Exposure to human-associated fecal indicators and self-reported illness among swimmers at recreational beaches: a cohort study

Environmental Health

Research

Jill R. Stewart¹  Charles Poole²  David J. Weber³  Alfred P. Dufour⁴  Jennifer S. Lavender⁴  Richard Haugland⁴  Manju Varma⁴  Timothy J. Wade⁵  Melanie D. Napier⁶ 

[1] 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, 27599, Chapel Hill, NC, 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, 27599, Chapel Hill, NC, 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, 27599, Chapel Hill, NC, USA;Division of Infectious Diseases, School of Medicine, University of North Carolina Health Care, Bioinformatics Building, 130 Mason Farm Road, 2nd Floor, CB#7030, 27599, Chapel Hill, NC, USA;U.S. Environmental Protection Agency, Office of Research and Development, National Exposure Research Laboratory, 26 W. Martin Luther King Drive, Cincinnati, OH, USA;U.S. Environmental Protection Agency, Office of Research and Development, National Health and Environmental Effects Research Laboratory, 109 T.W. Alexander Drive, 27709, Research Triangle Park, NC, USA;U.S. Environmental Protection Agency, Office of Research and Development, National Health and Environmental Effects Research Laboratory, 109 T.W. Alexander Drive, 27709, Research Triangle Park, NC, 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, 27599, Chapel Hill, NC, USA;

关键词: Recreational water quality;    Fecal indicator bacteria;    Gastrointestinal illness;    Diarrhea;    Respiratory illness;    Microbial source tracking;    Bacteroides;   

DOI  :  10.1186/s12940-017-0308-3

 received in 2017-03-27, accepted in 2017-09-18,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundFecal 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.MethodsWe 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.ResultsOverall 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.ConclusionsQuantitative 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.

【 授权许可】

CC BY   
© The Author(s). 2017