1. The BEACHES Study: health effects and exposures from non-point source microbial contaminants in subtropical recreational marine waters.
- Author
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Fleisher JM, Fleming LE, Solo-Gabriele HM, Kish JK, Sinigalliano CD, Plano L, Elmir SM, Wang JD, Withum K, Shibata T, Gidley ML, Abdelzaher A, He G, Ortega C, Zhu X, Wright M, Hollenbeck J, and Backer LC
- Subjects
- Adult, Age Factors, Gastrointestinal Diseases etiology, Humans, Middle Aged, Oceans and Seas, Prospective Studies, Respiratory Tract Infections etiology, Sewage microbiology, Sex Factors, Skin Diseases, Bacterial etiology, Time Factors, Water Pollutants analysis, Water Pollution analysis, Bathing Beaches, Enterococcus isolation & purification, Environmental Exposure adverse effects, Gram-Positive Bacterial Infections etiology, Water Pollutants adverse effects, Water Pollution adverse effects
- Abstract
Background: Microbial water-quality indicators, in high concentrations in sewage, are used to determine whether water is safe for recreational purposes. Recently, the use of these indicators to regulate recreational water bodies, particularly in sub/tropical recreational marine waters without known sources of sewage, has been questioned. The objectives of this study were to evaluate the risk to humans from exposure to subtropical recreational marine waters with no known point source, and the possible relationship between microbe densities and reported symptoms in human subjects with random-exposure assignment and intensive individual microbial monitoring in this environment., Methods: A total of 1303 adult regular bathers were randomly assigned to bather and non-bather groups, with subsequent follow-up for reported illness, in conjunction with extensive environmental sampling of indicator organisms (enterococci)., Results: Bathers were 1.76 times more likely to report gastrointestinal illness [95% confidence interval (CI) 0.94-3.30; P = 0.07]; 4.46 times more likely to report acute febrile respiratory illness (95% CI 0.99-20.90; P = 0.051) and 5.91 times more likely to report a skin illness (95% CI 2.76-12.63; P < 0.0001) relative to non-bathers. Evidence of a dose-response relationship was found between skin illnesses and increasing enterococci exposure among bathers [1.46 times (95% CI 0.97-2.21; P = 0.07) per increasing log(10) unit of enterococci exposure], but not for gastrointestinal or respiratory illnesses., Conclusions: This study indicated that bathers may be at increased risk of several illnesses relative to non-bathers, even in the absence of any known source of domestic sewage impacting the recreational marine waters. There was no dose-response relationship between gastroenteritis and increasing exposure to enterococci, even though many current water-monitoring standards use gastroenteritis as the major outcome illness.
- Published
- 2010
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