Document Detail


The BEACHES Study: health effects and exposures from non-point source microbial contaminants in subtropical recreational marine waters.
MedLine Citation:
PMID:  20522483     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jay M Fleisher; Lora E Fleming; Helena M Solo-Gabriele; Jonathan K Kish; Christopher D Sinigalliano; Lisa Plano; Samir M Elmir; John D Wang; Kelly Withum; Tomoyuki Shibata; Maribeth L Gidley; Amir Abdelzaher; Guoqing He; Cristina Ortega; Xiaofang Zhu; Mary Wright; Julie Hollenbeck; Lorraine C Backer
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.     Date:  2010-06-03
Journal Detail:
Title:  International journal of epidemiology     Volume:  39     ISSN:  1464-3685     ISO Abbreviation:  Int J Epidemiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-11-05     Completed Date:  2011-03-10     Revised Date:  2014-09-09    
Medline Journal Info:
Nlm Unique ID:  7802871     Medline TA:  Int J Epidemiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1291-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Bathing Beaches*
Enterococcus / isolation & purification*
Environmental Exposure / adverse effects*
Gastrointestinal Diseases / etiology
Gram-Positive Bacterial Infections / 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 / adverse effects*,  analysis
Water Pollution / adverse effects*,  analysis
Grant Support
ID/Acronym/Agency:
P50 ES012736/ES/NIEHS NIH HHS; P50 ES12736/ES/NIEHS NIH HHS
Chemical
Reg. No./Substance:
0/Sewage; 0/Water Pollutants
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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