Online Program

Integrative health risks associated with recreational water exposure to viral and bacterial contaminants at an Ohio freshwater beach

Wednesday, November 6, 2013 : 1:35 p.m. - 1:50 p.m.

Jason Marion, Ph.D., Department of Environmental Health Science, Eastern Kentucky University, Richmond, KY
Cheonghoon Lee, Ph.D., Department of Environmental Health Sciences, The Ohio State University, Columbus, OH
Changsoo Lee, Ph.D., Department of Environmental Health Sciences, The Ohio State University, Columbus, OH
Stanley Lemeshow, Ph.D., Department of Biostatistics, The Ohio State University, Columbus
Timothy Buckley, PhD, Division of Environmental Health Sciences, The Ohio State University, Columbus, OH
Jiyoung Lee, Ph.D., Division of Environmental Health Sciences, The Ohio State University, Columbus, OH
Swimming-related illnesses have been linked to increasing culturable E. coli densities and various genetic markers; however, there are no epidemiological studies evaluating swimming-related illness associations with multiple bacterial and viral genetic markers occurring together in single models. To address this knowledge gap, we investigated illness associations with varying viral and bacterial marker densities in beach water among freshwater beach users.
 We used a prospective cohort study design to ascertain exposure and health status information from East Fork beach users. We paired exposure data with viral and bacterial marker densities, such as human adenovirus (HAdv), quantified by quantitative polymerase chain reaction (qPCR). Logistic and linear regression models were constructed to evaluate single- and multi-marker/multi-indicator approaches for predicting swimming-related illness. Using qPCR we quantified six bacterial and viral markers from 23 samples collected over 23 weekend days during 2009. Health and exposure data were collected from 278 households representing 891 individuals. None of the bacterial markers were positively associated with swimming-associated illness; however HAdV (log10 HAdV gene copies) was associated with gastrointestinal (GI) illness (adjusted odds ratio = 1.7; 95% confidence interval: 1.0 - 2.8). Furthermore, a two-term model using HAdV and culturable E. coli densities represented a significant improvement over single-marker models for predicting GI illness (p < 0.05; likelihood ratio test). Although limited to a single reservoir, we provide evidence that recreational water exposure classification based on a combination of a bacterial indicator and viral marker is more predictive of disease risk than either approach alone.

Learning Areas:

Environmental health sciences
Public health biology
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Describe the benefits of using bacterial and viral measures of recreational water quality in tandem for assessing health risks associated with beach water

Keyword(s): Water Quality, Environmental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the lead author on epidemiology and water quality articles recently appearing in the high impact journals Water Research and Environmental Science and Technology. I have been a vital part of a very successful research team that has acquired multiple federal and state grants. Lastly, recreational water quality and illnesses associated with human exposure to natural waters are among my scientific interests.
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.