Skip to main content
PMC home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2001 Jun;55(6):442–447. doi: 10.1136/jech.55.6.442

Recreation in coastal waters: health risks associated with bathing in sea water

M Prieto 1, B Lopez 1, J Juanes 1, J Revilla 1, J Llorca 1, M Delgado-Rodriguez 1
PMCID: PMC1731921  PMID: 11351003

Abstract

STUDY OBJECTIVE—To find out whether bathing in sewage polluted waters implies a danger to bathers' health and to determine the best microbiological indicator to predict the relation between bathing and the appearance of some symptoms.
DESIGN—Cohort study.
SETTING—City of Santander (north of Spain).
PARTICIPANTS—From the people going to four Santander beaches in the period from 1 July to 16 September 1998, a cohort of 2774 persons was recruited who agreed to participate in this study. Of those, 1858 successfully completed a follow up interview conducted in seven days. Respiratory, gastrointestinal, eye, and ear symptoms, and fever occurring during the seven day follow up were recorded.
MAIN RESULTS—A total of 136 participants (7.5%) reported symptoms. Visitors reported experiencing symptoms with more frequency than residents. Incidence rates of gastrointestinal, cutaneous and high respiratory tract symptoms were higher in bathers, but the differences were not significant. Total symptoms were related with the amount of total coliforms, faecal coliforms, and faecal streptococci in the water. Gastrointestinal and skin symptoms kept a positive trend with the degree of water pollution by total coliforms in both crude and adjusted analyses. An increased risk was observed in 2500-9999 total coliforms per 100 ml, a figure over the proposed standard, although below the European Union mandatory limit.
CONCLUSIONS—The results of this study suggest that total coliforms are the best predictors of the symptoms.


Keywords: follow up study; water pollution; water microbiology; seawater; bathing beaches

Full Text

The Full Text of this article is available as a PDF (150.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Balarajan R., Soni Raleigh V., Yuen P., Wheeler D., Machin D., Cartwright R. Health risks associated with bathing in sea water. BMJ. 1991 Dec 7;303(6815):1444–1445. doi: 10.1136/bmj.303.6815.1444. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Brown J. M., Campbell E. A., Rickards A. D., Wheeler D. Sewage pollution of bathing water. Lancet. 1987 Nov 21;2(8569):1208–1209. doi: 10.1016/s0140-6736(87)91342-0. [DOI] [PubMed] [Google Scholar]
  3. Cabelli V. J., Dufour A. P., McCabe L. J., Levin M. A. Swimming-associated gastroenteritis and water quality. Am J Epidemiol. 1982 Apr;115(4):606–616. doi: 10.1093/oxfordjournals.aje.a113342. [DOI] [PubMed] [Google Scholar]
  4. Cheung W. H., Chang K. C., Hung R. P., Kleevens J. W. Health effects of beach water pollution in Hong Kong. Epidemiol Infect. 1990 Aug;105(1):139–162. doi: 10.1017/s0950268800047737. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Corbett S. J., Rubin G. L., Curry G. K., Kleinbaum D. G. The health effects of swimming at Sydney beaches. The Sydney Beach Users Study Advisory Group. Am J Public Health. 1993 Dec;83(12):1701–1706. doi: 10.2105/ajph.83.12.1701. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Fleisher J. M., Jones F., Kay D., Stanwell-Smith R., Wyer M., Morano R. Water and non-water-related risk factors for gastroenteritis among bathers exposed to sewage-contaminated marine waters. Int J Epidemiol. 1993 Aug;22(4):698–708. doi: 10.1093/ije/22.4.698. [DOI] [PubMed] [Google Scholar]
  7. Fleisher J. M., Kay D., Salmon R. L., Jones F., Wyer M. D., Godfree A. F. Marine waters contaminated with domestic sewage: nonenteric illnesses associated with bather exposure in the United Kingdom. Am J Public Health. 1996 Sep;86(9):1228–1234. doi: 10.2105/ajph.86.9.1228. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Fleisher J. M. The effects of measurement error on previously reported mathematical relationships between indicator organism density and swimming-associated illness: a quantitative estimate of the resulting bias. Int J Epidemiol. 1990 Dec;19(4):1100–1106. doi: 10.1093/ije/19.4.1100. [DOI] [PubMed] [Google Scholar]
  9. Kay D., Fleisher J. M., Salmon R. L., Jones F., Wyer M. D., Godfree A. F., Zelenauch-Jacquotte Z., Shore R. Predicting likelihood of gastroenteritis from sea bathing: results from randomised exposure. Lancet. 1994 Oct 1;344(8927):905–909. doi: 10.1016/s0140-6736(94)92267-5. [DOI] [PubMed] [Google Scholar]
  10. Prüss A. Review of epidemiological studies on health effects from exposure to recreational water. Int J Epidemiol. 1998 Feb;27(1):1–9. doi: 10.1093/ije/27.1.1. [DOI] [PubMed] [Google Scholar]
  11. Saliba L. J., Helmer R. Health risks associated with pollution of coastal bathing waters. World Health Stat Q. 1990;43(3):177–187. [PubMed] [Google Scholar]
  12. Seyfried P. L., Tobin R. S., Brown N. E., Ness P. F. A prospective study of swimming-related illness. I. Swimming-associated health risk. Am J Public Health. 1985 Sep;75(9):1068–1070. doi: 10.2105/ajph.75.9.1068. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Seyfried P. L., Tobin R. S., Brown N. E., Ness P. F. A prospective study of swimming-related illness. II. Morbidity and the microbiological quality of water. Am J Public Health. 1985 Sep;75(9):1071–1075. doi: 10.2105/ajph.75.9.1071. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES