期刊
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
卷 39, 期 5, 页码 1291-1298出版社
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyq084
关键词
Gastrointestinal illness; respiratory illness; skin illness; indicator organisms; enterococci; recreational water quality
资金
- National Center for Environmental Health (NCEH), Centers for Disease Control and Prevention (CDC)
- Florida Dept of Health (FL DOH) through Florida Dept of Environmental Protection (FL DEP)
- EPA
- National Science Foundation (NSF)
- National Institute of Environmental Health Sciences (NIEHS) Oceans and Human Health Center at the University of Miami Rosenstiel School [NSF 0CE0432368, NIEHS P50 ES12736]
- NSF REU in Oceans and Human Health
- NSF SGER in Oceans and Human Health [NSF SGER 0743987]
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.
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