reference : Estimating the primary etiologic agents in recreational freshwaters impacted by human sources of faecal contamination

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reftype Journal Article
Abstract Epidemiology studies of recreational waters have demonstrated that swimmers exposed to faecally-contaminated recreational waters are at risk of excess gastrointestinal illness. Epidemiology studies provide valuable information on the nature and extent of health effects, the magnitude of risks, and how these risks are modified or associated with levels of faecal contamination and other measures of pollution. However, such studies have not provided information about the specific microbial agents that are responsible for the observed illnesses in swimmers. The objective of this work was to understand more fully the reported epidemiologic results from studies conducted on the Great Lakes in the US during 2003 and 2004 by identifying pathogens that could have caused the observed illnesses in those studies. We used a Quantitative Microbial Risk Assessment (QMRA) approach to estimate the likelihood of pathogen-induced adverse health effects. The reference pathogens used for this analysis were Norovirus, rotavirus, adenovirus, Cryptosporidium spp., Giardia lamblia, Campylobacter jejuni, Salmonella enterica, and Escherichia coli O157:H7. Two QMRA-based approaches were used to estimate the pathogen combinations that would be consistent with observed illness rates: in the first, swimming-associated gastrointestinal (GI) illnesses were assumed to occur in the same proportion as known illnesses in the US due to all non-foodborne sources, and in the second, pathogens were assumed to occur in the recreational waters in the same proportion as they occur in disinfected secondary effluent. The results indicate that human enteric viruses and in particular, Norovirus could have caused the vast majority of the observed swimming-associated GI illnesses during the 2003/2004 water epidemiology studies. Evaluation of the time-to-onset of illness strongly supports the principal finding and sensitivity analyses support the overall trends of the analyses even given their substantial uncertainties. © 2010 Elsevier Ltd.
Author Soller, J. A.; Bartrand, T.; Ashbolt, N. J.; Ravenscroft, J.; Wade, T. J.
DOI 10.1016/j.watres.2010.07.064
ISSN 1879-2448
Issue 16
Journal Water Research
Keywords Quantitative microbial risk assessment; Recreational water; Water epidemiology; Adverse health effects; Campylobacter jejuni; Cryptosporidium spp; Escherichia coli O157:H7; Etiologic agents; Faecal contamination; Fresh Water; Giardia lamblia; Great Lakes; Health effects; Human enteric virus; Rotaviruses; Salmonella enterica; Secondary effluent; Contamination; Effluents; Epidemiology; Escherichia coli; Health risks; Lakes; Pathogens; Risk perception; Sensitivity analysis; Viruses; Water analysis; Risk assessment; anthropogenic source; effluent; etiology; fecal coliform; flagellate; freshwater; gastroenteritis; health impact; pathogen; recreational facility; risk factor; virus; water quality; Adenovirus; article; Cryptosporidium; enteric virus; environmental exposure; Escherichia coli O157; gastrointestinal disease; human; nonhuman; Norovirus; priority journal; Rotavirus; swimming; United States; water contamination; Bacteria; Communicable Diseases; Feces; Humans; Recreation; Swimming Pools; Uncertainty; Water Microbiology; Water Pollution; Water Supply; Great Lakes [North America]; Adenoviridae; Giardia intestinalis
Notes Cited By (since 1996):22 Export Date: 7 November 2013 Source: Scopus CODEN: WATRA PubMed ID: 20728915 Language of Original Document: English Correspondence Address: Soller, J.A.; Soller Environmental, LLC, 3022 King St, Berkeley, CA 94703, United States; email:
Pages 4736-4747
Title Estimating the primary etiologic agents in recreational freshwaters impacted by human sources of faecal contamination
Volume 44
Year 2010
Bibliographic identifiers
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