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Young I, Sanchez JJ, Sekerciouglu F, Desta BN, Holeton C, Lyng D, Peczulis V, Renwick S, Brooks T, Tustin J. Burden of recreational water illness due to exposure to cyanobacteria and their toxins in freshwater beaches in Canada: protocol of a prospective cohort study. BMJ Open 2024; 14:e085406. [PMID: 38866574 PMCID: PMC11177695 DOI: 10.1136/bmjopen-2024-085406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/31/2024] [Indexed: 06/14/2024] Open
Abstract
INTRODUCTION Cyanobacterial blooms are increasingly common in freshwater sources used for swimming and other recreational water contact activities in Canada. Many species of cyanobacteria can produce toxins that affect human and animal health, but there are limited data on the risk of illness associated with water contact at impacted beaches. METHODS AND ANALYSIS This study will investigate the incidence of recreational water illness due to exposure to cyanobacterial blooms and their toxins in four targeted and popular freshwater beaches in Ontario, Manitoba and Nova Scotia, Canada. A prospective cohort design and One Health approach will be used. On-site recruitment of recreational water users will be conducted at two beaches per year during the summers of 2024 and 2025. The population of interest includes recreational water users of any age and their pet dogs. After enrolment, an in-person survey will determine beach exposures and confounding factors, and a 3-day follow-up survey will ascertain any acute illness outcomes experienced by participants or their dogs. The target sample size is 2500 recreational water users. Water samples will be taken each recruitment day and analysed for cyanobacterial indicators (pigments), cell counts and toxin levels. Bayesian regression analysis will be conducted to estimate the association with water contact, cyanobacterial levels and risks of different acute illness outcomes. ETHICS AND DISSEMINATION This study has been approved by the Toronto Metropolitan University Research Ethics Board (REB 2023-461). Study results will be published in a peer-reviewed journal and as infographics on a project website.
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Affiliation(s)
- Ian Young
- Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - J Johanna Sanchez
- Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Fatih Sekerciouglu
- Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Binyam N Desta
- Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Claire Holeton
- Environmental Monitoring and Reporting Branch, Ontario Ministry of the Environment, Toronto, Ontario, Canada
| | - Dylan Lyng
- Water Science and Watershed Management, Government of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Shane Renwick
- Canadian Veterinary Medical Association, Ottawa, Ontario, Canada
| | - Teresa Brooks
- Water and Air Quality Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Jordan Tustin
- Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
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2
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Blanford WJ, O'Mullan GD. Evaluation of a novel porous antimicrobial media for industrial and HVAC water biocontrol. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2023; 87:2457-2473. [PMID: 37257103 PMCID: wst_2023_076 DOI: 10.2166/wst.2023.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A novel treatment method, consisting of pea-gravel with a marine coating supplemented with alkyldimethylbenzylammonium chloride (ADBAC or benzalkonium chloride), has been examined for its antimicrobial performance and coating stability in aqueous environments. Initial column studies examining the porous media's ability to reduce bacterial loads in heating, ventilation, and air conditioning (HVAC) water found average reductions of 94% from pre-flush levels (106 colony forming unit (CFU)/mL) when assessed with R2A spread plates and 83% reductions with SimPlates. There was no observed statistical difference between the average of pre- and post-flush waters from four tests of the media without ADBAC. Taxonomic identification, by 16S rRNA gene sequencing, of colonies drawn from pre- and post-ABDAC R2A plates showed similarities with taxa observed in high frequency from prior cultivation-independent surveys of other cooling tower systems. With this proof of concept, two versions of the media were evaluated for potential coating components released during aqueous exposure. Neither released measurable volatile organic compounds (VOC) components, but one did release bisphenol A and ABDAC compounds. Subsequent column tests of the more durable coating were conducted using cultures of interest in industrial water and demonstrated significant reductions in neutralized post-column Enterococcus faecalis samples and near complete loss of Legionella pneumophila in non-neutralized fluids, but lower reductions in Pseudomonas aeruginosa.
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Affiliation(s)
- William James Blanford
- School of Earth and Environmental Science, Queens College, CUNY, 6530 Kissena Boulevard, D202 SB, Flushing, NY 11367, USA E-mail: ;
| | - Gregory D O'Mullan
- School of Earth and Environmental Science, Queens College, CUNY, 6530 Kissena Boulevard, D202 SB, Flushing, NY 11367, USA E-mail: ;
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3
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Moulton M, Suanda SH, Garwood JC, Kumar N, Fewings MR, Pringle JM. Exchange of Plankton, Pollutants, and Particles Across the Nearshore Region. ANNUAL REVIEW OF MARINE SCIENCE 2023; 15:167-202. [PMID: 35973720 DOI: 10.1146/annurev-marine-032122-115057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Exchange of material across the nearshore region, extending from the shoreline to a few kilometers offshore, determines the concentrations of pathogens and nutrients near the coast and the transport of larvae, whose cross-shore positions influence dispersal and recruitment. Here, we describe a framework for estimating the relative importance of cross-shore exchange mechanisms, including winds, Stokes drift, rip currents, internal waves, and diurnal heating and cooling. For each mechanism, we define an exchange velocity as a function of environmental conditions. The exchange velocity applies for organisms that keep a particular depth due to swimming or buoyancy. A related exchange diffusivity quantifies horizontal spreading of particles without enough vertical swimming speed or buoyancy to counteract turbulent velocities. This framework provides a way to determinewhich processes are important for cross-shore exchange for a particular study site, time period, and particle behavior.
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Affiliation(s)
- Melissa Moulton
- Climate and Global Dynamics Laboratory, National Center for Atmospheric Research, Boulder, Colorado, USA;
- Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
| | - Sutara H Suanda
- Department of Physics and Physical Oceanography, University of North Carolina Wilmington, Wilmington, North Carolina, USA;
| | - Jessica C Garwood
- College of Earth, Ocean, and Atmospheric Sciences, Oregon State University, Corvallis, Oregon, USA; ,
| | - Nirnimesh Kumar
- Department of Civil and Environmental Engineering, University of Washington, Seattle, Washington, USA
| | - Melanie R Fewings
- College of Earth, Ocean, and Atmospheric Sciences, Oregon State University, Corvallis, Oregon, USA; ,
| | - James M Pringle
- Department of Earth Sciences and Institute for the Study of Earth, Oceans, and Space, University of New Hampshire, Durham, New Hampshire, USA;
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Adolf JE, Weisburg J, Hanna K, Lohnes V. Enterococcus exceedances related to environmental variability at New Jersey ocean beaches. ENVIRONMENTAL MONITORING AND ASSESSMENT 2022; 195:250. [PMID: 36585506 PMCID: PMC9803596 DOI: 10.1007/s10661-022-10788-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
Microbial pollution at ocean beaches is a global public health problem that can be exacerbated by excessive rainfall, particularly at beaches adjacent to urban areas. Rain is acknowledged as a predictive factor of Enterococcus levels at NJ beaches, but to date no study has explicitly examined the link. Here, five beaches (156 observations) in Monmouth County, NJ, with storm drain outflows present were sampled for Enterococcus and water quality during dry and wet periods. Hypotheses included (1) beaches differ in Enterococcus levels, (2) Enterococcus is present year-round, and (3) Enterococcus exceedances could be modeled based on environmental parameters. Beaches showed significantly different median Enterococcus levels, with site SEA2 (Neptune Blvd. in Deal, NJ) lower than others and site SEA4 (South Bath Ave. in Long Branch, NJ) higher than the other sites. Elevated Enterococcus levels were detected at water temperatures from 6.5 to 22.2 °C. Multiple linear regression models identified rainfall (+), water temperature (+), and water level (-) as related to Enterococcus concentrations levels at these beaches. For the purpose of simulating the efficacy of different monitoring strategies, a hindcast model of Enterococcus abundance based on historic rainfall, water temperature, and water level data was produced. Results indicated that once-per-week sampling detected ~14% (e.g., 1/7) exceedance events, while sampling during summer alone detected ~ 50% of annual exceedance events. Models of Enterococcus exceedance based on readily available environmental time series have the potential to supplement and improve Enterococcus monitoring at NJ beaches.
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Affiliation(s)
- Jason E Adolf
- Biology Department, Monmouth University, 400 Cedar Ave., NJ, 07764, West Long Branch, USA.
- Urban Coast Institute, Monmouth University, 400 Cedar Ave., NJ, 07764, West Long Branch, USA.
| | - Jeffrey Weisburg
- Biology Department, Monmouth University, 400 Cedar Ave., NJ, 07764, West Long Branch, USA
| | - Kelly Hanna
- Biology Department, Monmouth University, 400 Cedar Ave., NJ, 07764, West Long Branch, USA
| | - Victoria Lohnes
- Biology Department, Monmouth University, 400 Cedar Ave., NJ, 07764, West Long Branch, USA
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McNair JN, Lane MJ, Hart JJ, Porter AM, Briggs S, Southwell B, Sivy T, Szlag DC, Scull BT, Pike S, Dreelin E, Vernier C, Carter B, Sharp J, Nowlin P, Rediske RR. Validity assessment of Michigan's proposed qPCR threshold value for rapid water-quality monitoring of E. coli contamination. WATER RESEARCH 2022; 226:119235. [PMID: 36257159 DOI: 10.1016/j.watres.2022.119235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/01/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
Michigan's water-quality standards specify that E. coli concentrations at bathing beaches must not exceed 300 E. coli per 100 mL, as determined by the geometric mean of culture-based concentrations in three or more representative samples from a given beach on a given day. Culture-based analysis requires 18-24 h to complete, so results are not available on the day of sampling. This one-day delay is problematic because results cannot be used to prevent recreation at beaches that are unsafe on the sampling day, nor do they reliably indicate whether recreation should be prevented the next day, due to high between-day variability in E. coli concentrations demonstrated by previous studies. By contrast, qPCR-based E. coli concentrations can be obtained in 3-4 h, making same-day beach notification decisions possible. Michigan has proposed a qPCR threshold value (qTV) for E. coli of 1.863 log10 gene copies per reaction as a potential equivalent value to the state standard, based on statistical analysis of a set of state-wide training data from 2016 to 2018. The main purpose of the present study is to assess the validity of the proposed qTV by determining whether the implied qPCR-based beach notification decisions agree well with culture-based decisions on two sets of test data from 2016-2018 (6,564 samples) and 2019-2020 (3,205 samples), and whether performance of the proposed qTV is similar on the test and training data. The results show that performance of Michigan's proposed qTV on both sets of test data was consistently good (e.g., 95% agreement with culture-based beach notification decisions during 2019-2020) and was as good as or better than its performance on the training data set. The false-negative rate for the proposed qTV was 25-29%, meaning that beach notification decisions based on the qTV would be expected to permit recreation on the day of sampling in 25-29% of cases where the beach exceeds the state standard for FIB contamination. This false-negative rate is higher than one would hope to see but is well below the corresponding error rate for culture-based decisions, which permit recreation at beaches that exceed the state standard on the day of sampling in 100% of cases because of the one-day delay in obtaining results. The key advantage of qPCR-based analysis is that it permits a large percentage (71-75%) of unsafe beaches to be identified in time to prevent recreation on the day of sampling.
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Affiliation(s)
- James N McNair
- Robert B. Annis Water Resources Institute, 740 West Shoreline Dr., Muskegon, MI 49441, USA.
| | - Molly J Lane
- Robert B. Annis Water Resources Institute, 740 West Shoreline Dr., Muskegon, MI 49441, USA
| | - John J Hart
- Robert B. Annis Water Resources Institute, 740 West Shoreline Dr., Muskegon, MI 49441, USA
| | - Alexis M Porter
- Robert B. Annis Water Resources Institute, 740 West Shoreline Dr., Muskegon, MI 49441, USA
| | - Shannon Briggs
- Michigan Department of Environment, Great Lakes, and Energy, 525W. Allegan St., Lansing, MI 48909, USA
| | - Benjamin Southwell
- Lake Superior State University, 650W Easterday Ave., Sault Ste Marie, MI 49783, USA
| | - Tami Sivy
- Saginaw Valley State University, Department of Chemistry, 7400 Bay Road, University Center, MI 48710, USA
| | - David C Szlag
- Oakland University, Department of Chemistry, 146 Library Dr., Rochester, MI 48309, USA
| | - Brian T Scull
- Robert B. Annis Water Resources Institute, 740 West Shoreline Dr., Muskegon, MI 49441, USA
| | - Schuyler Pike
- Ferris State University, Shimadzu Core Laboratory, 820 Campus Dr., Big Rapids, MI 49307, USA
| | - Erin Dreelin
- Michigan State University, Department of Fisheries and Wildlife, 420 Wilson Rd, East Lansing, MI 48824, USA
| | - Chris Vernier
- Assurance Water Laboratory, Central Michigan District Health Department, 103N Bowery Ave, Gladwin, MI 48624, USA
| | - Bonnie Carter
- Oakland County Health Division Laboratory, 1200N. Telegraph, Pontiac, MI, 48341, USA
| | - Josh Sharp
- Biology Department, Northern Michigan University, 1401 Presque Isle Avenue, Marquette, MI 49855, USA
| | - Penny Nowlin
- Northern Michigan Regional Lab, Health Department of Northwest Michigan, 95 Livingston Blvd, Gaylord, MI 49735, USA
| | - Richard R Rediske
- Robert B. Annis Water Resources Institute, 740 West Shoreline Dr., Muskegon, MI 49441, USA
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Cyterski M, Shanks OC, Wanjugi P, McMinn B, Korajkic A, Oshima K, Haugland R. Bacterial and viral fecal indicator predictive modeling at three Great Lakes recreational beach sites. WATER RESEARCH 2022; 223:118970. [PMID: 35985141 PMCID: PMC9724166 DOI: 10.1016/j.watres.2022.118970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
Coliphage are viruses that infect Escherichia coli (E. coli) and may indicate the presence of enteric viral pathogens in recreational waters. There is an increasing interest in using these viruses for water quality monitoring and forecasting; however, the ability to use statistical models to predict the concentrations of coliphage, as often done for cultured fecal indicator bacteria (FIB) such as enterococci and E. coli, has not been widely assessed. The same can be said for FIB genetic markers measured using quantitative polymerase chain reaction (qPCR) methods. Here we institute least-angle regression (LARS) modeling of previously published concentrations of cultured FIB (E. coli, enterococci) and coliphage (F+, somatic), along with newly reported genetic concentrations measured via qPCR for E. coli, enterococci, and general Bacteroidales. We develop site-specific models from measures taken at three beach sites on the Great Lakes (Grant Park, South Milwaukee, WI; Edgewater Beach, Cleveland, OH; Washington Park, Michigan City, IN) to investigate the efficacy of a statistical predictive modeling approach. Microbial indicator concentrations were measured in composite water samples collected five days per week over a beach season (∼15 weeks). Model predictive performance (cross-validated standardized root mean squared error of prediction [SRMSEP] and R2PRED) were examined for seven microbial indicators (using log10 concentrations) and water/beach parameters collected concurrently with water samples. Highest predictive performance was seen for qPCR-based enterococci and Bacteroidales models, with F+ coliphage consistently yielding poor performing models. Influential covariates varied by microbial indicator and site. Antecedent rainfall, bird abundance, wave height, and wind speed/direction were most influential across all models. Findings suggest that some fecal indicators may be more suitable for water quality forecasting than others at Great Lakes beaches.
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Affiliation(s)
- Mike Cyterski
- U.S. Environmental Protection Agency, Office of Research and Development, Athens, GA, 30605, United States.
| | - Orin C Shanks
- U.S. Environmental Protection Agency, Office of Research and Development, Cincinnati, OH 45268, United States
| | - Pauline Wanjugi
- New York State Department of Health, Center for Environmental Health, Bureau of Water Supply Protection, New York City Watershed Section, Albany, NY 12201, United States
| | - Brian McMinn
- U.S. Environmental Protection Agency, Office of Research and Development, Cincinnati, OH 45268, United States
| | - Asja Korajkic
- U.S. Environmental Protection Agency, Office of Research and Development, Cincinnati, OH 45268, United States
| | - Kevin Oshima
- U.S. Environmental Protection Agency, Office of Research and Development, Cincinnati, OH 45268, United States
| | - Rich Haugland
- U.S. Environmental Protection Agency, Office of Research and Development, Cincinnati, OH 45268, United States
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7
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Health risks to children from exposure to fecally-contaminated recreational water. PLoS One 2022; 17:e0266749. [PMID: 35413082 PMCID: PMC9004770 DOI: 10.1371/journal.pone.0266749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/27/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Children may be at higher risk for swimming-associated illness following exposure to fecally-contaminated recreational waters. We analyzed a pooled data set of over 80,000 beachgoers from 13 beach sites across the United States to compare risks associated with the fecal indicator bacteria Enterococcus spp. (measured by colony forming units, CFU and quantitative polymerase chain reaction cell equivalents, qPCR CE) for different age groups across different exposures, sites and health endpoints.
Methods
Sites were categorized according to the predominant type of fecal contamination (human or non-human). Swimming exposures of varying intensity were considered according to degree of contact and time spent in the water. Health endpoints included gastrointestinal and respiratory symptoms and skin rashes. Logistic regression models were used to analyze the risk of illness as a function of fecal contamination in water as measured by Enterococcus spp. among the exposed groups. Non-swimmers (those who did not enter the water) were excluded from the models to reduce bias and facilitate comparison across groups.
Results
Gastrointestinal symptoms were the most sensitive health endpoint and strongest associations were observed with Enterococcus qPCR CE at sites impacted by human fecal contamination. Under several exposure scenarios, associations between illness and Enterococcus spp. levels were significantly higher among children compared to adolescents and adults. Respiratory symptoms were also associated with Enterococcus spp. exposures among young children at sites affected by human fecal sources, although small sample sizes resulted in imprecise estimates for these associations.
Conclusion
Under many exposure scenarios, children were at higher risk of illness associated with exposure to fecal contamination as measured by the indicator bacteria Enterococcus spp. The source of fecal contamination and the intensity of swimming exposure were also important factors affecting the association between Enterococcus spp. and swimming-associated illness.
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Farrell ML, Joyce A, Duane S, Fitzhenry K, Hooban B, Burke LP, Morris D. Evaluating the potential for exposure to organisms of public health concern in naturally occurring bathing waters in Europe: A scoping review. WATER RESEARCH 2021; 206:117711. [PMID: 34637971 DOI: 10.1016/j.watres.2021.117711] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/13/2021] [Accepted: 09/22/2021] [Indexed: 06/13/2023]
Abstract
Globally, water-based bathing pastimes are important for both mental and physical health. However, exposure to waterborne organisms could present a substantial public health issue. Bathing waters are shown to contribute to the transmission of illness and disease and represent a reservoir and pathway for the dissemination of antimicrobial resistant (AMR) organisms. Current bathing water quality regulations focus on enumeration of faecal indicator organisms and are not designed for detection of specific waterborne organisms of public health concern (WOPHC), such as antimicrobial resistant (AMR)/pathogenic bacteria, or viruses. This investigation presents the first scoping review of the occurrence of waterborne organisms of public health concern (WOPHC) in identified natural bathing waters across the European Union (EU), which aimed to critically evaluate the potential risk of human exposure and to assess the appropriateness of the current EU bathing water regulations for the protection of public health. Accordingly, this review sought to identify and synthesise all literature pertaining to a selection of bacterial (Campylobacter spp., Escherichia coli, Salmonella spp., Shigella spp., Vibrio spp., Pseudomonas spp., AMR bacteria), viral (Hepatitis spp., enteroviruses, rotavirus, adenovirus, norovirus), and protozoan (Giardia spp., and Cryptosporidium spp.) contaminants in EU bathing waters. Sixty investigations were identified as eligible for inclusion and data was extracted. Peer-reviewed investigations included were from 18 countries across the EU, totalling 87 investigations across a period of 35 years, with 30% published between 2011 and 2015. A variety of water bodies were identified, with 27 investigations exclusively assessing coastal waters. Waterborne organisms were classified into three categories; bacteria, viruses, and protozoa; amounting to 58%, 36% and 17% of the total investigations, respectively. The total number of samples across all investigations was 8,118, with detection of one or more organisms in 2,449 (30%) of these. Viruses were detected in 1281 (52%) of all samples where WOPHC were found, followed by bacteria (865(35%)) and protozoa (303(12%)). Where assessed (442 samples), AMR bacteria had a 47% detection rate, emphasising their widespread occurrence in bathing waters. Results of this scoping review highlight the potential public health risk of exposure to WOPHC in bathing waters that normally remain undetected within the current monitoring parameters.
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Affiliation(s)
- Maeve Louise Farrell
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, National University of Ireland Galway, Ireland; Centre for One Health, Ryan Institute, National University of Ireland Galway, Ireland.
| | - Aoife Joyce
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, National University of Ireland Galway, Ireland; Centre for One Health, Ryan Institute, National University of Ireland Galway, Ireland
| | - Sinead Duane
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, National University of Ireland Galway, Ireland; Centre for One Health, Ryan Institute, National University of Ireland Galway, Ireland; Whitaker Institute, National University of Ireland Galway, Ireland
| | - Kelly Fitzhenry
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, National University of Ireland Galway, Ireland; Centre for One Health, Ryan Institute, National University of Ireland Galway, Ireland
| | - Brigid Hooban
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, National University of Ireland Galway, Ireland; Centre for One Health, Ryan Institute, National University of Ireland Galway, Ireland
| | - Liam P Burke
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, National University of Ireland Galway, Ireland; Centre for One Health, Ryan Institute, National University of Ireland Galway, Ireland
| | - Dearbháile Morris
- Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, National University of Ireland Galway, Ireland; Centre for One Health, Ryan Institute, National University of Ireland Galway, Ireland
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Bruschi A, Lisi I, De Angelis R, Querin S, Cossarini G, Di Biagio V, Salon S, Solidoro C, Fassina D, Ancona S, Silvestri C. Indexes for the assessment of bacterial pollution in bathing waters from point sources: The northern Adriatic Sea CADEAU service. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2021; 293:112878. [PMID: 34091140 DOI: 10.1016/j.jenvman.2021.112878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 04/21/2021] [Accepted: 05/21/2021] [Indexed: 06/12/2023]
Abstract
This paper presents a novel set of water quality indexes to identify the area potentially affected by point sources of bacterial pollution in coastal bathing waters. The indexes, developed in the framework of the CADEAU service, are evaluated on the results of a modelling system based on the integration of a high-resolution ocean model, remote sensing observations and in situ monitoring data for the northern Adriatic Sea. In particular, the system is a downscaling of the Mediterranean Copernicus Marine Environment Monitoring Service and exploits data produced within the Bathing Waters Directive, the Water Framework Directive and the Urban Waste Water Treatment Directive to create added value products. The aim of the proposed indexes is to support the identification of areas of influence for bathing waters by identifying the potential threat from point sources of bacterial pollution, both in standard conditions and peculiar events such as a total bypass of wastewater treatment plants. The results for the Chioggia Municipality case study show the potential of the indexes to significantly improve the geographical identification and quantitative evaluation of the impacts of bacterial pollution sources on bathing waters, facilitating the design of mitigation measures. The proposed methodology represents a new management approach to support local authorities in defining the area of influence within the water bathing profile through the proper characterization of the point sources of bacterial pollution.
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Affiliation(s)
- Antonello Bruschi
- Institute for Environmental Protection and Research (ISPRA), via Vitaliano Brancati 48, 00144, Rome, Italy.
| | - Iolanda Lisi
- Institute for Environmental Protection and Research (ISPRA), via Vitaliano Brancati 48, 00144, Rome, Italy
| | - Roberta De Angelis
- Institute for Environmental Protection and Research (ISPRA), via Vitaliano Brancati 48, 00144, Rome, Italy
| | - Stefano Querin
- National Institute of Oceanography and Applied Geophysics (OGS), Borgo Grotta Gigante 42/C, 34010, Sgonico (TS), Italy
| | - Gianpiero Cossarini
- National Institute of Oceanography and Applied Geophysics (OGS), Borgo Grotta Gigante 42/C, 34010, Sgonico (TS), Italy
| | - Valeria Di Biagio
- National Institute of Oceanography and Applied Geophysics (OGS), Borgo Grotta Gigante 42/C, 34010, Sgonico (TS), Italy
| | - Stefano Salon
- National Institute of Oceanography and Applied Geophysics (OGS), Borgo Grotta Gigante 42/C, 34010, Sgonico (TS), Italy
| | - Cosimo Solidoro
- National Institute of Oceanography and Applied Geophysics (OGS), Borgo Grotta Gigante 42/C, 34010, Sgonico (TS), Italy
| | - Daniel Fassina
- Regional Agency for Environmental Protection of Veneto (ARPAV), Via Ospedale Civile, 24, 35121, Padova, Italy
| | - Sara Ancona
- Regional Agency for Environmental Protection of Veneto (ARPAV), Via Ospedale Civile, 24, 35121, Padova, Italy
| | - Cecilia Silvestri
- Institute for Environmental Protection and Research (ISPRA), via Vitaliano Brancati 48, 00144, Rome, Italy
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10
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Mushi D, Kebede G, Linke RB, Lakew A, Hayes DS, Graf W, Farnleitner AH. Microbial faecal pollution of river water in a watershed of tropical Ethiopian highlands is driven by diffuse pollution sources. JOURNAL OF WATER AND HEALTH 2021; 19:575-591. [PMID: 34371495 DOI: 10.2166/wh.2021.269] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Tropical communities in the developing world depend heavily on riverine systems for their socioeconomic development. However, these resources are poorly protected from diffuse pollution, and there is a lack of quantitative information regarding the microbial pollution characteristics of riverine water, despite frequently reported gastrointestinal diseases. The aim of our study was to apply faecal taxation (i.e., faecal pellet counting in representative test areas to estimate the potential availability of diffuse pollution sources) in combination with a detailed microbiological faecal pollution analysis in a riverine environment to elucidate the importance of diffuse pollution. To realize this approach, ambient faecal pellets, a multiparametric data set for standard faecal indicator bacteria (SFIB), including Escherichia coli, Clostridium perfringens spores and enterococci from catchment soil and river water, and a number of riverine water physicochemical variables were analysed during a one-year cycle. We demonstrated that the abundance of ambient faecal pellets, which were consistently counted at reference sites in the catchment, was associated with faecal pollution in the river water. Water SFIB, dissolved oxygen, nutrients, conductivity and total suspended solids were strongly linked with the abundance of ambient faecal pellets in the river catchment, as demonstrated by principal component analysis (PCA). Elevated concentrations of SFIB in the riverine water in the absence of rainfall also suggested the direct input of faecal bacteria into the riverine water by livestock (e.g., during watering) and humans (e.g., during bathing). Statistical analyses further revealed that the microbiological water quality of the investigated riverine water was not influenced by SFIB potentially occurring in the soil. This study demonstrates the importance of diffuse faecal pollution sources as major drivers of the microbiological quality of riverine water in the Ethiopian highlands. In addition, the new successfully applied integrated approach could be very useful for developing predictive models, which would aid in forecasting riverine microbiological quality in tropical developing countries.
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Affiliation(s)
- Douglas Mushi
- Department of Biosciences, Solomon Mahlangu College of Science and Education, Sokoine University of Agriculture, P.O. Box 3038, Morogoro, Tanzania E-mail: ; Douglas Mushi and Geda Kebede contributed equally to this article
| | - Geda Kebede
- Department of Biological Sciences, Ambo University, P.O. Box 95, Ambo, Ethiopia; Institute of Hydrobiology and Aquatic Ecosystem Management (IHG), BOKU, University of Natural Resources and Life Sciences, Gregor-Mendel-Straße 33, 1180 Vienna, Austria; Douglas Mushi and Geda Kebede contributed equally to this article
| | - Rita B Linke
- Research Group of Environmental Microbiology and Molecular Diagnostics 166/5/3, Institute of Chemical, Environmental and Bioscience Engineering, TU Wien, Gumpendorferstrasse 1A/166, 1060 Vienna, Austria
| | - Aschalew Lakew
- National Fishery and Aquatic Life Research Centre, Ethiopian Institute of Agricultural Research (EIAR), P.O. Box 64, Sebeta, Ethiopia
| | - Daniel S Hayes
- Institute of Hydrobiology and Aquatic Ecosystem Management (IHG), BOKU, University of Natural Resources and Life Sciences, Gregor-Mendel-Straße 33, 1180 Vienna, Austria; Centro de Estudos Florestais (CEF), University of Lisbon, Instituto Superior de Agronomia, Tapada da Ajuda, 1349-017 Lisbon, Portugal
| | - Wolfram Graf
- Institute of Hydrobiology and Aquatic Ecosystem Management (IHG), BOKU, University of Natural Resources and Life Sciences, Gregor-Mendel-Straße 33, 1180 Vienna, Austria
| | - Andreas H Farnleitner
- Research Group of Environmental Microbiology and Molecular Diagnostics 166/5/3, Institute of Chemical, Environmental and Bioscience Engineering, TU Wien, Gumpendorferstrasse 1A/166, 1060 Vienna, Austria; Research Division Water Quality and Health, Department of Pharmacology, Physiology and Microbiology, Karl Landsteiner University for Health Sciences, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria
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11
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Crain C, Kezer K, Steele S, Owiti J, Rao S, Victorio M, Austin B, Volner A, Draper W, Griffith J, Steele J, Seifert M. Application of ddPCR for detection of Enterococcus spp. in coastal water quality monitoring. J Microbiol Methods 2021; 184:106206. [PMID: 33766607 DOI: 10.1016/j.mimet.2021.106206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 11/28/2022]
Abstract
Droplet digital polymerase chain reaction (ddPCR) was evaluated for the detection of fecal indicator bacteria (FIB), Enterococcus spp., in San Diego County beach water samples collected under diverse conditions, from multiple pollution sources, as part of regulatory monitoring activities over 20 months. Two US EPA-approved methods, qPCR (EPA 1609.1) and Enterolert (SM9230D), were used as reference comparator methods. A total of 361 samples were assayed by both ddPCR and qPCR and yielded an acceptable Index of Agreement (IA) of 0.89, based on EPA Site-Specific analysis guidelines. A Pearson's correlation coefficient of r = 0.87 (p < 0.001), further indicated a strong relationship between the methods results. From the 361 samples, 185 split samples with ddPCR and Enterolert values within the limits of quantification, were used as a 'training' data set to derive an intrinsic copy number equation (ICE) for scaling ddPCR gene copy number to Enterolert most probable number (MPN). Of the 1993 samples that comprised the complete 'test' data set assayed by ddPCR and Enterolert, 1086 generated results that fell within the limits of quantification for Enterolert and yielded an overall IA of 0.64. Re-analysis using median as a measure of central tendency to account for significant skewing of Enterolert data yielded an IA of 0.72. Beach grouping-specific IA values ranged from 0.63 to 0.93. Pearson's correlation coefficient, r, ranged from 0.13 to 0.94 within beach groupings and generated a combined value of 0.60 for all groupings. Using the ICE, a ddPCR advisory threshold of 1413 DNA copy number/100 mL was empirically determined to be the equivalent to the California Enterolert beach action threshold of 104 MPN/100 mL, based on comparison with all 1993 paired ddPCR and Enterolert results. Using the 1413 DNA copy number/100 mL as a beach action threshold for ddPCR resulted in a 90.4% agreement with Enterolert (6.0% false negative and 3.7% false positive). Together these findings support the conclusion that ddPCR readouts align closely with Enterolert MPN for identifying FIB exceedance levels of Enterococcus spp. in coastal waters of San Diego, CA.
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Affiliation(s)
- Chad Crain
- California Department of Public Health, Drinking Water and Radiation Laboratory Branch, 850 Marina Bay Pkwy G164, Richmond, CA 94804, United States of America.
| | - Keith Kezer
- San Diego County Department of Environmental Health, 5500 Overland Ave #170, San Diego, CA 92123, United States of America
| | - Syreeta Steele
- San Diego County Public Health Laboratory, 3851 Rosecrans St, San Diego, CA 92110, United States of America
| | - Judith Owiti
- California Department of Public Health, Drinking Water and Radiation Laboratory Branch, 850 Marina Bay Pkwy G164, Richmond, CA 94804, United States of America
| | - Sphoorthy Rao
- California Department of Public Health, Drinking Water and Radiation Laboratory Branch, 850 Marina Bay Pkwy G164, Richmond, CA 94804, United States of America
| | - Maria Victorio
- San Diego County Public Health Laboratory, 3851 Rosecrans St, San Diego, CA 92110, United States of America
| | - Brett Austin
- San Diego County Public Health Laboratory, 3851 Rosecrans St, San Diego, CA 92110, United States of America
| | - Alon Volner
- California Department of Public Health, Drinking Water and Radiation Laboratory Branch, 850 Marina Bay Pkwy G164, Richmond, CA 94804, United States of America
| | - William Draper
- California Department of Public Health, Drinking Water and Radiation Laboratory Branch, 850 Marina Bay Pkwy G164, Richmond, CA 94804, United States of America
| | - John Griffith
- Southern California Coastal Water Research Project, 3535 Harbor Blvd. Suite 110, Costa Mesa, CA 92626, United States of America
| | - Joshua Steele
- Southern California Coastal Water Research Project, 3535 Harbor Blvd. Suite 110, Costa Mesa, CA 92626, United States of America
| | - Marva Seifert
- University of California San Diego, 9500 Gilman Dr, La Jolla, CA 92093, United States of America
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12
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Searcy RT, Boehm AB. A Day at the Beach: Enabling Coastal Water Quality Prediction with High-Frequency Sampling and Data-Driven Models. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:1908-1918. [PMID: 33471505 DOI: 10.1021/acs.est.0c06742] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
To reduce the incidence of recreational waterborne illness, fecal indicator bacteria (FIB) are measured to assess water quality and inform beach management. Recently, predictive FIB models have been used to aid managers in making beach posting and closure decisions. However, those predictive models must be trained using rich historical data sets consisting of FIB and environmental data that span years, and many beaches lack such data sets. Here, we investigate whether water quality data collected during discrete short duration, high-frequency beach sampling events (e.g., samples collected at sub-hourly intervals for 24-48 h) are sufficient to train predictive models that can be used for beach management. We use data collected during six high-frequency sampling events at three California marine beaches and train a total of 126 models using common data-driven techniques. Tide, solar irradiation, water temperature, significant wave height, and offshore wind speed were found to be the most important environmental variables in the models. We validate the predictive performance of models using withheld data. Random forests are consistently the top performing model type. Overall, we find that data-driven models trained using high-frequency FIB and environmental data perform well at predicting water quality and can be used to inform public health decisions at beaches.
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Affiliation(s)
- Ryan T Searcy
- Department of Civil & Environmental Engineering, Stanford University, 473 Via Ortega, Stanford, Palo Alto 94305, California, United States
| | - Alexandria B Boehm
- Department of Civil & Environmental Engineering, Stanford University, 473 Via Ortega, Stanford, Palo Alto 94305, California, United States
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13
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Myers EM, Juhl AR. Particle association of Enterococcus sp. increases growth rates and simulated persistence in water columns of varying light attenuation and turbulent diffusivity. WATER RESEARCH 2020; 186:116140. [PMID: 33096438 DOI: 10.1016/j.watres.2020.116140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/22/2020] [Accepted: 07/02/2020] [Indexed: 06/11/2023]
Abstract
Predicting water quality and the human health risks associated with sewage-derived microbes requires understanding the fate and transport of these contaminants. Sewage-derived pathogen risks are typically assessed and monitored by measuring concentrations of fecal indicating bacteria (FIB), like Enterococcus sp. Previous research demonstrated that a high fraction of FIB is particle-associated, which can alter FIB dynamics within secondary water bodies. In this study, we experimentally quantified the effect of particle association on dark, temperature- and light-dependent growth and sinking rates of enterococci. Particle association significantly increased dark growth rates, light-dependent growth rates (i.e. decreased mortality), and sinking rates, relative to free-living enterococci. Simulations using a novel, 1-dimensional model parameterized by these rates indicate greater persistence (T90) for particle-associated enterococci in water bodies across a wide range of diffuse attenuation coefficients of light (Kd) and turbulent diffusivity (D) values. In addition, persistence of both fractions increased in simulated turbid and turbulent waters, compared to clear and/or quiescent conditions. Simulated persistence of both fractions also increased when enterococci discharges occurred later in a diel cycle (towards sunset, as opposed to sunrise), especially for the free-living population, because later discharges under our model conditions allowed both fractions to mix deeper before inactivation via sunlight. Model sensitivity testing revealed that T90 variability was greatest when dark growth rates were altered, suggesting that future empirical studies should focus on quantifying these rates for free-living and particle-associated sewage-derived microbes. Despite greater sensitivity of T90 to variability in dark growth rates, omitting light-dependent growth rates from simulations dramatically influenced T90 values. Our results demonstrate that particle association can increase enterococci persistence in receiving waters and highlight the importance of incorporating particle association in future water quality models.
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Affiliation(s)
- Elise M Myers
- Columbia University, 535 W 116th Street, New York, NY, 10027, USA; Lamont Doherty Earth Observatory, 61 Route 9W, Palisades, NY, 10964, USA.
| | - Andrew R Juhl
- Columbia University, 535 W 116th Street, New York, NY, 10027, USA; Lamont Doherty Earth Observatory, 61 Route 9W, Palisades, NY, 10964, USA
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14
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Jamal R, Mubarak S, Sahulka SQ, Kori JA, Tajammul A, Ahmed J, Mahar RB, Olsen MS, Goel R, Weidhaas J. Informing water distribution line rehabilitation through quantitative microbial risk assessment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 739:140021. [PMID: 32758946 DOI: 10.1016/j.scitotenv.2020.140021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/01/2020] [Accepted: 06/04/2020] [Indexed: 06/11/2023]
Abstract
Poor urban water quality has been linked to diminished source water quality, poorly functioning water treatment systems and infiltration into distribution lines after treatment resulting in microbiological contamination. With limited funding to rehabilitate distribution lines, developing nations need tools to identify the areas of greatest concern to human health so as to target cost effective remediation approaches. Herein, a case study of Hyderabad, Pakistan was used to demonstrate the efficacy of combining quantitative microbial risk assessment (QMRA) for multiple pathogens with spatial distribution system modeling to identify areas for pipe rehabilitation. Abundance of Escherichia coli, Enterococcus (enterococci), Salmonella spp., Shigella spp., Giardia intestinalis, Vibrio cholera, norovirus GI and adenovirus 40/41, were determined in 85 locations including the source water, treatment plant effluent and the city distribution lines. Bayesian statistics and Monte Carlo simulations were used in the QMRA to account for left-censored microbial abundance distributions. Bacterial and viral abundances in the distribution system samples decreased as follows: 9400 ± 19,800 norovirus gene copies/100 mL (average ± standard deviation, 100% of samples positive); 340 ± 2200 enterococci CFU/100 mL (94%), 71 ± 97 Shigella sp. CFU/100 mL (97%), 60 ± 360 E. coli CFU/100 mL (89%), 35 ± 79 adenovirus gene copies/100 mL (100%), and 21 ± 46 Salmonella sp. CFU/100 mL (76%). The QMRA revealed unacceptable probabilities of illness (>1 in 10,000 illness level) from the four exposure routes considered (drinking water, or only showering, tooth brushing, and rinsing vegetables consumed raw). Disease severity indices based on the QMRA combined with mapping the distribution system revealed areas for targeted rehabilitation. The combined intensive sampling, risk assessment and mapping can be used in low- and middle-income countries to target distribution system rehabilitation efforts and improve health outcomes.
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Affiliation(s)
- Rubayat Jamal
- Civil and Environmental Engineering, University of Utah, 110 Central Campus Drive Suite 2000, Salt Lake City, UT 84112, USA
| | - Shaista Mubarak
- US Pakistan Center for Advanced Studies in Water, Mehran University of Engineering and Technology, Jamshoro, 76062, Sindh, Pakistan
| | - Sierra Q Sahulka
- Civil and Environmental Engineering, University of Utah, 110 Central Campus Drive Suite 2000, Salt Lake City, UT 84112, USA
| | - Junaid A Kori
- US Pakistan Center for Advanced Studies in Water, Mehran University of Engineering and Technology, Jamshoro, 76062, Sindh, Pakistan
| | - Ayesha Tajammul
- US Pakistan Center for Advanced Studies in Water, Mehran University of Engineering and Technology, Jamshoro, 76062, Sindh, Pakistan
| | - Jamil Ahmed
- US Pakistan Center for Advanced Studies in Water, Mehran University of Engineering and Technology, Jamshoro, 76062, Sindh, Pakistan
| | - Rasool B Mahar
- US Pakistan Center for Advanced Studies in Water, Mehran University of Engineering and Technology, Jamshoro, 76062, Sindh, Pakistan
| | | | - Ramesh Goel
- Civil and Environmental Engineering, University of Utah, 110 Central Campus Drive Suite 2000, Salt Lake City, UT 84112, USA
| | - Jennifer Weidhaas
- Civil and Environmental Engineering, University of Utah, 110 Central Campus Drive Suite 2000, Salt Lake City, UT 84112, USA.
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15
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Lane MJ, Rediske RR, McNair JN, Briggs S, Rhodes G, Dreelin E, Sivy T, Flood M, Scull B, Szlag D, Southwell B, Isaacs NM, Pike S. A comparison of E. coli concentration estimates quantified by the EPA and a Michigan laboratory network using EPA Draft Method C. J Microbiol Methods 2020; 179:106086. [PMID: 33058947 DOI: 10.1016/j.mimet.2020.106086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 10/09/2020] [Accepted: 10/09/2020] [Indexed: 01/15/2023]
Abstract
We evaluated data from 10 laboratories that analyzed water samples from 82 recreational water sites across the state of Michigan between 2016 and 2018. Water sample replicates were analyzed by experienced U.S. Environmental Protection Agency (EPA) analysts and Michigan laboratories personnel, many of whom were newly trained, using EPA Draft Method C-a rapid quantitative polymerase chain reaction (qPCR) technique that provides same day Escherichia coli (E. coli) concentration results. Beach management decisions (i.e. remain open or issue an advisory or closure) based on E. coli concentration estimates obtained by Michigan labs and by the EPA were compared; the beach management decision agreed in 94% of the samples analyzed. We used the Wilcoxon one-sample signed rank test and nonparametric quantile regression to assess (1) the degree of agreement between E. coli concentrations quantified by Michigan labs versus the EPA and (2) Michigan lab E. coli measurement precision, relative to EPA results, in different years and water body types. The median quantile regression curve for Michigan labs versus EPA approximated the 1:1 line of perfect agreement more closely as years progressed. Similarly, Michigan lab E. coli estimates precision also demonstrated yearly improvements. No meaningful difference was observed in the degree of association between Michigan lab and EPA E. coli concentration estimates for inland lake and Great Lakes samples (median regression curve average slopes 0.93 and 0.95, respectively). Overall, our study shows that properly trained laboratory personnel can perform Draft Method C to a degree comparable with experienced EPA analysts. This allows health departments that oversee recreational water quality monitoring to be confident in qPCR results generated by the local laboratories responsible for analyzing the water samples.
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Affiliation(s)
- Molly J Lane
- Annis Water Resources Institute, Grand Valley State University, 1 Campus Dr., Allendale, MI 49401, USA.
| | - Richard R Rediske
- Annis Water Resources Institute, Grand Valley State University, 1 Campus Dr., Allendale, MI 49401, USA.
| | - James N McNair
- Annis Water Resources Institute, Grand Valley State University, 1 Campus Dr., Allendale, MI 49401, USA.
| | - Shannon Briggs
- Michigan Department of Environment, Great Lakes and Energy (EGLE), 525 W. Allegan St., Lansing, MI 48909, USA.
| | - Geoff Rhodes
- Michigan Department of Environment, Great Lakes and Energy (EGLE), 525 W. Allegan St., Lansing, MI 48909, USA.
| | - Erin Dreelin
- Michigan State University, Department of Fisheries and Wildlife, Natural Resource Building, 420 Wilson Rd, Room 13, East Lansing, MI 48824, USA.
| | - Tami Sivy
- Saginaw Valley State University, Department of Chemistry, 7400 Bay Road, University Center, MI 48710, USA.
| | - Matthew Flood
- Michigan State University, Department of Fisheries and Wildlife, Natural Resource Building, 420 Wilson Rd, Room 13, East Lansing, MI 48824, USA.
| | - Brian Scull
- Annis Water Resources Institute, Grand Valley State University, 1 Campus Dr., Allendale, MI 49401, USA.
| | - David Szlag
- Oakland University, Department of Chemistry, 146 Library Dr., Rochester, MI 48309, USA.
| | - Benjamin Southwell
- Lake Superior State University, 650 W Easterday Ave., Sault Ste Marie, MI 49783, USA.
| | - Natasha M Isaacs
- U.S. Geological Survey (USGS), Upper Midwest Water Science Center, 5840 Enterprise Dr., Lansing, MI 48911, USA.
| | - Schuyler Pike
- Ferris State University, Shimadzu Core Laboratory for Academic and Research Excellence, 820 Campus Dr., Big Rapids, MI 49307, USA.
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16
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Holcomb DA, Stewart JR. Microbial Indicators of Fecal Pollution: Recent Progress and Challenges in Assessing Water Quality. Curr Environ Health Rep 2020; 7:311-324. [PMID: 32542574 PMCID: PMC7458903 DOI: 10.1007/s40572-020-00278-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Fecal contamination of water is a major public health concern. This review summarizes recent developments and advancements in water quality indicators of fecal contamination. RECENT FINDINGS This review highlights a number of trends. First, fecal indicators continue to be a valuable tool to assess water quality and have expanded to include indicators able to detect sources of fecal contamination in water. Second, molecular methods, particularly PCR-based methods, have advanced considerably in their selected targets and rigor, but have added complexity that may prohibit adoption for routine monitoring activities at this time. Third, risk modeling is beginning to better connect indicators and human health risks, with the accuracy of assessments currently tied to the timing and conditions where risk is measured. Research has advanced although challenges remain for the effective use of both traditional and alternative fecal indicators for risk characterization, source attribution and apportionment, and impact evaluation.
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Affiliation(s)
- David A Holcomb
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr., Chapel Hill, NC, 27599-7435, USA
| | - Jill R Stewart
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr., Chapel Hill, NC, 27599-7431, USA.
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17
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Federigi I, Bonadonna L, Bonanno Ferraro G, Briancesco R, Cioni L, Coccia AM, Della Libera S, Ferretti E, Gramaccioni L, Iaconelli M, La Rosa G, Lucentini L, Mancini P, Suffredini E, Vicenza T, Veneri C, Verani M, Carducci A. Quantitative Microbial Risk Assessment as support for bathing waters profiling. MARINE POLLUTION BULLETIN 2020; 157:111318. [PMID: 32658683 DOI: 10.1016/j.marpolbul.2020.111318] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/02/2020] [Accepted: 05/24/2020] [Indexed: 06/11/2023]
Abstract
Profiling bathing waters supported by Quantitative Microbial Risk Assessment (QMRA) is key to the WHO's recommendations for the 2020/2021 revision of the European Bathing Water Directive. We developed an area-specific QMRA model on four pathogens, using fecal indicator concentrations (E. coli, enterococci) for calculating pathogen loads. The predominance of illness was found to be attributable to Human Adenovirus, followed by Salmonella, Vibrio, and Norovirus. Overall, the cumulative illness risk showed a median of around 1 case/10000 exposures. The risk estimates were strongly influenced by the indicators that were used, suggesting the need for a more detailed investigation of the different sources of fecal contamination. Area-specific threshold values for fecal indicators were estimated on a risk-basis by modelling the cumulative risk against E. coli and enterococci concentrations. To improve bathing waters assessment, we suggest considering source apportionment, locally estimating of pathogen/indicator ratios, and calculating site-specific indicators thresholds based on risk assessment.
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Affiliation(s)
| | - Lucia Bonadonna
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Rossella Briancesco
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Lorenzo Cioni
- Scuola Normale Superiore, Piazza dei Cavalieri 7, 56123 Pisa, Italy
| | - Anna Maria Coccia
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Emanuele Ferretti
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Marcello Iaconelli
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Giuseppina La Rosa
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Luca Lucentini
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Pamela Mancini
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Elisabetta Suffredini
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Teresa Vicenza
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Carolina Veneri
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Verani
- Department of Biology, University of Pisa, Pisa, Italy
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18
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Russo GS, Eftim SE, Goldstone AE, Dufour AP, Nappier SP, Wade TJ. Evaluating health risks associated with exposure to ambient surface waters during recreational activities: A systematic review and meta-analysis. WATER RESEARCH 2020; 176:115729. [PMID: 32240845 DOI: 10.1016/j.watres.2020.115729] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/13/2020] [Accepted: 03/15/2020] [Indexed: 05/26/2023]
Abstract
Recreational water quality guidelines protect the public from health risks associated with water recreation by helping to prevent unacceptable concentrations of pathogenic organisms in ambient water. However, illness risk is associated with both the concentration of pathogens in the water and the degree of contact with those pathogens. Different recreational activities can result in different levels of contact with ambient water containing water-borne pathogens. We conducted a systematic literature review and meta-analysis to evaluate risks of illness associated with different recreational activities and different levels of contact to ambient surface waters. We screened 8,618 potentially relevant studies for quantitative measures of risk using inclusion/exclusion criteria established in advance. We categorized recreational activities as swimming, sports-related contact, minimal contact, and sand contact. We combined relative risks using a random effects meta-analysis for adverse health outcome categories representing gastrointestinal illness, respiratory illness, skin, eye, ear, nose, throat, and cold/flu illness. We identified 92 studies meeting our inclusion criteria. Pooled risk estimates indicate significant elevation of gastrointestinal illness with the recreational activity categories swimming (2.19, 95% CI: 1.82, 2.63) and sports-related contact (2.69, 95% CI: 1.04, 6.92), and nonsignificant elevation of gastrointestinal illness with minimal contact (1.27, 95% CI: 0.74, 2.16). We also found a significant elevation of respiratory illness with swimming (1.78, 95% CI: 1.38, 2.29) and sports-related contact (1.49, 95% CI: 1.00, 2.24), and no elevation of respiratory illness with minimal contact (0.90, 95% CI: 0.71, 1.14). This study suggests that exposures associated with different types of recreational activities are important characteristics of the exposure pathway when assessing illness risk associated with recreation in ambient surface waters.
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Affiliation(s)
- Gary S Russo
- U.S. Environmental Protection Agency, Office of Water, Office of Science and Technology, Standards and Health Protection Division, 1200 Pennsylvania Avenue, NW, Mail Code 4305T, Washington, DC, 20460, USA.
| | | | | | - Alfred P Dufour
- U.S. Environmental Protection Agency, National Exposure Research Laboratory, 26 West Martin Luther King Drive, Mail Code 587, Cincinnati, OH, 45268, USA
| | - Sharon P Nappier
- U.S. Environmental Protection Agency, Office of Water, Office of Science and Technology, Health and Ecological Division, 1200 Pennsylvania Avenue, NW, Mail Code 4304T, Washington, DC, 20460, USA
| | - Timothy J Wade
- U.S. Environmental Protection Agency, National Health and Environmental Effects Research Laboratory, 109 T.W. Alexander Drive, Mail Code 58C, Research Triangle Park, NC, 27709, USA
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19
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Leonard AFC, Garside R, Ukoumunne OC, Gaze WH. A cross-sectional study on the prevalence of illness in coastal bathers compared to non-bathers in England and Wales: Findings from the Beach User Health Survey. WATER RESEARCH 2020; 176:115700. [PMID: 32234605 DOI: 10.1016/j.watres.2020.115700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 02/12/2020] [Accepted: 03/06/2020] [Indexed: 06/11/2023]
Abstract
The risks of illness associated with bathing in UK coastal waters have not been quantified since the early 1990s. Efforts have been made since then to improve the quality of bathing waters. The aim of this study was to quantify the prevalence of symptoms of illness associated with sea bathing in bathers in England and Wales. A cross-sectional study was conducted between June 2014 and April 2015. An online survey collected information from sea bathers and non-bathers on their visits to beaches in England and Wales along with the occurrence of symptoms of illness. 2631 people (1693 bathers, 938 non-bathers) responded to the survey. Compared to non-bathers, bathers were more likely to report skin ailments (adjusted prevalence odds ratio (AOR) = 2.64, 95% confidence interval (CI) 1.23 to 5.65, p = 0.01), ear ailments (AOR = 3.77, 95% CI 1.84 to 7.73, p < 0.001), and any symptoms of illness (AOR = 3.73, 95% CI 2.63 to 5.29, p < 0.001). There was weak evidence of an increase in the odds of gastrointestinal illness (AOR = 1.59, 95% CI 0.96 to 2.65, p = 0.07), respiratory ailments (AOR = 2.44, 95% CI 0.92 to 6.48, p = 0.07) and eye ailments (AOR = 2.12, 95% CI 0.83 to 5.39, p = 0.11). While the study design does not allow inference of causality, we do observe an association between sea bathing in England and Wales and reported symptoms of ill health. This suggests that despite higher rates of compliance with water quality criteria among bathing waters nowadays, the odds of illness for bathers relative to non-bathers is similar in magnitude to estimates made in the 1990s.
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Affiliation(s)
- Anne F C Leonard
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, TR1 3HD, UK.
| | - Ruth Garside
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, TR1 3HD, UK
| | - Obioha C Ukoumunne
- National Institute for Health Research Applied Research Collaboration South West Peninsula, University of Exeter Medical School, Exeter, EX1 2LU, UK
| | - William H Gaze
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, TR1 3HD, UK.
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20
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DeFlorio-Barker S, Holman D, Landolfi R, Arnold BF, Colford JM, Weisberg SB, Schiff KC, Sams EA, Wade TJ. Incidence and public health burden of sunburn among beachgoers in the United States. Prev Med 2020; 134:106047. [PMID: 32142856 PMCID: PMC7271251 DOI: 10.1016/j.ypmed.2020.106047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 12/28/2022]
Abstract
The beach environment creates many barriers to effective sun protection, putting beachgoers at risk for sunburn, a well-established risk factor for skin cancer. Our objective was to estimate incidence of sunburn among beachgoers and evaluate the relationship between sunburn incidence and sun-protective behaviors. A secondary analysis, of prospective cohorts at 12 locations within the U.S. from 2003 to 2009 (n = 75,614), were pooled to evaluate sunburn incidence 10-12 days after the beach visit. Behavioral and environmental conditions were cross-tabulated with sunburn incidence. Multivariable logistic regression was used to estimate the association between new sunburn and sun-protective behaviors. Overall, 13.1% of beachgoers reported sunburn. Those aged 13-18 years (16.5%), whites (16.0%), and those at beach locations along the Eastern Seaboard (16.1%), had the highest incidence of sunburn. For those spending ≥5 h in the sun, the use of multiple types of sun protection reduced odds of sunburn by 55% relative to those who used no sun protection (Odds Ratio = 0.45 (95% Confidence Interval:0.27-0.77)) after adjusting for skin type, age, and race. Acute health effects of sunburn tend to be mild and self-limiting, but potential long-term health consequences are more serious and costly. Efforts to encourage and support proper sun-protective behaviors, and increase access to shade, protective clothing, and sunscreen, can help prevent sunburn and reduce skin cancer risk among beachgoers.
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Affiliation(s)
- Stephanie DeFlorio-Barker
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, 109 T.W. Alexander Drive M/D B243-01, Research Triangle Park, NC 27709, USA.
| | - Dawn Holman
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Robert Landolfi
- Office of Atmospheric Programs, Office of Air and Radiation, U.S. Environmental Protection Agency, Washington, DC, USA.
| | - Benjamin F Arnold
- Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
| | - John M Colford
- Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
| | - Stephen B Weisberg
- Southern California Coastal Water Research Project Authority, Costa Mesa, CA, USA.
| | - Kenneth C Schiff
- Southern California Coastal Water Research Project Authority, Costa Mesa, CA, USA.
| | - Elizabeth A Sams
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, 109 T.W. Alexander Drive M/D B243-01, Research Triangle Park, NC 27709, USA.
| | - Timothy J Wade
- Center for Public Health and Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, 109 T.W. Alexander Drive M/D B243-01, Research Triangle Park, NC 27709, USA.
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21
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Verhougstraete MP, Pogreba-Brown K, Reynolds KA, Lamparelli CC, Zanoli Sato MI, Wade TJ, Eisenberg JNS. A critical analysis of recreational water guidelines developed from temperate climate data and applied to the tropics. WATER RESEARCH 2020; 170:115294. [PMID: 31765827 PMCID: PMC6962556 DOI: 10.1016/j.watres.2019.115294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/29/2019] [Accepted: 11/08/2019] [Indexed: 06/10/2023]
Abstract
Recreational water epidemiology studies are rare in settings with minimal wastewater treatment where risk may be highest, and in tropical settings where warmer temperature influences the ecology of fecal indicator bacteria commonly used to monitor recreational waters. One exception is a 1999 study conducted in São Paulo Brazil. We compared the risk and exposure characteristics of these data with those conducted in the United Kingdom (UK) in the early 1990s that are the basis of the World Health Organization's (WHO) guidelines on recreational water risks. We then developed adjusted risk difference models (excess gastrointestinal illness per swimming event) for children (<10 years of age) and non-children (≥10 years of age) across five Brazil beaches. We used these models along with beach water quality data from 2004 to 2015 to assess spatial and temporal trends in water quality and human risk. Risk models indicate that children in Brazil have as much as two times the risk of gastrointestinal illness than non-children. In Brazil, 11.8% of the weekly water samples from 2004 to 2015 exceeded 158 enterococci CFU/100 ml, the highest level of fecal streptococci concentration measured in the UK study. Risks associated with these elevated levels equated to median NEEAR-Gastrointestinal Illness (NGI) risks of 53 and 96 excess cases per 1000 swimmers in non-children and children, respectively. Two of the five beaches appear to drive the overall elevated NGI risks seen during this study. Distinct enteric pathogen profiles that exist in tropical settings as well as in settings with minimal wastewater treatment highlight the importance of regionally specific guideline development.
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Affiliation(s)
- Marc P Verhougstraete
- The University of Arizona, Mel and Enid Zuckerman College of Public Health, Department of Community Environment and Policy, USA.
| | - Kristen Pogreba-Brown
- The University of Arizona, Mel and Enid Zuckerman College of Public Health, Department of Epidemiology and Biostatistics, USA.
| | - Kelly A Reynolds
- The University of Arizona, Mel and Enid Zuckerman College of Public Health, Department of Community Environment and Policy, USA.
| | | | - Maria Inês Zanoli Sato
- Environmental Analysis Department, Environmental Company of São Paulo State (CETESB), São Paulo, Brazil.
| | - Timothy J Wade
- United States Environmental Protection Agency, Chapel Hill, NC, USA
| | - Joseph N S Eisenberg
- University of Michigan, School of Public Health, Department of Epidemiology, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
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Wu B, Wang C, Zhang C, Sadowsky MJ, Dzakpasu M, Wang XC. Source-Associated Gastroenteritis Risk from Swimming Exposure to Aging Fecal Pathogens. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:921-929. [PMID: 31800232 DOI: 10.1021/acs.est.9b01188] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Human contact with fecally contaminated waters often raises public health concern. The infection potential closely relates to the fecal source type and the aging persistence of waterborne pathogens. In this study, the health risk of contracting gastroenteritis from exposure to aging fecal contamination was predicted using source-associated markers. Microbial decay characteristics in typical summer seawater were incorporated into a pathogen dose estimation model for a constant fecal input. Results show that the median illness probability commensurate with the health benchmark of 36/1000 corresponded to the marker concentrations of ∼7.8, ∼6.6, ∼3.7, and ∼3.5 log10 gene copies/100 mL for seagulls, cattle, raw sewage, and treated effluent, respectively. The error in risk estimates due to neglecting microbial decay was linearly correlated to the decay differences between markers and pathogens. Specifically, the health risk associated with nonhuman sources, which was primarily contributed by bacterial and parasitic pathogens, can be substantially overestimated, while that for virus-dominated human sources was insignificantly affected by the differential decay. Additionally, seagulls dominated the Enterococcus concentration in waters with a mixture of the above-mentioned sources, although they posed limited health risk. This study provides an approach to understanding the influence of fecal aging on health risk estimation.
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Affiliation(s)
- Baolei Wu
- International Science & Technology Cooperation Center for Urban Alternative Water Resources Development; Key Lab of Northwest Water Resource, Environment and Ecology, Ministry of Education; Shaanxi Key Laboratory of Environmental Engineering; and School of Environmental and Municipal Engineering , Xi'an University of Architecture and Technology , Number 13, Yanta Road , Xi'an , Shaanxi 710055 , P. R. China
| | - Chunwei Wang
- International Science & Technology Cooperation Center for Urban Alternative Water Resources Development; Key Lab of Northwest Water Resource, Environment and Ecology, Ministry of Education; Shaanxi Key Laboratory of Environmental Engineering; and School of Environmental and Municipal Engineering , Xi'an University of Architecture and Technology , Number 13, Yanta Road , Xi'an , Shaanxi 710055 , P. R. China
| | - Chongmiao Zhang
- International Science & Technology Cooperation Center for Urban Alternative Water Resources Development; Key Lab of Northwest Water Resource, Environment and Ecology, Ministry of Education; Shaanxi Key Laboratory of Environmental Engineering; and School of Environmental and Municipal Engineering , Xi'an University of Architecture and Technology , Number 13, Yanta Road , Xi'an , Shaanxi 710055 , P. R. China
| | - Michael J Sadowsky
- BioTechnology Institute, Department of Soil, Water, & Climate and Department of Plant & Microbial Biology , University of Minnesota , 1479 Gortner Avenue , Saint Paul , Minnesota 55108 , United States
| | - Mawuli Dzakpasu
- International Science & Technology Cooperation Center for Urban Alternative Water Resources Development; Key Lab of Northwest Water Resource, Environment and Ecology, Ministry of Education; Shaanxi Key Laboratory of Environmental Engineering; and School of Environmental and Municipal Engineering , Xi'an University of Architecture and Technology , Number 13, Yanta Road , Xi'an , Shaanxi 710055 , P. R. China
| | - Xiaochang C Wang
- International Science & Technology Cooperation Center for Urban Alternative Water Resources Development; Key Lab of Northwest Water Resource, Environment and Ecology, Ministry of Education; Shaanxi Key Laboratory of Environmental Engineering; and School of Environmental and Municipal Engineering , Xi'an University of Architecture and Technology , Number 13, Yanta Road , Xi'an , Shaanxi 710055 , P. R. China
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Li J, Zhang X. Beach Pollution Effects on Health and Productivity in California. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111987. [PMID: 31167463 PMCID: PMC6604031 DOI: 10.3390/ijerph16111987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 06/01/2019] [Accepted: 06/02/2019] [Indexed: 12/02/2022]
Abstract
The United States (U.S.) Clean Water Act triggered over $1 trillion in investments in water pollution abatement. However, treated sewage discharge and untreated runoff water that are contaminated by fecal matter are discharged into California beach waters daily. Warnings are posted to thwart the public from contacting polluted coastal water, according to the California Code of Regulations (CCR). This paper evaluated the current policy by empirically examining the productivity loss, in the form of sick leave, which is caused by fecal-contaminated water along the California coast under the CCR. The findings of this study showed that Californians suffer productivity losses in the amount of 3.56 million sick leave days per year due to recreational beach water pollution. This paper also empirically examined the pollution-to-sickness graph that Cabelli’s classic study theoretically proposed. The results of the research assure that the existing water quality thresholds are still reasonably safe and appropriate, despite the thresholds being based on studies from the 1950s. The weakness of the CCR lies in its poor enforcement or compliance. Better compliance, in terms of posting pollution advisories and increasing public awareness regarding beach pollution effects on health, would lead to a significant decrease in sick leaves and a corresponding increase in productivity. Therefore, this study advocates for stronger enforcement by displaying pollution advisories and better public awareness of beach pollution effects on health.
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Affiliation(s)
- Jingjing Li
- Department of Geosciences and Environment, California State University Los Angeles, Los Angeles, CA 90032, USA.
| | - Xiaohan Zhang
- Department of Economics and Statistics, California State University Los Angeles, Los Angeles, CA 90032, USA.
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24
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Sivaganesan M, Aw TG, Briggs S, Dreelin E, Aslan A, Dorevitch S, Shrestha A, Isaacs N, Kinzelman J, Kleinheinz G, Noble R, Rediske R, Scull B, Rosenberg S, Weberman B, Sivy T, Southwell B, Siefring S, Oshima K, Haugland R. Standardized data quality acceptance criteria for a rapid Escherichia coli qPCR method (Draft Method C) for water quality monitoring at recreational beaches. WATER RESEARCH 2019; 156:456-464. [PMID: 30952079 PMCID: PMC9943056 DOI: 10.1016/j.watres.2019.03.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 03/05/2019] [Accepted: 03/12/2019] [Indexed: 05/31/2023]
Abstract
There is growing interest in the application of rapid quantitative polymerase chain reaction (qPCR) and other PCR-based methods for recreational water quality monitoring and management programs. This interest has strengthened given the publication of U.S. Environmental Protection Agency (EPA)-validated qPCR methods for enterococci fecal indicator bacteria (FIB) and has extended to similar methods for Escherichia coli (E. coli) FIB. Implementation of qPCR-based methods in monitoring programs can be facilitated by confidence in the quality of the data produced by these methods. Data quality can be determined through the establishment of a series of specifications that should reflect good laboratory practice. Ideally, these specifications will also account for the typical variability of data coming from multiple users of the method. This study developed proposed standardized data quality acceptance criteria that were established for important calibration model parameters and/or controls from a new qPCR method for E. coli (EPA Draft Method C) based upon data that was generated by 21 laboratories. Each laboratory followed a standardized protocol utilizing the same prescribed reagents and reference and control materials. After removal of outliers, statistical modeling based on a hierarchical Bayesian method was used to establish metrics for assay standard curve slope, intercept and lower limit of quantification that included between-laboratory, replicate testing within laboratory, and random error variability. A nested analysis of variance (ANOVA) was used to establish metrics for calibrator/positive control, negative control, and replicate sample analysis data. These data acceptance criteria should help those who may evaluate the technical quality of future findings from the method, as well as those who might use the method in the future. Furthermore, these benchmarks and the approaches described for determining them may be helpful to method users seeking to establish comparable laboratory-specific criteria if changes in the reference and/or control materials must be made.
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Affiliation(s)
- Mano Sivaganesan
- U.S. Environmental Protection Agency, National Risk Management Research Laboratory, 26 W. M.L. King Dr, Cincinnati, OH, 45268, USA
| | - Tiong Gim Aw
- Department of Global Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2100, New Orleans, LA, 70112, USA
| | - Shannon Briggs
- Water Resources Division, Michigan Department of Environmental Quality, P. O. Box 30458, 525 West Allegan Street, Lansing, MI, 48909, USA
| | - Erin Dreelin
- Center for Water Sciences, Michigan State University, 1405 South Harrison Road, East Lansing, MI, 48823, USA
| | - Asli Aslan
- Georgia Southern University, Department of Environmental Health Sciences, 501 Forest Drive, Statesboro, GA, 30458, USA
| | - Samuel Dorevitch
- University of Illinois at Chicago, School of Public Health, 2121 W. Taylor Street, Chicago, IL, 60612, USA
| | - Abhilasha Shrestha
- University of Illinois at Chicago, School of Public Health, 2121 W. Taylor Street, Chicago, IL, 60612, USA
| | - Natasha Isaacs
- U.S. Geological Survey, Upper Midwest Water Science Center, 6520 Mercantile Way, Ste 5, Lansing, MI, 48911, USA
| | - Julie Kinzelman
- City of Racine Public Health Department, 730 Washington Ave, Racine, WI, 53403, USA
| | - Greg Kleinheinz
- University of Wisconsin-Oshkosh, Environmental Research Laboratory, 800 Algoma Boulevard, Oshkosh, WI, 54901, USA
| | - Rachel Noble
- Institute of Marine Sciences, University of North Carolina at Chapel Hill, 3431 Arendell Street, Morehead City, NC, 28557, USA
| | - Rick Rediske
- Annis Water Resources Institute, Lake Michigan Center, 740 W. Shoreline Dr, Muskegon, MI, 49441, USA
| | - Brian Scull
- Annis Water Resources Institute, Lake Michigan Center, 740 W. Shoreline Dr, Muskegon, MI, 49441, USA
| | - Susan Rosenberg
- Oakland County Health Division Laboratory, 1200 N. Telegraph, Pontiac, MI, 48341, USA
| | - Barbara Weberman
- Oakland County Health Division Laboratory, 1200 N. Telegraph, Pontiac, MI, 48341, USA
| | - Tami Sivy
- Saginaw Valley State University, Department of Chemistry, 7400 Bay Road, University Center, MI, 48710, USA
| | - Ben Southwell
- Lake Superior State University, Environmental Analysis Laboratory, 650 W. Easterday Ave, Sault Ste Marie, MI, 49783, USA
| | - Shawn Siefring
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, 26 W. M.L. King Dr, Cincinnati, OH, 45268, USA
| | - Kevin Oshima
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, 26 W. M.L. King Dr, Cincinnati, OH, 45268, USA
| | - Richard Haugland
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, 26 W. M.L. King Dr, Cincinnati, OH, 45268, USA.
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25
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Sanderson E, Macdonald-Wallis C, Davey Smith G. Negative control exposure studies in the presence of measurement error: implications for attempted effect estimate calibration. Int J Epidemiol 2019; 47:587-596. [PMID: 29088358 PMCID: PMC5913619 DOI: 10.1093/ije/dyx213] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2017] [Indexed: 11/12/2022] Open
Abstract
Background Negative control exposure studies are increasingly being used in epidemiological studies to strengthen causal inference regarding an exposure-outcome association when unobserved confounding is thought to be present. Negative control exposure studies contrast the magnitude of association of the negative control, which has no causal effect on the outcome but is associated with the unmeasured confounders in the same way as the exposure, with the magnitude of the association of the exposure with the outcome. A markedly larger effect of the exposure on the outcome than the negative control on the outcome strengthens inference that the exposure has a causal effect on the outcome. Methods We investigate the effect of measurement error in the exposure and negative control variables on the results obtained from a negative control exposure study. We do this in models with continuous and binary exposure and negative control variables using analysis of the bias of the estimated coefficients and Monte Carlo simulations. Results Our results show that measurement error in either the exposure or negative control variables can bias the estimated results from the negative control exposure study. Conclusions Measurement error is common in the variables used in epidemiological studies; these results show that negative control exposure studies cannot be used to precisely determine the size of the effect of the exposure variable, or adequately adjust for unobserved confounding; however, they can be used as part of a body of evidence to aid inference as to whether a causal effect of the exposure on the outcome is present.
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Affiliation(s)
- Eleanor Sanderson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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26
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Clark GG, Jamal R, Weidhaas J. Roofing material and irrigation frequency influence microbial risk from consuming homegrown lettuce irrigated with harvested rainwater. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 651:1011-1019. [PMID: 30266046 DOI: 10.1016/j.scitotenv.2018.09.277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/20/2018] [Accepted: 09/20/2018] [Indexed: 06/08/2023]
Abstract
Rooftop harvested rainwater has become an alternative, potable, and non-potable water source used around the world. In the United States, rooftop harvested rainwater is most commonly used for irrigation. Rooftop harvested rainwater may contain contaminants from bird or animal feces that may present a risk to water users. Different roofing materials may influence the survival of fecal bacteria on the rooftop prior to runoff during rainfall. In this study, three pathogen groups (E. coli, enterococci and Salmonella enterica) in rooftop runoff from three, replicated roof types (asphalt shingle, synthetic slate, and wood shake) were quantified in multiple rain events. Matched roofs were selected from locations with differing amounts of tree cover. Enterococci were the most frequently detected bacteria from all roof types. Wood shake and asphalt shingle roofing materials had the poorest microbial water quality. Rainwater runoff from two of the six buildings failed to meet United States Food and Drug Administration microbial standards for irrigation water. A quantitative microbial risk assessment indicated that the annual probability of illness from consuming lettuce irrigated with rooftop harvested rainwater varied by roofing material, irrigation water withholding period, and exposure frequency. Consuming lettuce immediately after irrigation with rooftop rainwater presented the highest human health risk based on the probability of illness from E. coli and enterococci exposure. Withholding irrigation by 1 day prior to harvest decreased the annual probability of illness from E. coli by 2 log, but had a minimal effect on the risk from enterococci.
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Affiliation(s)
- Gemma G Clark
- Civil and Environmental Engineering, University of Utah, 110 Central Campus Drive Suite 2000, Salt Lake City, UT 84112, USA
| | - Rubayat Jamal
- Civil and Environmental Engineering, University of Utah, 110 Central Campus Drive Suite 2000, Salt Lake City, UT 84112, USA
| | - Jennifer Weidhaas
- Civil and Environmental Engineering, University of Utah, 110 Central Campus Drive Suite 2000, Salt Lake City, UT 84112, USA.
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Laureano-Rosario AE, Duncan AP, Symonds EM, Savic DA, Muller-Karger FE. Predicting culturable enterococci exceedances at Escambron Beach, San Juan, Puerto Rico using satellite remote sensing and artificial neural networks. JOURNAL OF WATER AND HEALTH 2019; 17:137-148. [PMID: 30758310 DOI: 10.2166/wh.2018.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Predicting recreational water quality is key to protecting public health from exposure to wastewater-associated pathogens. It is not feasible to monitor recreational waters for all pathogens; therefore, monitoring programs use fecal indicator bacteria (FIB), such as enterococci, to identify wastewater pollution. Artificial neural networks (ANNs) were used to predict when culturable enterococci concentrations exceeded the U.S. Environmental Protection Agency (U.S. EPA) Recreational Water Quality Criteria (RWQC) at Escambron Beach, San Juan, Puerto Rico. Ten years of culturable enterococci data were analyzed together with satellite-derived sea surface temperature (SST), direct normal irradiance (DNI), turbidity, and dew point, along with local observations of precipitation and mean sea level (MSL). The factors identified as the most relevant for enterococci exceedance predictions based on the U.S. EPA RWQC were DNI, turbidity, cumulative 48 h precipitation, MSL, and SST; they predicted culturable enterococci exceedances with an accuracy of 75% and power greater than 60% based on the Receiving Operating Characteristic curve and F-Measure metrics. Results show the applicability of satellite-derived data and ANNs to predict recreational water quality at Escambron Beach. Future work should incorporate local sanitary survey data to predict risky recreational water conditions and protect human health.
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Affiliation(s)
- Abdiel E Laureano-Rosario
- College of Marine Science, University of South Florida, 140 7th Avenue South, Saint Petersburg, FL 33701, USA E-mail:
| | - Andrew P Duncan
- Centre for Water Systems, University of Exeter, Harrison Building, North Park Road, Exeter EX4 4QF, UK
| | - Erin M Symonds
- College of Marine Science, University of South Florida, 140 7th Avenue South, Saint Petersburg, FL 33701, USA E-mail:
| | - Dragan A Savic
- Centre for Water Systems, University of Exeter, Harrison Building, North Park Road, Exeter EX4 4QF, UK
| | - Frank E Muller-Karger
- College of Marine Science, University of South Florida, 140 7th Avenue South, Saint Petersburg, FL 33701, USA E-mail:
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Korajkic A, McMinn BR, Harwood VJ. Relationships between Microbial Indicators and Pathogens in Recreational Water Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2842. [PMID: 30551597 PMCID: PMC6313479 DOI: 10.3390/ijerph15122842] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 12/10/2018] [Accepted: 12/11/2018] [Indexed: 11/16/2022]
Abstract
Fecal pollution of recreational waters can cause scenic blight and pose a threat to public health, resulting in beach advisories and closures. Fecal indicator bacteria (total and fecal coliforms, Escherichia coli, and enterococci), and alternative indicators of fecal pollution (Clostridium perfringens and bacteriophages) are routinely used in the assessment of sanitary quality of recreational waters. However, fecal indicator bacteria (FIB), and alternative indicators are found in the gastrointestinal tract of humans, and many other animals and therefore are considered general indicators of fecal pollution. As such, there is room for improvement in terms of their use for informing risk assessment and remediation strategies. Microbial source tracking (MST) genetic markers are closely associated with animal hosts and are used to identify fecal pollution sources. In this review, we examine 73 papers generated over 40 years that reported the relationship between at least one indicator and one pathogen group or species. Nearly half of the reports did not include statistical analysis, while the remainder were almost equally split between those that observed statistically significant relationships and those that did not. Statistical significance was reported less frequently in marine and brackish waters compared to freshwater, and the number of statistically significant relationships was considerably higher in freshwater (p < 0.0001). Overall, significant relationships were more commonly reported between FIB and pathogenic bacteria or protozoa, compared to pathogenic viruses (p: 0.0022⁻0.0005), and this was more pronounced in freshwater compared to marine. Statistically significant relationships were typically noted following wet weather events and at sites known to be impacted by recent fecal pollution. Among the studies that reported frequency of detection, FIB were detected most consistently, followed by alternative indicators. MST markers and the three pathogen groups were detected least frequently. This trend was mirrored by reported concentrations for each group of organisms (FIB > alternative indicators > MST markers > pathogens). Thus, while FIB, alternative indicators, and MST markers continue to be suitable indicators of fecal pollution, their relationship with waterborne pathogens, particularly viruses, is tenuous at best and influenced by many different factors such as frequency of detection, variable shedding rates, differential fate and transport characteristics, as well as a broad range of site-specific factors such as the potential for the presence of a complex mixture of multiple sources of fecal contamination and pathogens.
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Affiliation(s)
- Asja Korajkic
- National Exposure Research Laboratory, Office of Research and Development, United States Environmental Protection Agency, 26 West Martin Luther King Drive, Cincinnati, OH 45268, USA.
| | - Brian R McMinn
- National Exposure Research Laboratory, Office of Research and Development, United States Environmental Protection Agency, 26 West Martin Luther King Drive, Cincinnati, OH 45268, USA.
| | - Valerie J Harwood
- Department of Integrative Biology, University of South Florida, 4202 East Fowler Ave, SCA 110, Tampa, FL 33620, USA.
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Boehm AB, Graham KE, Jennings WC. Can We Swim Yet? Systematic Review, Meta-Analysis, and Risk Assessment of Aging Sewage in Surface Waters. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2018; 52:9634-9645. [PMID: 30080397 DOI: 10.1021/acs.est.8b01948] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This study investigated the risk of gastrointestinal illness associated with swimming in surface waters with aged sewage contamination. First, a systematic review compiled 333 first order decay rate constants ( k) for human norovirus and its surrogates feline calicivirus and murine norovirus, Salmonella, Campylobacter, Escherichia coli O157:H7, Giardia, and Cryptosporidium, and human-associated indicators in surface water. A meta-analysis investigated effects of sunlight, temperature, and water matrix on k. There was a relatively large number of k for bacterial pathogens and some human-associated indicators ( n > 40), fewer for protozoans ( n = 14-22), and few for human norovirus and its Caliciviridae surrogates ( n = 2-4). Average k ranked: Campylobacter > human-associated markers > Salmonella> E. coli O157:H7 > norovirus and its surrogates > Giardia > Cryptosporidium. Compiled k values were used in a quantitative microbial risk assessment (QMRA) to simulate gastrointestinal illness risk associated with swimming in water with aged sewage contamination. The QMRA used human-associated fecal indicator HF183 as an index for the amount of sewage present and thereby provided insight into how risk relates to HF183 concentrations in surface water. Because exposure to norovirus contributed the majority of risk, and HF183 k is greater than norovirus k, the risk associated with exposure to a fixed HF183 concentration increases with the age of contamination. Swimmer exposure to sewage after it has aged ∼3 days results in median risks less than 30/1000. A risk-based water quality threshold for HF183 in surface waters that takes into account uncertainty in contamination age is derived to be 4100 copies/100 mL.
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Affiliation(s)
- Alexandria B Boehm
- Department of Civil and Environmental Engineering , Stanford University , Stanford , California 94305 , United States
| | - Katherine E Graham
- Department of Civil and Environmental Engineering , Stanford University , Stanford , California 94305 , United States
| | - Wiley C Jennings
- Department of Civil and Environmental Engineering , Stanford University , Stanford , California 94305 , United States
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Napier MD, Poole C, Stewart JR, Weber DJ, Glassmeyer ST, Kolpin DW, Furlong ET, Dufour AP, Wade TJ. Exposure to Human-Associated Chemical Markers of Fecal Contamination and Self-Reported Illness among Swimmers at Recreational Beaches. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2018; 52:7513-7523. [PMID: 29901991 PMCID: PMC6192706 DOI: 10.1021/acs.est.8b00639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Anthropogenic chemicals have been proposed as potential markers of human fecal contamination in recreational water. However, to date, there are no published studies describing their relationships with illness risks. Using a cohort of swimmers at seven U.S. beaches, we examined potential associations between the presence of chemical markers of human fecal pollution and self-reported gastrointestinal (GI) illness, diarrhea, and respiratory illness. Swimmers were surveyed about their beach activities, water exposure, and baseline symptoms on the day of their beach visit, and about any illness experienced 10-12 days later. Risk differences were estimated using model-based standardization and adjusted for the swimmer's age, beach site, sand contact, rainfall, and water temperature. Sixty-two chemical markers were analyzed from daily water samples at freshwater and marine beaches. Of those, 20 were found consistently. With the possible exception of bisphenol A and cholesterol, no chemicals were consistently associated with increased risks of illness. These two chemicals were suggestively associated with 2% and 1% increased risks of GI illness and diarrhea in both freshwater and marine beaches. Additional research using the more sensitive analytic methods currently available for a wider suite of analytes is needed to support the use of chemical biomarkers to quantify illness risk and identify fecal pollution sources.
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Affiliation(s)
- Melanie D. Napier
- U.S. Environmental Protection Agency, Office of Research and Development, National Health and Environmental Effects Research Laboratory, 109 T.W. Alexander Drive, Research Triangle Park, NC, USA
- Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC USA
- Corresponding author: Melanie D. Napier, , 919-972-8915
| | - Charles Poole
- Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC USA
| | - Jill R. Stewart
- Department of Environmental Sciences and Engineering, University of North Carolina-Chapel Hill, Chapel Hill, NC USA
| | - David J. Weber
- Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC USA
- Division of Infectious Diseases, School of Medicine, University of North Carolina Health Care, 2153 Bioinformatics Building, 130 Mason Farm Road, 2 Floor, CB#7030, Chapel Hill, NC USA
| | - Susan T. Glassmeyer
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, Cincinnati, OH, USA
| | - Dana W. Kolpin
- U.S. Geological Survey, Central Midwest Water Science Center, Iowa City, IA, USA
| | - Edward T. Furlong
- U.S. Geological Survey, National Water Quality Laboratory, Denver, CO, USA
| | - Alfred P. Dufour
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, Cincinnati, OH, USA
| | - Timothy J. Wade
- U.S. Environmental Protection Agency, Office of Research and Development, National Health and Environmental Effects Research Laboratory, 109 T.W. Alexander Drive, Research Triangle Park, NC, USA
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Coliphages and Gastrointestinal Illness in Recreational Waters: Pooled Analysis of Six Coastal Beach Cohorts. Epidemiology 2018; 28:644-652. [PMID: 28489717 PMCID: PMC5538927 DOI: 10.1097/ede.0000000000000681] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Coliphages have been proposed as indicators of fecal contamination in recreational waters because they better mimic the persistence of pathogenic viruses in the environment and wastewater treatment than fecal indicator bacteria. We estimated the association between coliphages and gastrointestinal illness and compared it with the association with culturable enterococci. METHODS We pooled data from six prospective cohort studies that enrolled coastal beachgoers in California, Alabama, and Rhode Island. Water samples were collected and gastrointestinal illness within 10 days of the beach visit was recorded. Samples were tested for enterococci and male-specific and somatic coliphages. We estimated cumulative incidence ratios (CIR) for the association between swimming in water with detectable coliphage and gastrointestinal illness when human fecal pollution was likely present, not likely present, and under all conditions combined. The reference group was unexposed swimmers. We defined continuous and threshold-based exposures (coliphage present/absent, enterococci >35 vs. ≤35 CFU/100 ml). RESULTS Under all conditions combined, there was no association between gastrointestinal illness and swimming in water with detectable coliphage or enterococci. When human fecal pollution was likely present, coliphage and enterococci were associated with increased gastrointestinal illness, and there was an association between male-specific coliphage level and illness that was somewhat stronger than the association between enterococci and illness. There were no substantial differences between male-specific and somatic coliphage. CONCLUSIONS Somatic coliphage and enterococci had similar associations with gastrointestinal illness; there was some evidence that male-specific coliphage had a stronger association with illness than enterococci in marine waters with human fecal contamination.
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DeFlorio-Barker S, Arnold BF, Sams EA, Dufour AP, Colford JM, Weisberg SB, Schiff KC, Wade TJ. Child environmental exposures to water and sand at the beach: Findings from studies of over 68,000 subjects at 12 beaches. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2018; 28:93-100. [PMID: 29115288 PMCID: PMC5814355 DOI: 10.1038/jes.2017.23] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 07/30/2017] [Indexed: 05/13/2023]
Abstract
Swimming and recreating in lakes, oceans, and rivers is common, yet the literature suggests children may be at greater risk of illness following such exposures. These effects might be due to differences in immunity or differing behavioral factors such as poorer hygiene, longer exposures to, and greater ingestion of potentially contaminated water and sand. We pooled data from 12 prospective cohorts (n=68,685) to examine exposures to potentially contaminated media such as beach water and sand among children compared with adults, and conducted a simulation using self-reported time spent in the water and volume of water swallowed per minute by age to estimate the total volume of water swallowed per swimming event by age category. Children aged 4-7 and 8-12 years had the highest exposures to water, sand, and algae compared with other age groups. Based on our simulation, we found that children (6-12 years) swallow a median of 36 ml (90th percentile=150 ml), whereas adults aged ≥35 years swallow 9 ml (90th percentile=64 ml) per swimming event, with male children swallowing a greater amount of water compared with females. These estimates may help to reduce uncertainty surrounding routes and durations of recreational exposures and can support the development of chemical and microbial risk assessments.
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Affiliation(s)
- Stephanie DeFlorio-Barker
- National Health and Environmental Effects Research Laboratory, Office of Research and Development, US Environmental Protection Agency, 109 TW Alexander MC 58C, Research Triangle Park, North Carolina, USA
| | - Benjamin F Arnold
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkley, California, USA
| | - Elizabeth A Sams
- National Health and Environmental Effects Research Laboratory, Office of Research and Development, US Environmental Protection Agency, 109 TW Alexander MC 58C, Research Triangle Park, North Carolina, USA
| | - Alfred P Dufour
- National Exposure Research Laboratory, Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - John M Colford
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkley, California, USA
| | - Steven B Weisberg
- Southern California Coastal Water Research Project, Costa Mesa, California, USA
| | - Kenneth C Schiff
- Southern California Coastal Water Research Project, Costa Mesa, California, USA
| | - Timothy J Wade
- National Health and Environmental Effects Research Laboratory, Office of Research and Development, US Environmental Protection Agency, 109 TW Alexander MC 58C, Research Triangle Park, North Carolina, USA
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Urban Estuarine Beaches and Urban Water Cycle Seepage: The Influence of Temporal Scales. WATER 2018. [DOI: 10.3390/w10020173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Brief Report: Negative Controls to Detect Selection Bias and Measurement Bias in Epidemiologic Studies. Epidemiology 2018; 27:637-41. [PMID: 27182642 PMCID: PMC4969055 DOI: 10.1097/ede.0000000000000504] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Supplemental Digital Content is available in the text. Biomedical laboratory experiments routinely use negative controls to identify possible sources of bias, but epidemiologic studies have infrequently used this type of control in their design or measurement approach. Recently, epidemiologists proposed the routine use of negative controls in observational studies and defined the structure of negative controls to detect bias due to unmeasured confounding. We extend this previous study and define the structure of negative controls to detect selection bias and measurement bias in both observational studies and randomized trials. We illustrate the strengths and limitations of negative controls in this context using examples from the epidemiologic literature. Given their demonstrated utility and broad generalizability, the routine use of prespecified negative controls will strengthen the evidence from epidemiologic studies.
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Graham KE, Prussin AJ, Marr LC, Sassoubre LM, Boehm AB. Microbial community structure of sea spray aerosols at three California beaches. FEMS Microbiol Ecol 2018; 94:4810542. [DOI: 10.1093/femsec/fiy005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 01/12/2018] [Indexed: 02/04/2023] Open
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Environmental Factors Correlated with Culturable Enterococci Concentrations in Tropical Recreational Waters: A Case Study in Escambron Beach, San Juan, Puerto Rico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121602. [PMID: 29257092 PMCID: PMC5751019 DOI: 10.3390/ijerph14121602] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 12/12/2017] [Accepted: 12/16/2017] [Indexed: 01/26/2023]
Abstract
Enterococci concentration variability at Escambron Beach, San Juan, Puerto Rico, was examined in the context of environmental conditions observed during 2005–2015. Satellite-derived sea surface temperature (SST), turbidity, direct normal irradiance, and dew point were combined with local precipitation, winds, and mean sea level (MSL) observations in a stepwise multiple regression analyses (Akaike Information Criteria model selection). Precipitation, MSL, irradiance, SST, and turbidity explained 20% of the variation in observed enterococci concentrations based upon these analyses. Changes in these parameters preceded increases in enterococci concentrations by 24 h up to 11 days, particularly during positive anomalies of turbidity, SST, and 480–960 mm of accumulated (4 days) precipitation, which relates to bacterial ecology. Weaker, yet still significant, increases in enterococci concentrations were also observed during positive dew point anomalies. Enterococci concentrations decreased with elevated irradiance and MSL anomalies. Unsafe enterococci concentrations per US EPA recreational water quality guidelines occurred when 4-day cumulative precipitation ranged 481–960 mm; irradiance < 667 W·m−2; daily average turbidity anomaly >0.005 sr−1; SST anomaly >0.8 °C; and 3-day average MSL anomaly <−18.8 cm. This case study shows that satellite-derived environmental data can be used to inform future water quality studies and protect human health.
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Brown KI, Graham KE, Soller JA, Boehm AB. Estimating the probability of illness due to swimming in recreational water with a mixture of human- and gull-associated microbial source tracking markers. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2017; 19:1528-1541. [PMID: 29114693 DOI: 10.1039/c7em00316a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Beaches often receive fecal contamination from more than one source. Human sources include untreated sewage as well as treated wastewater effluent, and animal sources include wildlife such as gulls. Different contamination sources are expected to pose different health risks to swimmers. Genetic microbial source tracking (MST) markers can be used to detect bacteria that are associated with different animal sources, but the health risks associated with a mixture of MST markers are unknown. This study presents a method for predicting these health risks, using human- and gull-associated markers as an example. Quantitative Microbial Risk Assessment (QMRA) is conducted with MST markers as indicators. We find that risks associated with exposure to a specific concentration of a human-associated MST marker (HF) are greater if the HF source is untreated sewage rather than treated wastewater effluent. We also provide a risk-based threshold of HF from untreated sewage at a beach, to stay below a predicted illness risk of 3 per 100 swimmers, that is a function of gull-associated MST marker (CAT) concentration.
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Affiliation(s)
- Kendra I Brown
- Department of Civil and Environmental Engineering, Environmental Engineering and Science, Stanford University, 94305-4020, USA.
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Napier MD, Haugland R, Poole C, Dufour AP, Stewart JR, Weber DJ, Varma M, Lavender JS, Wade TJ. Exposure to human-associated fecal indicators and self-reported illness among swimmers at recreational beaches: a cohort study. Environ Health 2017; 16:103. [PMID: 28969670 PMCID: PMC5625766 DOI: 10.1186/s12940-017-0308-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 09/18/2017] [Indexed: 05/24/2023]
Abstract
BACKGROUND Fecal indicator bacteria used to assess illness risks in recreational waters (e.g., Escherichia coli, Enterococci) cannot discriminate among pollution sources. To address this limitation, human-associated Bacteroides markers have been proposed, but the risk of illness associated with the presence of these markers in recreational waters is unclear. Our objective was to estimate associations between human-associated Bacteroides markers in water and self-reported illness among swimmers at 6 U.S. beaches spanning 2003-2007. METHODS We used data from a prospectively-enrolled cohort of 12,060 swimmers surveyed about beach activities and water exposure on the day of their beach visit. Ten to twelve days later, participants reported gastroinestinal, diarrheal, and respiratory illnesses experienced since the visit. Daily water samples were analyzed for the presence of human-associated Bacteroides genetic markers: HF183, BsteriF1, BuniF2, HumM2. We used model-based standardization to estimate risk differences (RD) and 95% confidence intervals (CI). We assessed whether the presence of Bacteroides markers were modifiers of the association between general Enterococcus and illness among swimmers using interaction contrast. RESULTS Overall we observed inconsistent associations between the presence of Bacteroides markers and illness. There was a pattern of increased risks of gastrointestinal (RD = 1.9%; 95% CI: 0.1%, 3.7%), diarrheal (RD = 1.3%; 95% CI: -0.2%, 2.7%), and respiratory illnesses (RD = 1.1%; 95% CI: -0.2%, 2.5%) associated with BsteriF1. There was no evidence that Bacteroides markers acted as modifiers of Enterococcus and illness. Patterns were similar when stratified by water matrix. CONCLUSIONS Quantitative measures of fecal pollution using Bacteroides, rather than presence-absence indicators, may be necessary to accurately assess human risk specific to the presence of human fecal pollution.
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Affiliation(s)
- Melanie D. Napier
- U.S. Environmental Protection Agency, Office of Research and Development, National Health and Environmental Effects Research Laboratory, 109 T.W. Alexander Drive, Research Triangle Park, NC 27709 USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599 USA
| | - Richard Haugland
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, 26 W. Martin Luther King Drive, Cincinnati, OH USA
| | - Charles Poole
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599 USA
| | - Alfred P. Dufour
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, 26 W. Martin Luther King Drive, Cincinnati, OH USA
| | - Jill R. Stewart
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 166 Rosenau Hall, CB #7431, Chapel Hill, NC 27599 USA
| | - David J. Weber
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599 USA
- Division of Infectious Diseases, School of Medicine, University of North Carolina Health Care, Bioinformatics Building, 130 Mason Farm Road, 2nd Floor, CB#7030, Chapel Hill, NC 27599 USA
| | - Manju Varma
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, 26 W. Martin Luther King Drive, Cincinnati, OH USA
| | - Jennifer S. Lavender
- U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, 26 W. Martin Luther King Drive, Cincinnati, OH USA
| | - Timothy J. Wade
- U.S. Environmental Protection Agency, Office of Research and Development, National Health and Environmental Effects Research Laboratory, 109 T.W. Alexander Drive, Research Triangle Park, NC 27709 USA
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Arnold BF, Schiff KC, Ercumen A, Benjamin-Chung J, Steele JA, Griffith JF, Steinberg SJ, Smith P, McGee CD, Wilson R, Nelsen C, Weisberg SB, Colford JM. Acute Illness Among Surfers After Exposure to Seawater in Dry- and Wet-Weather Conditions. Am J Epidemiol 2017; 186:866-875. [PMID: 28498895 PMCID: PMC5860265 DOI: 10.1093/aje/kwx019] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 01/23/2017] [Indexed: 11/17/2022] Open
Abstract
Rainstorms increase levels of fecal indicator bacteria in urban coastal waters, but it is unknown whether exposure to seawater after rainstorms increases rates of acute illness. Our objective was to provide the first estimates of rates of acute illness after seawater exposure during both dry- and wet-weather periods and to determine the relationship between levels of indicator bacteria and illness among surfers, a population with a high potential for exposure after rain. We enrolled 654 surfers in San Diego, California, and followed them longitudinally during the 2013–2014 and 2014–2015 winters (33,377 days of observation, 10,081 surf sessions). We measured daily surf activities and illness symptoms (gastrointestinal illness, sinus infections, ear infections, infected wounds). Compared with no exposure, exposure to seawater during dry weather increased incidence rates of all outcomes (e.g., for earache or infection, adjusted incidence rate ratio (IRR) = 1.86, 95% confidence interval (CI): 1.27, 2.71; for infected wounds, IRR = 3.04, 95% CI: 1.54, 5.98); exposure during wet weather further increased rates (e.g., for earache or infection, IRR = 3.28, 95% CI: 1.95, 5.51; for infected wounds, IRR = 4.96, 95% CI: 2.18, 11.29). Fecal indicator bacteria measured in seawater (Enterococcus species, fecal coliforms, total coliforms) were strongly associated with incident illness only during wet weather. Urban coastal seawater exposure increases the incidence rates of many acute illnesses among surfers, with higher incidence rates after rainstorms.
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Affiliation(s)
- Benjamin F. Arnold
- Correspondence to Dr. Benjamin F. Arnold, Division of Epidemiology, School of Public Health, University of California, Berkeley, 101 Haviland Hall, MC #7358, Berkeley, CA 94720-7358 (e-mail: )
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Soller JA, Schoen M, Steele JA, Griffith JF, Schiff KC. Incidence of gastrointestinal illness following wet weather recreational exposures: Harmonization of quantitative microbial risk assessment with an epidemiologic investigation of surfers. WATER RESEARCH 2017; 121:280-289. [PMID: 28558279 DOI: 10.1016/j.watres.2017.05.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 05/02/2017] [Accepted: 05/08/2017] [Indexed: 05/26/2023]
Abstract
We modeled the risk of gastrointestinal (GI) illness associated with recreational exposures to marine water following storm events in San Diego County, California. We estimated GI illness risks via quantitative microbial risk assessment (QMRA) techniques by consolidating site specific pathogen monitoring data of stormwater, site specific dilution estimates, literature-based water ingestion data, and literature based pathogen dose-response and morbidity information. Our water quality results indicated that human sources of contamination contribute viral and bacterial pathogens to streams draining an urban watershed during wet weather that then enter the ocean and affect nearshore water quality. We evaluated a series of approaches to account for uncertainty in the norovirus dose-response model selection and compared our model results to those from a concurrently conducted epidemiological study that provided empirical estimates for illness risk following ocean exposure. The preferred norovirus dose-response approach yielded median risk estimates for water recreation-associated illness (15 GI illnesses per 1000 recreation events) that closely matched the reported epidemiological results (12 excess GI illnesses per 1000 wet weather recreation events). The results are consistent with norovirus, or other pathogens associated with norovirus, as an important cause of gastrointestinal illness among surfers in this setting. This study demonstrates the applicability of QMRA for recreational water risk estimation, even under wet weather conditions and describes a process that might be useful in developing site-specific water quality criteria in this and other locations.
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Affiliation(s)
- Jeffrey A Soller
- Soller Environmental, LLC, 3022 King St., Berkeley, CA 94703, USA.
| | - Mary Schoen
- Soller Environmental, LLC, 3022 King St., Berkeley, CA 94703, USA
| | - Joshua A Steele
- Southern California Coastal Water Research Project, 3535 Harbor Blvd #110, Costa Mesa, CA 92626, USA
| | - John F Griffith
- Southern California Coastal Water Research Project, 3535 Harbor Blvd #110, Costa Mesa, CA 92626, USA
| | - Kenneth C Schiff
- Southern California Coastal Water Research Project, 3535 Harbor Blvd #110, Costa Mesa, CA 92626, USA
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Mika KB, Chavarria KA, Imamura G, Tang C, Torres R, Jay JA. Sources and persistence of fecal indicator bacteria and Bacteroidales in sand as measured by culture-based and culture-independent methods: A case study at Santa Monica Pier, California. WATER, AIR, AND SOIL POLLUTION 2017; 228:124. [PMID: 30853729 PMCID: PMC6404519 DOI: 10.1007/s11270-017-3291-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study investigated causes of persistent fecal indicator bacteria (FIB) in beach sand under the pier in Santa Monica, CA. FIB levels were up to 1,000 times higher in sand underneath the pier than that collected from adjacent to the pier, with the highest concentrations under the pier in spring and fall. Escherichia coli (EC) and enterococci (ENT) under the pier were significantly positively correlated with moisture (ρ = 0.61, p < 0.001, n = 59; ρ = 0.43, p < 0.001, n = 59, respectively), and ENT levels measured by qPCR (qENT) were much higher than those measured by membrane filtration (cENT). Microcosm experiments tested the ability of EC, qENT, cENT, and general Bacteroidales (GenBac) to persist under in-situ moisture conditions (10% and 0.1%). Decay rates of qENT, cENT, and GenBac were not significantly different from zero at either moisture level, while decay rates for EC were relatively rapid during the microcosm at 10% moisture (k = 0.7 days-1). Gull/pelican marker was detected at eight of 12 sites and no human-associated markers (TaqHF183 and HumM2) were detected at any site during a one-day site survey. Results from this study indicate that the high levels of FIB observed likely stem from environmental sources combined with high persistence of FIB under the pier.
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Affiliation(s)
- Kathryn B Mika
- Department of Civil and Environmental Engineering, University of California Los Angeles, Los Angeles, CA 90095
| | - Karina A Chavarria
- Department of Civil and Environmental Engineering, University of California Los Angeles, Los Angeles, CA 90095
| | - Greg Imamura
- Department of Civil and Environmental Engineering, University of California Los Angeles, Los Angeles, CA 90095
| | - Chay Tang
- Department of Civil and Environmental Engineering, University of California Los Angeles, Los Angeles, CA 90095
| | - Robert Torres
- Department of Civil and Environmental Engineering, University of California Los Angeles, Los Angeles, CA 90095
| | - Jennifer A. Jay
- Department of Civil and Environmental Engineering, University of California Los Angeles, Los Angeles, CA 90095
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Lim KY, Shao S, Peng J, Grant SB, Jiang SC. Evaluation of the dry and wet weather recreational health risks in a semi-enclosed marine embayment in Southern California. WATER RESEARCH 2017; 111:318-329. [PMID: 28104518 DOI: 10.1016/j.watres.2017.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 12/07/2016] [Accepted: 01/02/2017] [Indexed: 06/06/2023]
Abstract
For many coastal regions around the world, recreational beach water quality is assessed using fecal indicator bacteria (FIB). However, the utility of FIB as indicators of recreational water illness (RWI) risk has been questioned, particularly in coastal settings with no obvious sources of human sewage. In this study we employed a source-apportionment quantitative microbial risk assessment (SA-QMRA) to assess RWI risk at a popular semi-enclosed recreational beach in Southern California (Baby Beach, City of Dana Point) with no obvious point sources of human sewage. Our SA-QMRA results suggest that, during dry weather, the median RWI risk at this beach is below the U.S. EPA recreational water quality criteria (RWQC) of 36 illness cases per 1000 bathers. During wet weather, the median RWI risk predicted by SA-QMRA depends on the assumed level of human waste associated with stormwater; the RWI risk is below the EPA RWQC illness risk benchmark 100% of the time provided that <2% of the FIB in stormwater are of human origin. However, these QMRA outcomes contrast strongly with the EPA RWQC for 30-day geometric mean of enterococci bacteria. Our results suggest that SA-QMRA is a useful framework for estimating robust RWI risk that takes into account local information about possible human and non-human sources of FIB.
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Affiliation(s)
- Keah-Ying Lim
- Department of Civil and Environmental Engineering, University of California, Irvine, CA, United States
| | - Stella Shao
- Orange County Environment Resources, Orange, CA, United States
| | - Jian Peng
- Orange County Environment Resources, Orange, CA, United States
| | - Stanley B Grant
- Department of Civil and Environmental Engineering, University of California, Irvine, CA, United States
| | - Sunny C Jiang
- Department of Civil and Environmental Engineering, University of California, Irvine, CA, United States.
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Wangkahad B, Mongkolsuk S, Sirikanchana K. Integrated Multivariate Analysis with Nondetects for the Development of Human Sewage Source-Tracking Tools Using Bacteriophages of Enterococcus faecalis. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2017; 51:2235-2245. [PMID: 27983829 DOI: 10.1021/acs.est.6b04714] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We developed sewage-specific microbial source tracking (MST) tools using enterococci bacteriophages and evaluated their performance with univariate and multivariate analyses involving data below detection limits. Newly isolated Enterococci faecalis bacterial strains AIM06 (DSM100702) and SR14 (DSM100701) demonstrated 100% specificity and 90% sensitivity to human sewage without detecting 68 animal manure pooled samples of cats, chickens, cows, dogs, ducks, pigs, and pigeons. AIM06 and SR14 bacteriophages were present in human sewage at 2-4 orders of magnitude. A principal component analysis confirmed the importance of both phages as main water quality parameters. The phages presented only in the polluted water, as classified by a cluster analysis, and at median concentrations of 1.71 × 102 and 4.27 × 102 PFU/100 mL, respectively, higher than nonhost specific RYC2056 phages and sewage-specific KS148 phages (p < 0.05). Interestingly, AIM06 and SR14 phages exhibited significant correlations with each other and with total coliforms, E. coli, enterococci, and biochemical oxygen demand (Kendall's tau = 0.348 to 0.605, p < 0.05), a result supporting their roles as water quality indicators. This research demonstrates the multiregional applicability of enterococci hosts in MST application and highlights the significance of multivariate analysis with nondetects in evaluating the performance of new MST host strains.
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Affiliation(s)
| | - Skorn Mongkolsuk
- Department of Biotechnology and Center for Emerging Bacterial Infections, Faculty of Science, Mahidol University , Bangkok, Thailand 10400
- Laboratory of Biotechnology, Chulabhorn Research Institute , Bangkok, Thailand 10210
- Center of Excellence on Environmental Health and Toxicology, CHE, Ministry of Education , Phitsanulok 10400, Thailand
| | - Kwanrawee Sirikanchana
- Laboratory of Biotechnology, Chulabhorn Research Institute , Bangkok, Thailand 10210
- Center of Excellence on Environmental Health and Toxicology, CHE, Ministry of Education , Phitsanulok 10400, Thailand
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A large outbreak of gastrointestinal illness at an open-water swimming event in the River Thames, London. Epidemiol Infect 2017; 145:1246-1255. [DOI: 10.1017/s0950268816003393] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
SUMMARYOpen-water swimming is increasingly popular, often in water not considered safe for bathing. Limited evidence exists on the associated health risks. We investigated gastrointestinal illness in 1100 swimmers in a River Thames event in London, UK, to describe the outbreak and identify risk factors. We conducted a retrospective cohort study. Our case definition was swimmers with any: diarrhoea, vomiting, abdominal cramps lasting ⩾48 h, nausea lasting ⩾48 h, with onset within 9 days after the event. We used an online survey to collect information on symptoms, demographics, pre- and post-swim behaviours and open-water experience. We tested associations using robust Poisson regression. We followed up case microbiological results. Survey response was 61%, and attack rate 53% (338 cases). Median incubation period was 34 h and median symptom duration 4 days. Five cases had confirmed microbiological diagnoses (four Giardia, one Cryptosporidium). Wearing a wetsuit [adjusted relative risk (aRR) 6·96, 95% confidence interval (CI) 1·04–46·72] and swallowing water (aRR 1·42, 95% CI 1·03–1·97) were risk factors. Recent river-swimming (aRR 0·78, 95% CI 0·67–0·92) and age >40 years (aRR 0·83, 95% CI 0·70–0·98) were protective. Action to reduce risk of illness in future events is recommended, including clarification of oversight arrangements for future swims to ensure appropriate risk assessment and advice is provided.
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DeFlorio-Barker S, Wade TJ, Jones RM, Friedman LS, Wing C, Dorevitch S. Estimated Costs of Sporadic Gastrointestinal Illness Associated with Surface Water Recreation: A Combined Analysis of Data from NEEAR and CHEERS Studies. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:215-222. [PMID: 27459727 PMCID: PMC5289902 DOI: 10.1289/ehp130] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 03/10/2016] [Accepted: 07/05/2016] [Indexed: 05/26/2023]
Abstract
BACKGROUND The burden of illness can be described by addressing both incidence and illness severity attributable to water recreation. Monetized as cost, attributable disease burden estimates can be useful for environmental management decisions. OBJECTIVES We characterize the disease burden attributable to water recreation using data from two cohort studies using a cost of illness (COI) approach and estimate the largest drivers of the disease burden of water recreation. METHODS Data from the NEEAR study, which evaluated swimming and wading in marine and freshwater beaches in six U.S. states, and CHEERS, which evaluated illness after incidental-contact recreation (boating, canoeing, fishing, kayaking, and rowing) on waterways in the Chicago area, were used to estimate the cost per case of gastrointestinal illness and costs attributable to water recreation. Data on health care and medication utilization and missed days of work or leisure were collected and combined with cost data to construct measures of COI. RESULTS Depending on different assumptions, the cost of gastrointestinal symptoms attributable to water recreation are estimated to be $1,220 for incidental-contact recreation (range $338-$1,681) and $1,676 for swimming/wading (range $425-2,743) per 1,000 recreators. Lost productivity is a major driver of the estimated COI, accounting for up to 90% of total costs. CONCLUSIONS Our estimates suggest gastrointestinal illness attributed to surface water recreation at urban waterways, lakes, and coastal marine beaches is responsible for costs that should be accounted for when considering the monetary impact of efforts to improve water quality. The COI provides more information than the frequency of illness, as it takes into account disease incidence, health care utilization, and lost productivity. Use of monetized disease severity information should be included in future studies of water quality and health. Citation: DeFlorio-Barker S, Wade TJ, Jones RM, Friedman LS, Wing C, Dorevitch S. 2017. Estimated costs of sporadic gastrointestinal illness associated with surface water recreation: a combined analysis of data from NEEAR and CHEERS Studies. Environ Health Perspect 125:215-222; http://dx.doi.org/10.1289/EHP130.
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Affiliation(s)
- Stephanie DeFlorio-Barker
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois, Chicago, Illinois, USA
| | - Timothy J. Wade
- National Health and Environmental Effects Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA
| | - Rachael M. Jones
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois, Chicago, Illinois, USA
| | - Lee S. Friedman
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois, Chicago, Illinois, USA
| | - Coady Wing
- School of Public and Environmental Affairs, Indiana University, Bloomington, Indiana, USA
| | - Samuel Dorevitch
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois, Chicago, Illinois, USA
- Institute for Environmental Science and Policy, University of Illinois, Chicago, Illinois, USA
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Rodrigues VFV, Rivera ING, Lim KY, Jiang SC. Detection and risk assessment of diarrheagenic E. coli in recreational beaches of Brazil. MARINE POLLUTION BULLETIN 2016; 109:163-170. [PMID: 27301685 DOI: 10.1016/j.marpolbul.2016.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 05/25/2016] [Accepted: 06/02/2016] [Indexed: 05/13/2023]
Abstract
Marine beaches are important recreational and economic resources in Brazil, but the beaches' water quality is negatively impacted by the discharge of domestic sewage effluent. The occurrence of diarrheagenic Escherichiacoli among the E. coli isolated from three Brazilian marine beaches was investigated. Multiplex and single step PCR were used to screen 99 E. coli isolates for ten target toxin genes. Six toxin genes, stx1, eae, estp, esth, astA, and bfpA, were identified in 1% to 35% of the isolates. A quantitative microbial risk assessment (QMRA) of human exposure to diarrheagenic E. coli during marine recreation was carried out. The results indicated that the diarrheagenic E. coli risk is well below the U.S. EPA's recommended daily recreational risk benchmark. However, the overall recreational health risk due to all pathogens in the water could be much higher and exceeded the U.S. EPA's benchmark.
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Affiliation(s)
- Vanessa F V Rodrigues
- Biomedical Science Institute, Microbiology Department, University of São Paulo, Estado de São Paulo, SP 05508-000, Brazil; Department of Civil and Environmental Engineering, University of California, Irvine, CA 92697-2175, USA
| | - Irma N G Rivera
- Biomedical Science Institute, Microbiology Department, University of São Paulo, Estado de São Paulo, SP 05508-000, Brazil
| | - Keah-Ying Lim
- Department of Civil and Environmental Engineering, University of California, Irvine, CA 92697-2175, USA
| | - Sunny C Jiang
- Department of Civil and Environmental Engineering, University of California, Irvine, CA 92697-2175, USA.
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Arnold BF, Wade TJ, Benjamin-Chung J, Schiff KC, Griffith JF, Dufour AP, Weisberg SB, Colford JM. Acute Gastroenteritis and Recreational Water: Highest Burden Among Young US Children. Am J Public Health 2016; 106:1690-7. [PMID: 27459461 DOI: 10.2105/ajph.2016.303279] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To provide summary estimates of gastroenteritis risks and illness burden associated with recreational water exposure and determine whether children have higher risks and burden. METHODS We combined individual participant data from 13 prospective cohorts at marine and freshwater beaches throughout the United States (n = 84 411). We measured incident outcomes within 10 days of exposure: diarrhea, gastrointestinal illness, missed daily activity (work, school, vacation), and medical visits. We estimated the relationship between outcomes and 2 exposures: body immersion swimming and Enterococcus spp. fecal indicator bacteria levels in the water. We also estimated the population-attributable risk associated with these exposures. RESULTS Water exposure accounted for 21% of diarrhea episodes and 9% of missed daily activities but was unassociated with gastroenteritis leading to medical consultation. Children aged 0 to 4 and 5 to 10 years had the most water exposure, exhibited stronger associations between levels of water quality and illness, and accounted for the largest attributable illness burden. CONCLUSIONS The higher gastroenteritis risk and associated burden in young children presents important new information to inform future recreational water quality guidelines designed to protect public health.
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Affiliation(s)
- Benjamin F Arnold
- Benjamin F. Arnold, Jade Benjamin-Chung, and John M. Colford Jr are with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Timothy J. Wade is with the US Environmental Protection Agency (EPA), National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC. Kenneth C. Schiff, John F. Griffith, and Stephen B. Weisberg are with the Southern California Coastal Water Research Project, Costa Mesa, CA. Alfred P. Dufour is with the US EPA, National Exposure Research Laboratory, Cincinnati, OH
| | - Timothy J Wade
- Benjamin F. Arnold, Jade Benjamin-Chung, and John M. Colford Jr are with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Timothy J. Wade is with the US Environmental Protection Agency (EPA), National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC. Kenneth C. Schiff, John F. Griffith, and Stephen B. Weisberg are with the Southern California Coastal Water Research Project, Costa Mesa, CA. Alfred P. Dufour is with the US EPA, National Exposure Research Laboratory, Cincinnati, OH
| | - Jade Benjamin-Chung
- Benjamin F. Arnold, Jade Benjamin-Chung, and John M. Colford Jr are with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Timothy J. Wade is with the US Environmental Protection Agency (EPA), National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC. Kenneth C. Schiff, John F. Griffith, and Stephen B. Weisberg are with the Southern California Coastal Water Research Project, Costa Mesa, CA. Alfred P. Dufour is with the US EPA, National Exposure Research Laboratory, Cincinnati, OH
| | - Kenneth C Schiff
- Benjamin F. Arnold, Jade Benjamin-Chung, and John M. Colford Jr are with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Timothy J. Wade is with the US Environmental Protection Agency (EPA), National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC. Kenneth C. Schiff, John F. Griffith, and Stephen B. Weisberg are with the Southern California Coastal Water Research Project, Costa Mesa, CA. Alfred P. Dufour is with the US EPA, National Exposure Research Laboratory, Cincinnati, OH
| | - John F Griffith
- Benjamin F. Arnold, Jade Benjamin-Chung, and John M. Colford Jr are with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Timothy J. Wade is with the US Environmental Protection Agency (EPA), National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC. Kenneth C. Schiff, John F. Griffith, and Stephen B. Weisberg are with the Southern California Coastal Water Research Project, Costa Mesa, CA. Alfred P. Dufour is with the US EPA, National Exposure Research Laboratory, Cincinnati, OH
| | - Alfred P Dufour
- Benjamin F. Arnold, Jade Benjamin-Chung, and John M. Colford Jr are with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Timothy J. Wade is with the US Environmental Protection Agency (EPA), National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC. Kenneth C. Schiff, John F. Griffith, and Stephen B. Weisberg are with the Southern California Coastal Water Research Project, Costa Mesa, CA. Alfred P. Dufour is with the US EPA, National Exposure Research Laboratory, Cincinnati, OH
| | - Stephen B Weisberg
- Benjamin F. Arnold, Jade Benjamin-Chung, and John M. Colford Jr are with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Timothy J. Wade is with the US Environmental Protection Agency (EPA), National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC. Kenneth C. Schiff, John F. Griffith, and Stephen B. Weisberg are with the Southern California Coastal Water Research Project, Costa Mesa, CA. Alfred P. Dufour is with the US EPA, National Exposure Research Laboratory, Cincinnati, OH
| | - John M Colford
- Benjamin F. Arnold, Jade Benjamin-Chung, and John M. Colford Jr are with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Timothy J. Wade is with the US Environmental Protection Agency (EPA), National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC. Kenneth C. Schiff, John F. Griffith, and Stephen B. Weisberg are with the Southern California Coastal Water Research Project, Costa Mesa, CA. Alfred P. Dufour is with the US EPA, National Exposure Research Laboratory, Cincinnati, OH
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Griffith JF, Weisberg SB, Arnold BF, Cao Y, Schiff KC, Colford JM. Epidemiologic evaluation of multiple alternate microbial water quality monitoring indicators at three California beaches. WATER RESEARCH 2016; 94:371-381. [PMID: 27040577 DOI: 10.1016/j.watres.2016.02.036] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 02/12/2016] [Accepted: 02/14/2016] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Advances in molecular methods provide new opportunities for directly measuring pathogens or host-associated markers of fecal pollution instead of relying on fecal indicator bacteria (FIB) alone for beach water quality monitoring. Adoption of new indicators depends on identifying relationships between either the presence or concentration of the indicators and illness among swimmers. Here we present results from three epidemiologic studies in which a broad range of bacterial and viral indicators of fecal contamination were measured simultaneously by either culture or molecular methods along with Enterococcus to assess whether they provide better health risk prediction than current microbial indicators of recreational water quality. METHODS We conducted prospective cohort studies at three California beaches -- Avalon Bay (Avalon), Doheny State Beach (Doheny), Surfrider State Beach (Malibu) -- during the summers of 2007, 2008 and 2009. The studies enrolled 10,785 swimmers across the beaches and recorded each swimmer's water exposure. Water and sand samples were collected several times per day at multiple locations at each beach and analyzed for up to 41 target indicators using 67 different methodologies. Interviewers contacted participants by phone 10-14 days later and recorded symptoms of gastrointestinal illness occurring after their beach visit. Regression models were used to evaluate the association between water quality indicators and gastrointestinal illness among swimmers at each beach. RESULTS F+ coliphage (measured using EPA Method 1602) exhibited a stronger association with GI illness than did EPA Method 1600 at the two beaches where it was measured, while a molecular method, F+ RNA Coliphage Genotype II, was the only indicator significantly associated with GI illness at Malibu. MRSA, a known pathogen, had the strongest association with GI illness of any microbe measured at Avalon. There were two methods targeting human-associated fecal anaerobic bacteria that were more strongly associated with GI illness than EPA Method 1600, but only at Avalon. No indicator combinations consistently had a higher odds ratio than EPA Method 1600, but one composite indicator, based on the number of pathogens detected at a beach, was significantly associated with gastrointestinal illness at both Avalon and Doheny when freshwater flow was high. DISCUSSION While EPA Method1600 performed adequately at two beaches based on its consistency of association with gastrointestinal illness and the precision of its estimated associations, F+ coliphage measured by EPA Method 1602 had a stronger association with GI illness under high risk conditions at the two beaches where it was measured. One indicator, F+ Coliphage Genotype II was the only indicator significantly associated with GI illness at Malibu. Several indicators, particularly those targeting human associated bacteria, exhibited relationships with GI illness that were equal to or greater than that of EPA Method 1600 at Avalon, which has a focused human fecal source. Our results suggest that site-specific conditions at each beach determine which indicator or indicators best predict GI illness.
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Affiliation(s)
- John F Griffith
- Department of Microbiology, Southern California Coastal Water Research Project, 3535 Harbor Blvd. Suite 110, Costa Mesa, CA 92626, USA.
| | - Stephen B Weisberg
- Southern California Coastal Water Research Project Authority, Costa Mesa, CA, USA
| | - Benjamin F Arnold
- Division of Epidemiology, School of Public Health, University of California, Berkeley, USA
| | - Yiping Cao
- Southern California Coastal Water Research Project Authority, Costa Mesa, CA, USA
| | - Kenneth C Schiff
- Southern California Coastal Water Research Project Authority, Costa Mesa, CA, USA
| | - John M Colford
- Division of Epidemiology, School of Public Health, University of California, Berkeley, USA
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Multi-laboratory survey of qPCR enterococci analysis method performance in U.S. coastal and inland surface waters. J Microbiol Methods 2016; 123:114-25. [DOI: 10.1016/j.mimet.2016.01.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/31/2016] [Accepted: 01/31/2016] [Indexed: 11/22/2022]
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Feng Z, Reniers A, Haus BK, Solo-Gabriele HM, Kelly EA. Wave energy level and geographic setting correlate with Florida beach water quality. MARINE POLLUTION BULLETIN 2016; 104:54-60. [PMID: 26892203 PMCID: PMC4804752 DOI: 10.1016/j.marpolbul.2016.02.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 01/19/2016] [Accepted: 02/01/2016] [Indexed: 05/28/2023]
Abstract
Many recreational beaches suffer from elevated levels of microorganisms, resulting in beach advisories and closures due to lack of compliance with Environmental Protection Agency guidelines. We conducted the first statewide beach water quality assessment by analyzing decadal records of fecal indicator bacteria (enterococci and fecal coliform) levels at 262 Florida beaches. The objectives were to depict synoptic patterns of beach water quality exceedance along the entire Florida shoreline and to evaluate their relationships with wave condition and geographic location. Percent exceedances based on enterococci and fecal coliform were negatively correlated with both long-term mean wave energy and beach slope. Also, Gulf of Mexico beaches exceeded the thresholds significantly more than Atlantic Ocean ones, perhaps partially due to the lower wave energy. A possible linkage between wave energy level and water quality is beach sand, a pervasive nonpoint source that tends to harbor more bacteria in the low-wave-energy environment.
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Affiliation(s)
- Zhixuan Feng
- Department of Ocean Sciences, Rosenstiel School of Marine and Atmospheric Science, University of Miami, 4600 Rickenbacker Causeway, Miami, FL 33149, USA; NSF NIEHS Oceans and Human Health Center, Rosenstiel School of Marine and Atmospheric Science, University of Miami, 4600 Rickenbacker Causeway, Miami, FL 33149, USA; Biology Department, Woods Hole Oceanographic Institution, Woods Hole, MA 02543, USA.
| | - Ad Reniers
- Department of Hydraulic Engineering, Environmental Fluid Mechanics Section, Delft University of Technology, Stevinweg 1, 2628CN Delft, The Netherlands
| | - Brian K Haus
- Department of Ocean Sciences, Rosenstiel School of Marine and Atmospheric Science, University of Miami, 4600 Rickenbacker Causeway, Miami, FL 33149, USA; NSF NIEHS Oceans and Human Health Center, Rosenstiel School of Marine and Atmospheric Science, University of Miami, 4600 Rickenbacker Causeway, Miami, FL 33149, USA
| | - Helena M Solo-Gabriele
- NSF NIEHS Oceans and Human Health Center, Rosenstiel School of Marine and Atmospheric Science, University of Miami, 4600 Rickenbacker Causeway, Miami, FL 33149, USA; Department of Civil, Architectural, and Environmental Engineering, College of Engineering, 1251 Memorial Drive, University of Miami, Coral Gables, FL 33146, USA
| | - Elizabeth A Kelly
- NSF NIEHS Oceans and Human Health Center, Rosenstiel School of Marine and Atmospheric Science, University of Miami, 4600 Rickenbacker Causeway, Miami, FL 33149, USA; Leonard and Jayne Abess Center for Ecosystem Science and Policy, University of Miami, Coral Gables, FL 33146, USA
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