Evaluating health risks associated with exposure to ambient surface waters during recreational activities: A systematic review and meta-analysis

WATER RESEARCH

卷:176

Review

Russo, Gary S.¹  Eftim, Sorina E.²  Goldstone, Alexandra E.²  Dufour, Alfred P.³  Nappier, Sharon P.⁴  Wade, Timothy J.⁵ 

[1] US Environm Protect Agcy, Off Water Off Sci & Technol, Stand & Hlth Protect Div, 1200 Penn Ave NW,Mail Code 4305T, Washington, DC 20460 USA

[2] IFC LLC, 9300 Lee Highway, Fairfax, VA 22031 USA

[3] US EPA, Natl Exposure Res Lab, 26 West Martin Luther King Dr,Mail Code 587, Cincinnati, OH 45268 USA

[4] US EPA, Off Water Off Sci & Technol, Hlth & Ecol Div, 1200 Penn Ave NW,Mail Code 4304T, Washington, DC 20460 USA

[5] US EPA, Natl Hlth & Environm Effects Res Lab, 109 TW Alexander Dr,Mail Code 58C, Res Triangle Pk, NC 27709 USA

关键词: Primary;    Secondary;    Contact;    Illness;    Guidelines;    Standards;   

DOI  :  10.1016/j.watres.2020.115729

来源: Elsevier

【 摘 要 】

Recreational water quality guidelines protect the public from health risks associated with water recreation by helping to prevent unacceptable concentrations of pathogenic organisms in ambient water. However, illness risk is associated with both the concentration of pathogens in the water and the degree of contact with those pathogens. Different recreational activities can result in different levels of contact with ambient water containing water-borne pathogens. We conducted a systematic literature review and meta-analysis to evaluate risks of illness associated with different recreational activities and different levels of contact to ambient surface waters. We screened 8,618 potentially relevant studies for quantitative measures of risk using inclusion/exclusion criteria established in advance. We categorized recreational activities as swimming, sports-related contact, minimal contact, and sand contact. We combined relative risks using a random effects meta-analysis for adverse health outcome categories representing gastrointestinal illness, respiratory illness, skin, eye, ear, nose, throat, and cold/flu illness. We identified 92 studies meeting our inclusion criteria. Pooled risk estimates indicate significant elevation of gastrointestinal illness with the recreational activity categories swimming (2.19, 95% CI: 1.82, 2.63) and sports-related contact (2.69, 95% CI: 1.04, 6.92), and nonsignificant elevation of gastrointestinal illness with minimal contact (1.27, 95% CI: 0.74, 2.16). We also found a significant elevation of respiratory illness with swimming (1.78, 95% CI: 1.38, 2.29) and sports-related contact (1.49, 95% CI: 1.00, 2.24), and no elevation of respiratory illness with minimal contact (0.90, 95% CI: 0.71, 1.14). This study suggests that exposures associated with different types of recreational activities are important characteristics of the exposure pathway when assessing illness risk associated with recreation in ambient surface waters. Published by Elsevier Ltd.

【 授权许可】

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