Predicting likelihood of gastroenteritis from sea bathing: results from randomised exposure
Open Access
- 1 October 1994
- journal article
- clinical trial
- Published by Elsevier BV in The Lancet
- Vol. 344 (8927), 905-909
- https://doi.org/10.1016/s0140-6736(94)92267-5
Abstract
Summary The health effects of bathing in coastal waters is an area of scientific controversy. We conducted the first ever randomised "trial" of an environmental exposure to measure the health effects of this activity. The trial was spread over four summers in four UK resorts and 1216 adults took part. Detailed interviews were used to collect data on potential confounding factors and intensive water quality monitoring was used to provide more precise indices of exposure. 548 people were randomised to bathing, and the exposure included total immersion of the head. Crude rates of gastroenteritis were significantly higher in the exposed group (14·8 per 100) than the unexposed group (9·7 per 100; p=0·01). Linear trend and multiple logistic regression techniques were used to establish relations between gastroenteritis and microbiological water quality. Of a range of microbiological indicators assayed only faecal streptococci concentration, measured at chest depth, showed a significant dose-response relation with gastroenteritis. Adverse health effects were identified when faecal streptococci concentrations exceeded 32 per 100 mL. This relation was independent of non-water-related predictors of gastroenteritis. We do not suggest that faecal streptococci caused the excess of gastrointestinal symptoms in sea bathers but these microorganisms do seem to be a better indicator of water quality than the traditional coliform counts. Bathing water standards should be revised with these findings in mind.This publication has 14 references indexed in Scilit:
- Water and Non-Water-Related Risk Factors for Gastroenteritis among Bathers Exposed to Sewage-Contaminated Marine WatersInternational Journal of Epidemiology, 1993
- Sequence and Genome Organization of a Human Small Round-Structured (Norwalk-Like) VirusScience, 1993
- Symptomatology of children in contact with sea water contaminated with sewage.Journal of Epidemiology and Community Health, 1992
- Swimming--the hazards of taking a dip.BMJ, 1992
- Results of the First Pilot‐Scale Controlled Cohort Epidemiological Investigation into the Possible Health Effects of Bathing in Seawater at Langland Bay, SwanseaWater and Environment Journal, 1991
- An Appraisal of the Potential Health Impacts of Sewage Disposal to UK Coastal WatersWater and Environment Journal, 1990
- A prospective study of swimming-related illness. II. Morbidity and the microbiological quality of water.American Journal of Public Health, 1985
- A prospective study of swimming-related illness. I. Swimming-associated health risk.American Journal of Public Health, 1985
- The frequency of a Norwalk-like pattern of illness in outbreaks of acute gastroenteritis.American Journal of Public Health, 1982
- Studies of Bathing Water Quality and HealthAmerican Journal of Public Health and the Nations Health, 1953