Quantitative microbial risk assessment of human illness from exposure to marine beach sand

Toxigenic Escherichia coli with high antibiotic resistance index recovered from sands of recreational beaches of Mumbai, India

Mumbai, India's seven-island city, is known for its sandy beaches as a major tourist attraction, but urbanization and industrialization have weakened the environment. Unregulated sewage disposal and untreated effluents off the coast have made the beach environment vulnerable. Therefore, monitoring water and sand quality at beaches should be mandatory. This study was thus designed to determine the microbiological status of selected sandy beaches, viz. Versova, Juhu, and Girgaon. The study found fecal coliforms in the sand, with stx1 and stx2 genes specific for Shiga toxin-producing E. coli pathotypes in 5.5 % of isolates, whereas the presence of eaeA gene specific for enteropathogenic E. coli pathotype was detected in 12.2 % of isolates, and the presence of the LT and ST genes specific for enterotoxigenic E. coli pathotype was detected in 6.6 % of isolates. Multiple antibiotic-resistant indices indicated high-risk contamination sources. The study suggests routine monitoring of pollution levels at coastal cities' beaches.

Seasonal Variation in Fungi in Beach Sand in Summertime: Stintino (Italy)

BACKGROUND

The goal of this study was to monitor the microbial biodiversity in beach sand that is heavily visited by tourists during the summer, and to determinate whether the high presence of bathers (around 5000 per day) can modify sand microbial composition.

METHODS

Between 2016 and 2020, 150 sand samples were collected from nine different points at La Pelosa beach in Sardinia, Italy. Non-culturing methods were used; DNA extraction and meta-barcode sequencing were performed. All samples were analyzed with sequencing methods for 16S and ITS sequences.

RESULTS

Fungal genera differ on the three beaches and in the winter/summer zones. The ITS sequence showed the most common presence of Candida during summer and Paradendryphiella in the winter. The greatest diversity was found in the dune during winter, while in other parts of the beach, there are differences between bacteria and fungi, particularly in the wash zone during the winter, with high diversity for 16S sequences but low diversity for ITS sequences.

CONCLUSIONS

It appears reasonable that the sands, even on non-urban beaches, should be included in health monitoring programs in addition to the waters, and that access to them should be regulated by limiting the number of bathers with the aim of reducing the presence of pathogenic fungal species.

Virus contamination and infectivity in beach environment: Focus on sand and stranded material

To assess the exposure of beachgoers to viruses, a study on seawater, sand, and beach-stranded material was carried out, searching for human viruses, fecal indicator organisms, and total fungi. Moreover, for the first time, the genome persistence and infectivity of two model viruses was studied in laboratory-spiked sand and seawater samples during a one-week experiment. Viral genome was detected in 13.6 % of the environmental samples, but it was not infectious (Human Adenovirus - HAdV, and enterovirus). Norovirus and SARS-CoV-2 were not detected. The most contaminated samples were from sand and close to riverine discharges. In lab-scale experiments, the infectivity of HAdV5 decreased by ~1.5-Log₁₀ in a week, the one of Human Coronavirus-229E disappeared in <3 h in sand. The genome of both viruses persisted throughout the experiment. Our results confirm viral contamination of the beach and suggest HAdV as an index pathogen for beach monitoring and quantitative risk assessment.

Climate Change Impacts on Microbiota in Beach Sand and Water: Looking Ahead

Beach sand and water have both shown relevance for human health and their microbiology have been the subjects of study for decades. Recently, the World Health Organization recommended that recreational beach sands be added to the matrices monitored for enterococci and Fungi. Global climate change is affecting beach microbial contamination, via changes to conditions like water temperature, sea level, precipitation, and waves. In addition, the world is changing, and humans travel and relocate, often carrying endemic allochthonous microbiota. Coastal areas are amongst the most frequent relocation choices, especially in regions where desertification is taking place. A warmer future will likely require looking beyond the use of traditional water quality indicators to protect human health, in order to guarantee that waterways are safe to use for bathing and recreation. Finally, since sand is a complex matrix, an alternative set of microbial standards is necessary to guarantee that the health of beach users is protected from both sand and water contaminants. We need to plan for the future safer use of beaches by adapting regulations to a climate-changing world.

Quantified Activity Patterns for Young Children in Beach Environments Relevant for Exposure to Contaminants

In a study to evaluate beach play activities, 120 children were videotaped to observe and quantify factors that could influence their exposure to contaminants in the beach environment. Children aged 1 to 6 years were followed by researchers with video cameras at beaches (two in Miami, Florida and two in Galveston, Texas) for approximately one hour each. Factors evaluated included time spent in various beach locations, various activities engaged in, and various surfaces contacted (including contacts by hand and mouth). Activities recorded in the videos were transcribed to text files to allow for quantitative analyses. Across all sexes, age groups, and beaches, Wading was the most common activity and Seawater was the most common location where children played. The left hand was found to not be in contact with objects most of the time, while the right hand, considered the most dominant hand in most cases, contacted Plastic-Toys the most. Although activity patterns collection through videotaping and videotranslation can be labor-intensive, once collected, they can be widely useful for estimates of exposures to all contaminants in the beach environment (e.g., microorganisms and chemicals) as well as UV exposure, with considerations for whether the contaminants are found in water, sand or both. These activity patterns were collected to potentially look at exposures following the Deepwater Horizon 2010 Spill.

Soil-skin adherence measures from hand press trials in a Gulf study of exposures

Marine oil spills and the resulting environmental contamination is common along coastal areas; however, information is lacking about the safety of impacted beaches for public use, especially for the most vulnerable population: children. One route of exposure for children at oil impacted beaches is through contact with sands. The purpose of this study was to evaluate beach sand skin adherence for children under the age of seven. Each of 122 children participated in a hand press trial conducted at one of four different U.S. beaches (two in Miami, FL, and two in Galveston, TX USA). During the hand press trials, hand conditions of the children were randomized (dry, wet, or with sunscreen), and soil adherence (mass of sand per palmar surface area of the hand) and the maximum pressure applied (force applied per area of hand) was measured and calculated. Each child was instructed to press their hands on a soil laden tray for 5 s and pressure of contact was measured using a scale. Results (n = 98) showed that the average soil adherence for both palmar hands across the four beaches ranged from 0.200 to 234 mg/cm² with an average of 35.7 mg/cm², with boys (40.4 mg/cm²) showing slightly higher means than girls (31.7 mg/cm²), but these differences were not significant even after adjusting for age. Among the three conditions evaluated, the highest loading was measured for children with wet hands (mean 65.3 mg/cm²), followed by dry hands (mean 24.5 mg/cm²). Sunscreen hands (mean 23.2 mg/cm²) had the lowest loadings. The pressure of contact ranged from 0.180 to 1.69 psi and varied by age groups and by height and weight, where pressure of contact did not have a significant influence on soil adherence. The average adhered sand grain size and average ambient sand grain size both had a statistically significant impact on hand soil adherence. Overall results from this study can be utilized in exposure and risk assessment models to evaluate the possible health impacts from contaminants found in beach sands.

Estimating Health Risks to Children Associated with Recreational Play on Oil Spill-Contaminated Beaches

The human health impact from exposure to contaminated shorelines following an oil spill event has been investigated to some extent. However, the health risks to children have largely been characterized through the use of surveys and extrapolation from adult health outcomes. There is limited information on children's behaviors during beach play requiring assumptions made based on observations from play activities in home settings. The Beach Exposure and Child Health Study (BEACHES) quantified specific beach activities that can be used to inform human health risk assessments of children playing on beaches impacted by oil spills. The results of this study characterize children's risk of cancer from exposure to oil spill chemicals by incorporating exposure-related information collected from the BEACHES study and by assuming oral, dermal, and inhalation exposure routes. Point risk estimates are compared with a previous, similar study that applied default exposure parameter values obtained from the published literature. The point risk estimates informed by BEACHES data are one order of magnitude lower compared with the previous risk assessment, with dermal exposures the overall risk driver in both. Additional Monte Carlo simulations evaluating the BEACHES data provide ranges of health risks with the highest estimates associated with dermal and oral exposure routes.

Untreated sewage contamination of beach sand from a leaking underground sewage system

Thirty people (mostly children) experienced an episode of skin rash days after a sand sifting beach operation at Porto Pim Beach in Faial, Azores during June 2019. An environmental and epidemiologic investigation was conducted to identify the cause of the outbreak of skin rash. The epidemiologic investigation found that some of the patients experiencing symptoms had never entered the beach water. During the pollution period and throughout the epidemiologic investigation, faecal indicator bacteria levels (94 CFU/100 ml for intestinal enterococci and 61 CFU/100 ml for Escherichia coli) in water remained under the limits used for the ninety-five percentile calculation of an Excellent coastal and transitional bathing water defined in the Portuguese Legislation (100 CFU/100 ml for intestinal enterococci and 250 CFU/100 ml for Escherichia coli). Thus sand contact was considered as a likely primary exposure route. Sand microbiological analysis for faecal indicator organisms and electron microscopy strongly suggested faecal contamination. Chemical analysis of the sand also revealed a concomitant substance compatible with sodium-hypochlorite as analysed using gas chromatography and subsequently confirmed by free chlorine analysis. Inspection of the toilet facilities and sewage disposal system revealed a leaking sewage distribution box. Collectively, results suggest that the cause of the outbreak was the leaking underground sewage distribution box that serviced the beach toilet facilities (40 m from beach), where sodium-hypochlorite was used for cleaning and disinfection. This sewage then contaminated the surficial sands to which beach goers were exposed. Chlorine being an irritant substance, was believed to have been the cause of the symptoms given the sudden presentation and dissipation of skin rashes. No gastro-intestinal illness was reported during this episode and during the following 30 days. Like water, beach sand should also be monitored for safety, especially for areas serviced by aged infrastructure.

Spatiotemporal variability and key influencing factors of river fecal coliform within a typical complex watershed

Fecal coliform bacteria are a key indicator of human health risks; however, the spatiotemporal variability and key influencing factors of river fecal coliform have yet to be explored in a rural-suburban-urban watershed with multiple land uses. In this study, the fecal coliform concentrations in 21 river sections were monitored for 20 months, and 441 samples were analyzed. Multivariable regressions were used to evaluate the spatiotemporal dynamics of fecal coliform. The results showed that spatial differences were mainly dominated by urbanization level, and environmental factors could explain the temporal dynamics of fecal coliform in different urban patterns except in areas with high urbanization levels. Reducing suspended solids is a direct way to manage fecal coliform in the Beiyun River when the natural factors are difficulty to change, such as temperature and solar radiation. The export of fecal coliform from urban areas showed a quick and sensitive response to rainfall events and increased dozens of times in the short term. Landscape patterns, such as the fragmentation of impervious surfaces and the overall landscape, were identified as key factors influencing urban non-point source bacteria. The results obtained from this study will provide insight into the management of river fecal pollution.

Soil, Hand, and Body Adherence Measures across Four Beach Areas: Potential Influence on Exposure to Oil Spill Chemicals

Skin adherence (SA) of soil affects exposure from soil contaminants through dermal routes via loading on the skin and through ingestion routes through hand to mouth activities. The objectives of this study were to evaluate the relationships between adherence versus child-specific and environmental factors. Two sets of soil-to-skin adherence were evaluated. The first was based on loading on hands following hand presses (Hand SA). The second was based on body rinses following one hour of play activities on the beach (Body SA). Results for 98-119 children conducted at four beach sites show that mean Hand SA was 35.7 mg/cm2 (std. dev. 41.8 mg/cm2), while Body SA based on full coverage was 6.8 mg/cm2 (std. dev. 4.8 mg/cm2). Statistically significant differences in Body SA were observed between male (8.1 mg/cm2) and female (5.8 mg/cm2) children (p < 0.05). No significant difference by sex was found for Hand SA. Other statistically different observations were that Hand SA (p < 0.05), but not Body SA, differed across the four beaches (p < 0.05). For Hand SA, this difference was associated soil size variability across the beaches. Hand and Body SA values measured during this study are recommended for use in risk assessments that evaluate beach exposures to oil spill chemicals for young children.

Impacts of a changing earth on microbial dynamics and human health risks in the continuum between beach water and sand

Although infectious disease risk from recreational exposure to waterborne pathogens has been an active area of research for decades, beach sand is a relatively unexplored habitat for the persistence of pathogens and fecal indicator bacteria (FIB). Beach sand, biofilms, and water all present unique advantages and challenges to pathogen introduction, growth, and persistence. These dynamics are further complicated by continuous exchange between sand and water habitats. Models of FIB and pathogen fate and transport at beaches can help predict the risk of infectious disease from beach use, but knowledge gaps with respect to decay and growth rates of pathogens in beach habitats impede robust modeling. Climatic variability adds further complexity to predictive modeling because extreme weather events, warming water, and sea level change may increase human exposure to waterborne pathogens and alter relationships between FIB and pathogens. In addition, population growth and urbanization will exacerbate contamination events and increase the potential for human exposure. The cumulative effects of anthropogenic changes will alter microbial population dynamics in beach habitats and the assumptions and relationships used in quantitative microbial risk assessment (QMRA) and process-based models. Here, we review our current understanding of microbial populations and transport dynamics across the sand-water continuum at beaches, how these dynamics can be modeled, and how global change factors (e.g., climate and land use) should be integrated into more accurate beachscape-based models.

Children Exposure-Related Behavior Patterns and Risk Perception Associated with Recreational Beach Use

Background: Oil spill chemicals (OSCs) result not only from the crude oil components but also from dispersants used in the clean-up activities, where some may result in adverse health effects under certain exposure and dosage conditions. One of the main populations of concern for exposure to OSCs are children, who are frequent beach users. Activities such as ingestion of and digging in sand can increase dermal and ingestion exposure. Longer times spent at the beach can also increase exposures for all routes. Objectives: The Beach Exposure and Child Health Study (BEaCHeS) was initiated to evaluate the risk of exposure to children from oil contaminants. Reported here are results for surveys collected, as a part of the project, to address exposure-related behavior patterns and risk perception for parents or guardians who visit the beach. Methods: Over 400 parental surveys were collected at four beaches, two in Miami and two in Texas, to evaluate children’s exposure related activities. Surveys consisted of three general sections: demographics, exposure, and risk perception. Surveys were analyzed in REDcap and Stata to evaluate demographic and regional differences on activities related to beach behavior and potential exposures to oil contaminants (e.g., how much time spent on beach, cleaning habits following beach activities). The statistical analysis included the mean and standard errors, along with regressions to evaluate associations between parameters. Results: Overall, the data showed high variability in how children play on the beach, influenced more by age and less by gender. Variations were also seen in certain variables by beach region (e.g., hygiene practices). By race, variations were seen in income, distance of travel to beach, and preferred method of communication for beach warning. Other important findings are reflected in the article. Discussion: The data presented here may prove useful for those evaluating children exposures to a variety of contaminants, chemical, or bacterial in origin. In addition, coastal managers may find the risk perception and general behaviors useful for planning and maintenance of beach areas.

Evaluation of methods to sample fecal indicator bacteria in foreshore sand and pore water at freshwater beaches

Fecal indicator bacteria (FIB) are known to accumulate in foreshore beach sand and pore water (referred to as foreshore reservoir) where they act as a non-point source for contaminating adjacent surface waters. While guidelines exist for sampling surface waters at recreational beaches, there is no widely-accepted method to collect sand/sediment or pore water samples for FIB enumeration. The effect of different sampling strategies in quantifying the abundance of FIB in the foreshore reservoir is unclear. Sampling was conducted at six freshwater beaches with different sand types to evaluate sampling methods for characterizing the abundance of E. coli in the foreshore reservoir as well as the partitioning of E. coli between different components in the foreshore reservoir (pore water, saturated sand, unsaturated sand). Methods were evaluated for collection of pore water (drive point, shovel, and careful excavation), unsaturated sand (top 1 cm, top 5 cm), and saturated sand (sediment core, shovel, and careful excavation). Ankle-depth surface water samples were also collected for comparison. Pore water sampled with a shovel resulted in the highest observed E. coli concentrations (only statistically significant at fine sand beaches) and lowest variability compared to other sampling methods. Collection of the top 1 cm of unsaturated sand resulted in higher and more variable concentrations than the top 5 cm of sand. There were no statistical differences in E. coli concentrations when using different methods to sample the saturated sand. Overall, the unsaturated sand had the highest amount of E. coli when compared to saturated sand and pore water (considered on a bulk volumetric basis). The findings presented will help determine the appropriate sampling strategy for characterizing FIB abundance in the foreshore reservoir as a means of predicting its potential impact on nearshore surface water quality and public health risk.

Risk of Illness with Salmonella due to Consumption of Raw Unwashed Vegetables Irrigated with Water from the Bogotá River

The Bogotá River receives untreated wastewater from the city of Bogotá and many other towns. Downstream from Bogotá, water from the river is used for irrigation of crops. Concentrations of indicator organisms in the river are high, which is consistent with fecal contamination. To investigate the probability of illness due to exposure to enteric pathogens from the river, specifically Salmonella, we took water samples from the Bogotá River at six sampling locations in an area where untreated water from the river is used for irrigation of lettuce, broccoli, and cabbage. Salmonella concentrations were quantified by direct isolation and qPCR. Concentrations differed, depending on the quantification technique used, ranging between 107.7 and 109.9 number of copies of gene invA per L and 105.3 and 108.4 CFU/L, for qPCR and direct isolation, respectively. A quantitative microbial risk assessment model that estimates the daily risk of illness with Salmonella resulting from consuming raw unwashed vegetables irrigated with water from the Bogotá River was constructed using the Salmonella concentration data. The daily probability of illness from eating raw unwashed vegetables ranged between 0.62 and 0.85, 0.64 and 0.86, and 0.64 and 0.85 based on concentrations estimated by qPCR (0.47-0.85, 0.47-0.86, and 0.41-0.85 based on concentrations estimated by direct isolation) for lettuce, cabbage, and broccoli, respectively, which are all above the commonly propounded benchmark of 10-4 per year. Results obtained in this study highlight the necessity for appropriate wastewater treatment in the region, and emphasize the importance of postharvest practices, such as washing, disinfecting, and cooking.

Sediment characteristics and microbiological contamination of beach sand - A case-study in the archipelago of Madeira

Beach sand can harbour pathogenic and opportunistic microorganisms, as well as faecal indicator bacteria that influence directly the bathing water quality. Pathogenic and opportunistic microorganisms often raise concern of exposure during beach related recreational activities. In this work, three different types of sandy beaches (natural basaltic, natural calcareous and artificial calcareous) of the Archipelago of Madeira (Portugal) were sampled for bacterial and fungal contaminants and grain size distribution, during four years (2010-2013). Following an extreme weather event in 2010, the faecal indicator bacteria levels spiked, returning to base levels shortly thereafter. The same phenomenon occurred with fungi, where potentially pathogenic fungi were the dominant group. Yeast-like fungi and dermatophytes were, however, mainly associated to months of higher usage by recreational users. Statistical analysis showed higher contamination of sediment in artificial beaches compared to natural beaches and granulometry and chemical composition of sand did not influence in the microbial loads. Instead, bather density and the influence of coastal protection structures needed to maintain the volume of artificial beach sand regarding the removal potential of wave induced currents are obvious influencing factors.

Risk Assessment for Children Exposed to Beach Sands Impacted by Oil Spill Chemicals

Due to changes in the drilling industry, oil spills are impacting large expanses of coastlines, thereby increasing the potential for people to come in contact with oil spill chemicals. The objective of this manuscript was to evaluate the health risk to children who potentially contact beach sands impacted by oil spill chemicals from the Deepwater Horizon disaster. To identify chemicals of concern, the U.S. Environmental Protection Agency’s (EPA’s) monitoring data collected during and immediately after the spill were evaluated. This dataset was supplemented with measurements from beach sands and tar balls collected five years after the spill. Of interest is that metals in the sediments were observed at similar levels between the two sampling periods; some differences were observed for metals levels in tar balls. Although PAHs were not observed five years later, there is evidence of weathered-oil oxidative by-products. Comparing chemical concentration data to baseline soil risk levels, three metals (As, Ba, and V) and four PAHs (benzo[a]pyrene, benz[a]anthracene, benzo[b]fluoranthene, and dibenz[a,h]anthracene) were found to exceed guideline levels prompting a risk assessment. For acute or sub-chronic exposures, hazard quotients, computed by estimating average expected contact behavior, showed no adverse potential health effects. For cancer, computations using 95% upper confidence limits for contaminant concentrations showed extremely low increased risk in the 10⁻⁶ range for oral and dermal exposure from arsenic in sediments and from dermal exposure from benzo[a]pyrene and benz[a]anthracene in weathered oil. Overall, results suggest that health risks are extremely low, given the limitations of available data. Limitations of this study are associated with the lack of toxicological data for dispersants and oil-spill degradation products. We also recommend studies to collect quantitative information about children’s beach play habits, which are necessary to more accurately assess exposure scenarios and health risks.

Are fecal indicator bacteria appropriate measures of recreational water risks in the tropics: A cohort study of beach goers in Brazil?

Regulating recreational water exposure to pathogens within the tropics is a major public health and economic concern. Although numerous epidemiological studies estimating the risk to recreational marine water exposure have been conducted since the 1950s, few studies have been done in the tropics. Furthermore, many have suggested that the use of fecal indicator bacteria for monitoring recreational water quality in temperate regions is not appropriate in the tropics. We analyzed a large cohort study of five beaches in Sao Paulo, Brazil, conducted during consecutive weekends in the summer of 1999 that estimated risk to water, sand, and food exposures. Enterococci and Escherichia coli concentrations were measured each day of the study. Elevated risks were estimated for both swimming (OR = 1.36 95% CI: 1.05-1.58) and sand contact (OR = 1.29 95% CI 1.05-1.58). A 1 log increase in enterococci concentration was associated with an 11% increase in risk (OR = 1.11 95% CI: 1.04-1.19). For E. coli a 1-log increase in concentration was associated with 19% increase in risk (OR = 1.19 95% CI: 1.14-1.28). Most countries with beaches in the tropics are lower or middle income countries (LMIC) and rely on tourism as a major source of income. We present data that suggests fecal indicator bacteria such as enterococci are an appropriate indicator of risk in tropical urban settings where contamination is coming from predominantly human sources. Additional studies in tropical settings could help inform and refine guidelines for safe use of recreational waters.

Microbes in Beach Sands: Integrating Environment, Ecology and Public Health

Beach sand is a habitat that supports many microbes, including viruses, bacteria, fungi and protozoa (micropsammon). The apparently inhospitable conditions of beach sand environments belie the thriving communities found there. Physical factors, such as water availability and protection from insolation; biological factors, such as competition, predation, and biofilm formation; and nutrient availability all contribute to the characteristics of the micropsammon. Sand microbial communities include autochthonous species/phylotypes indigenous to the environment. Allochthonous microbes, including fecal indicator bacteria (FIB) and waterborne pathogens, are deposited via waves, runoff, air, or animals. The fate of these microbes ranges from death, to transient persistence and/or replication, to establishment of thriving populations (naturalization) and integration in the autochthonous community. Transport of the micropsammon within the habitat occurs both horizontally across the beach, and vertically from the sand surface and ground water table, as well as at various scales including interstitial flow within sand pores, sediment transport for particle-associated microbes, and the large-scale processes of wave action and terrestrial runoff. The concept of beach sand as a microbial habitat and reservoir of FIB and pathogens has begun to influence our thinking about human health effects associated with sand exposure and recreational water use. A variety of pathogens have been reported from beach sands, and recent epidemiology studies have found some evidence of health risks associated with sand exposure. Persistent or replicating populations of FIB and enteric pathogens have consequences for watershed/beach management strategies and regulatory standards for safe beaches. This review summarizes our understanding of the community structure, ecology, fate, transport, and public health implications of microbes in beach sand. It concludes with recommendations for future work in this vastly under-studied area.

Comparison of bacterial communities in sands and water at beaches with bacterial water quality violations

Recreational water quality, as measured by culturable fecal indicator bacteria (FIB), may be influenced by persistent populations of these bacteria in local sands or wrack, in addition to varied fecal inputs from human and/or animal sources. In this study, pyrosequencing was used to generate short sequence tags of the 16S hypervariable region ribosomal DNA from shallow water samples and from sand samples collected at the high tide line and at the intertidal water line at sites with and without FIB exceedance events. These data were used to examine the sand and water bacterial communities to assess the similarity between samples, and to determine the impact of water quality exceedance events on the community composition. Sequences belonging to a group of bacteria previously identified as alternative fecal indicators were also analyzed in relationship to water quality violation events. We found that sand and water samples hosted distinctly different overall bacterial communities, and there was greater similarity in the community composition between coastal water samples from two distant sites. The dissimilarity between high tide and intertidal sand bacterial communities, although more similar to each other than to water, corresponded to greater tidal range between the samples. Within the group of alternative fecal indicators greater similarity was observed within sand and water from the same site, likely reflecting the anthropogenic contribution at each beach. This study supports the growing evidence that community-based molecular tools can be leveraged to identify the sources and potential impact of fecal pollution in the environment, and furthermore suggests that a more diverse bacterial community in beach sand and water may reflect a less contaminated site and better water quality.

Routine screening of harmful microorganisms in beach sands: implications to public health

Beaches worldwide provide recreational opportunities to hundreds of millions of people and serve as important components of coastal economies. Beach water is often monitored for microbiological quality to detect the presence of indicators of human sewage contamination so as to prevent public health outbreaks associated with water contact. However, growing evidence suggests that beach sand can harbor microbes harmful to human health, often in concentrations greater than the beach water. Currently, there are no standards for monitoring, sampling, analyzing, or managing beach sand quality. In addition to indicator microbes, growing evidence has identified pathogenic bacteria, viruses, and fungi in a variety of beach sands worldwide. The public health threat associated with these populations through direct and indirect contact is unknown because so little research has been conducted relating to health outcomes associated with sand quality. In this manuscript, we present the consensus findings of a workshop of experts convened in Lisbon, Portugal to discuss the current state of knowledge on beach sand microbiological quality and to develop suggestions for standardizing the evaluation of sand at coastal beaches. The expert group at the "Microareias 2012" workshop recommends that 1) beach sand should be screened for a variety of pathogens harmful to human health, and sand monitoring should then be initiated alongside regular water monitoring; 2) sampling and analysis protocols should be standardized to allow proper comparisons among beach locations; and 3) further studies are needed to estimate human health risk with exposure to contaminated beach sand. Much of the manuscript is focused on research specific to Portugal, but similar results have been found elsewhere, and the findings have worldwide implications.

Characterization of fecal concentrations in human and other animal sources by physical, culture-based, and quantitative real-time PCR methods

The characteristics of fecal sources, and the ways in which they are measured, can profoundly influence the interpretation of which sources are contaminating a body of water. Although feces from various hosts are known to differ in mass and composition, it is not well understood how those differences compare across fecal sources and how differences depend on characterization methods. This study investigated how nine different fecal characterization methods provide different measures of fecal concentration in water, and how results varied across twelve different fecal pollution sources. Sources investigated included chicken, cow, deer, dog, goose, gull, horse, human, pig, pigeon, septage and sewage. A composite fecal slurry was prepared for each source by mixing feces from 6 to 22 individual samples with artificial freshwater. Fecal concentrations were estimated by physical (wet fecal mass added and total DNA mass extracted), culture-based (Escherichia coli and enterococci by membrane filtration and defined substrate), and quantitative real-time PCR (Bacteroidales, E. coli, and enterococci) characterization methods. The characteristics of each composite fecal slurry and the relationships between physical, culture-based and qPCR-based characteristics varied within and among different fecal sources. An in silico exercise was performed to assess how different characterization methods can impact identification of the dominant fecal pollution source in a mixed source sample. A comparison of simulated 10:90 mixtures based on enterococci by defined substrate predicted a source reversal in 27% of all possible combinations, while mixtures based on E. coli membrane filtration resulted in a reversal 29% of the time. This potential for disagreement in minor or dominant source identification based on different methods of measurement represents an important challenge for water quality managers and researchers.

An alternative approach to water regulations for public health protection at bathing beaches

New approaches should be considered as the US Environmental Protection Agency (EPA) moves rapidly to develop new beach monitoring guidelines by the end of 2012, as these guidelines serve as the basis by which states and territories with coasts along the oceans and Great Lakes can then develop and implement monitoring programs for recreational waters. We describe and illustrate one possible approach to beach regulation termed as the “Comprehensive Toolbox within an Approval Process (CTBAP).” The CTBAP consists of three components. The first is a “toolbox” consisting of an inventory of guidelines on monitoring targets, a series of measurement techniques, and guidance to improve water quality through source identification and prevention methods. The second two components are principles of implementation. These include first, “flexibility” to encourage and develop an individualized beach management plan tailored to local conditions and second, “consistency” of this management plan to ensure a consistent national level of public health protection. The results of this approach are illustrated through a case study at a well-studied South Florida recreational marine beach. This case study explores different monitoring targets based on two different health endpoints (skin versus gastrointestinal illness) and recommends a beach regulation program for the study beach that focuses predominately on source prevention.

A multi-beach study of Staphylococcus aureus, MRSA, and enterococci in seawater and beach sand

Incidences of Staphylococcus aureus and methicillin resistant S. aureus (MRSA) have risen worldwide prompting a need to better understand routes of human exposure and whether standard bacterial water quality monitoring practices adequately account for this potential threat. Beach water and sand samples were analyzed during summer months for S. aureus, enterococci, and MRSA at three southern California beaches (Avalon, Doheny, Malibu Surfrider). S. aureus frequently was detected in samples of seawater (59%, n = 328) and beach sand (53%, n = 358). MRSA sometimes was detected in seawater (1.6%, n = 366) and sand (2.7%, n = 366) at relatively low concentrations. Site specific differences were observed, with Avalon Beach presenting the highest concentrations of S. aureus and Malibu Surfrider the lowest in both seawater and sand. S. aureus concentrations in seawater and sand were correlated to each other and to a variety of other parameters. Multiple linear regression on the combined beach data indicated that significant explanatory variables for S. aureus in seawater were S. aureus in sand, water temperature, enterococci in seawater, and the number of swimmers. In sand, S. aureus concentrations were related to S. aureus in seawater, water temperature, enterococci in seawater, and inversely to surf height classification. Only the correlation to water temperature held for individually analyzed beaches and for S. aureus concentrations in both seawater and sand. To provide context for these results, the prevalence of S. aureus in sand was compared to published fomite studies, and results suggested that beach prevalence was similar to that in homes.

Relationship between enterococcal levels and sediment biofilms at recreational beaches in South Florida

Enterococci, recommended at the U.S. federal level for monitoring water quality at marine recreational beaches, have been found to reside and grow within beach sands. However, the environmental and ecological factors affecting enterococcal persistence remain poorly understood, making it difficult to determine levels of fecal pollution and assess human health risks. Here we document the presence of enterococci associated with beach sediment biofilms at eight south Florida recreational beaches. Enterococcal levels were highest in supratidal sands, where they displayed a nonlinear, unimodal relationship with extracellular polymeric secretions (EPS), the primary component of biofilms. Enterococcal levels peaked at intermediate levels of EPS, suggesting that biofilms may promote the survival of enterococci but also inhibit enterococci as the biofilm develops within beach sands. Analysis of bacterial community profiles determined by terminal restriction fragment length polymorphisms showed the bacterial communities of supratidal sediments to be significantly different from intertidal and subtidal communities; however, no differences were observed in bacterial community compositions associated with different EPS concentrations. Our results suggest that supratidal sands are a microbiologically unique environment favorable for the incorporation and persistence of enterococci within beach sediment biofilms.