days a year. This study examined lifeguard attendance records during the time periods of March 1 to September 30 in 2004 (no bloom) and March 1 to September 30 in 2005 (bloom). The lifeguard attendance data demonstrated statistically significant absenteeism during a Florida red tide bloom. The potential economic costs resulting from red tide blooms were comprised of both lifeguard absenteeism and presenteeism. Our estimate of the costs of absenteeism due to the 2005 red tide in Sarasota County is about $3000. On average, the capitalized costs of lifeguard absenteeism in Sarasota County may be on the order of $100,000 at Sarasota County beaches alone. When surveyed, lifeguards reported not only that they experienced adverse health effects of exposure to Florida red tide but also that their attentiveness and abilities to take preventative actions decrease when they worked during a bloom, implying presenteeism effects. The costs of presenteeism, which imply increased risks to beachgoers, arguably could exceed those of absenteeism by an order of magnitude. Due to the lack of data, however, we are unable to provide credible estimates of the costs of presenteeism or the potential increased risks to bathers. [Copyright &y& Elsevier]

Abstract: Florida red tides, an annual event off the west coast of Florida, are caused by the toxic dinoflagellate, Karenia brevis. K. brevis produces a suite of potent neurotoxins, brevetoxins, which kill fish, sea birds, and marine mammals, as well as sickening humans who consume contaminated shellfish. These toxins become part of the marine aerosol, and can also be inhaled by humans and other animals. Recent studies have demonstrated a significant increase in symptoms and decrease in lung function in asthmatics after only one hour of beach exposure during an onshore Florida red tide bloom. This study constructed a transect line placing high volume air samplers to measure brevetoxins at sites beginning at the beach, moving approximately 6.4km inland. One non-exposure and 2 exposure studies, each of 5 days duration, were conducted. No toxins were measured in the air during the non-exposure period. During the 2 exposure periods, the amount of brevetoxins varied considerably by site and by date. Nevertheless, brevetoxins were measured at least 4.2km from the beach and/or 1.6km from the coastal shoreline. Therefore, populations sensitive to brevetoxins (such as asthmatics) need to know that leaving the beach may not discontinue their environmental exposure to brevetoxin aerosols. [Copyright &y& Elsevier]

Abstract: Traditionally, the use of enterococci has been recommended as the fecal indicator bacteria of choice for testing marine recreational water quality, and prior studies have shown that bathers shed large numbers of enterococci into the water. The current study expands upon prior research by evaluating shedding from both toddlers and adults, and by the expansion of measurements to include enterococci shedding via three different methods (membrane filter (MF), chromogenic substrate (CS), and quantitative polymerase chain reaction (qPCR)) and shedding of alternative fecal indicator bacteria (Bacteroidales human markers UCD and HF8 via qPCR). Two sets of experiments were conducted. The first experiment consisted of two groups of 10 adults who bathed together in a large pool. The second study consisted of 14 toddlers who bathed individually in a small pool which allowed for sand recovery. Sand recovery was used to estimate the amount of sand transported on the bodies of toddlers and to estimate the number of fecal indicator bacteria released from this sand. The numbers of estimated enterococci shed per adult ranged from 1.8×104 to 2.8×106 CFU, from 1.9×103 to 4.5×106 MPN, and from 3.8×105 to 5.5×106 GEU based on the MF, CS, and qPCR methods, respectively. The estimated numbers of Bacteroidales human markers ranged from 1.8×104 to 1.3×106 for UCD, and ranged from the below detection limit to 1.6×105 for HF8. The estimated amount of sand transported per toddler (n =14) into the water column after sand exposure was 8±6g on average. When normalizing the numbers of enterococci shed from toddlers via sand by the 3.9 body surface area ratio, the differences between toddlers and adults were insignificant. Contributions of sands to the total enterococci (MF) shed per toddler was 3.7±4.4% on average. Although shedding via beach sand may contribute a small fraction of the microbial load during initial bathing, it may have a significant role if bathers go to water repetitively after sand exposure. [Copyright &y& Elsevier]

Abstract: Enterococci, a common fecal indicator, and Staphylococcus aureus, a common skin pathogen, can be shed by bathers affecting the quality of recreational waters and resulting in possible human health impacts. Due to limited information available concerning human shedding of these microbes, this study focused on estimating the amounts of enterococci and S. aureus shed by bathers directly off their skin and indirectly via sand adhered to skin. Two sets of experiments were conducted at a marine beach located in Miami-Dade County, Florida. The first study, referred to as the “large pool” study, involved 10 volunteers who immersed their bodies in 4700L during four 15min cycles with exposure to beach sand in cycles 3 and 4. The “small pool” study involved 10 volunteers who were exposed to beach sand for 30min before they individually entered a small tub. After each individual was rinsed with off-shore marine water, sand and rinse water were collected and analyzed for enterococci. Results from the “large pool” study showed that bathers shed concentrations of enterococci and S. aureus on the order of 6×105 and 6×106 colony forming units (CFU) per person in the first 15min exposure period, respectively. Significant reductions in the bacteria shed per bather (50% reductions for S. aureus and 40% for enterococci) were observed in the subsequent bathing cycles. The “small pool” study results indicated that the enterococci contribution from sand adhered to skin was small (about 2% of the total) in comparison with the amount shed directly from the bodies of the volunteers. Results indicated that bathers transport significant amounts of enterococci and S. aureus to the water column, and thus human microbial bathing load should be considered as a non-point source when designing recreational water quality models. [Copyright &y& Elsevier]

Abstract: The purpose of this study was to examine the distribution of brevetoxin-3 administered to pregnant dams and to determine the extent of placental transport to fetuses. Twenty-nine pregnant CD-1 mice were administered 3H-brevetoxin-3 (∼1.3μCi/animal; ∼2.8μg compound/kg) by intratracheal instillation on one of gestational days 15–18. Groups of four or five dams were killed at selected times through 48h post-dosing. Four pregnant dams were administered 3H-brevetoxin-3 on gestational day 15 or 16 via osmotic minipump to provide continuous delivery of compound (∼0.13μCi, 7.5ng compound/day) over a 72-h period. Then the dams and fetuses were killed. Brevetoxin-associated radioactivity was detected in placentas and fetuses within 0.5h of intratracheal administration. Concentrations of brevetoxin equivalents in fetuses were approximately 0.3ng/g throughout the 48-h post-dosing, resulting in a calculated dose to fetuses of 19ng/gh. Following brevetoxin infusion, concentration of brevetoxin equivalents in fetuses was 0.1ng/g, lower than that present in most maternal tissues. Results demonstrated placental transport of brevetoxin or its metabolites following maternal acute exposure and repeated low-dose exposure. The consequences of these findings for pregnant women exposed to brevetoxins by inhalation or ingestion remain to be determined. [Copyright &y& Elsevier]

Abstract: Microcystins, a family of cyclic heptapeptides produced by the cyanobacteria, Microcystis aeruginosa, have documented hepatotoxic and tumor promoting activities. The purpose of this study was to evaluate the toxicity of inhaled microcystin LR (microcystin). Male BALB/c mice were exposed by nose-only inhalation to 260–265μg microcystin/m3 for 7 days. The low-, mid- and high-dose groups were exposed for 0.5, 1, and 2h, respectively. Control animals were sham exposed to aerosolized vehicle. Treatment-related microscopic lesions were observed only in the nasal cavity of the mid- and high-dose groups. These lesions consisted of minimal to moderate multifocal degeneration and necrosis of the respiratory epithelium, with variable neutrophilic inflammation and minimal to marked degeneration, necrosis, and atrophy of the olfactory epithelium. The no-adverse-effect dose for the nasal lesions was approximately 3μg/kg body weight, or 20ng/cm2 of nasal epithelium. In serum, only two protein peaks, occurring at m/zs of 11,688 and 11,829Da, exhibited decreases in intensity that were microcystin dose-dependent. While these proteins have not been positively identified, they may be useful in the future as biomarkers of microcystin exposure in humans. [Copyright &y& Elsevier]