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198747 BEACHES Study: Health Effects and Exposures from Non-point Source Microbial Contaminants in Subtropical Recreational Marine Waters

Tuesday, November 10, 2009: 4:30 PM

Jay M. Fleisher, PhD , Master of Public Health Program, Nova Southeastern University, Ft. Lauderdale, FL
Jonathan K. Kish, MPH , Ohhc, University of Miami, Key Biscayne, FL
Lora E. Fleming, MD, PhD , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine - OHH Center and NIOSH Research Group, Miami, FL
Helena Solo-Gabriele, PhD , Ohhc, University of Miami, Key Biscayne, FL
Christopher Sinigalliano, PhD , Ohhc, University of Miami, Key Biscayne, FL
Lorraine C. Backer, PhD, MPH , National Center for Environmental Health, US Centers for Disease Control and Prevention, Chamblee, GA
Lisa Plano, MD PhD , Ohhc, University of Miami, Key Biscayne, FL
John Wang, PhD , Ohhc, University of Miami, Key Biscayne, FL
Tomoyuki Shibata, PhD , Ohhc, University of Miami, Key Biscayne, FL
Samir Elmir, PhD PE , Environmental Health and Engineering, Miami Dade County Health Department, Miami, FL
Kelly Withum, BS , Ohhc, University of Miami, Key Biscayne, FL
Amir Abdelzaher, MS , Ohhc, University of Miami, Key Biscayne, FL
Cristina Ortega , Ohhc, University of Miami, Key Biscayne, FL
Mary Wright, MS , Ohhc, University of Miami, Key Biscayne, FL
Xiaofang Zhu, MS , Ohhc, University of Miami, Key Biscayne, FL
Julie Hollenbeck, BA , Ohhc, University of Miami, Key Biscayne, FL
Maribeth Gidley, MD , Ohhc, University of Miami, Key Biscayne, FL
Guoqing He, PhD , Ohhc, University of Miami, Key Biscayne, FL
Objectives: Microbial water quality indicators, found in high concentrations in sewage, are used to determine whether water is safe for recreational purposes. Recently, concerns have been raised about the appropriate use of indicators to regulate recreational water bodies, particularly non-point source sub/tropical recreational marine waters.

Methods: 1303 adult regular bathers were randomly assigned to bather and non-bather groups, with subsequent follow-up for reported illness, in conjunction with an ongoing extensive environmental sampling of indicator organisms (enterococcus) and pathogens.

Results: After controlling for non-water related risk factors/ possible confounders, bathers were 1.75 times (95% Confidence interval=0.94–3.26; p=0.078) more likely to report gastrointestinal illness relative to non bathers; bathers were 4.46 times (0.99– 20.97; p=0.051) more likely to report acute febrile respiratory illness; and bathers were 5.51 times (2.68–11.36; p=0.<0.0001) more likely to report skin illness relative to non bathers after 7 days of follow up from beach exposure.

There was an apparent dose-response relationship between bather exposure to increasing levels of enterococcus and risks of reported skin and gastrointestinal illness, and some evidence of increased risk of respiratory illness among bathers relative to non-bathers. There was a possible threshold effect for gastrointestinal illness at approximately 40 CFU/100 mL of enterococcus, however no threshold effect was observed for skin illness.

Conclusions: Human exposures to and health risks from microbial pollution may occur even in a non point source recreational marine environment.

Learning Objectives:
1) Describe the issue of exposure and possible health effects from microbial pollution of recreational marine waters 2) Delineate possible public health interventions to monitor and prevent exposure and health effects from microbial pollution of recreational marine waters

Keywords: Environmental Health Hazards, Environmental Exposures

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the biostatistician/Epidemiologist for this project and my historical research forms the basis of the study design.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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