Recreational water exposures and illness outcomes at a freshwater beach in Toronto, Canada: A prospective cohort pilot study
Swimming and other recreational water activities in surface waters are popular in Canada during the summer. However, these activities can also increase the risk of recreational water illness. While routine monitoring of beach water quality is conducted by local authorities each summer, little resear...
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| Veröffentlicht in: | PloS one 2023-06, Vol.18 (6), p.e0286584-e0286584 |
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| creator | Young, Ian Sanchez, J Johanna Desta, Binyam Negussie Heasley, Cole Tustin, Jordan |
| description | Swimming and other recreational water activities in surface waters are popular in Canada during the summer. However, these activities can also increase the risk of recreational water illness. While routine monitoring of beach water quality is conducted by local authorities each summer, little research is available in Canada about beach exposures and illness risks.
We conducted a pilot of a prospective cohort study at a popular beach in Toronto, Ontario, Canada, in 2022 to determine characteristics of beachgoers, common water and sand exposures, the incidence of recreational water illness, and the feasibility for a larger, national cohort study. We enrolled beachgoers on-site and surveyed about their exposures at the beach and conducted a follow-up survey 7 days following their beach visit to ascertain acute gastrointestinal, respiratory, skin, ear, and eye illness outcomes. We descriptively tabulated and summarized the collected data.
We enrolled 649 households, consisting of 831 beachgoers. Water contact activities were reported by 56% of beachgoers, with swimming being the most common activity (44% of participants). Similarly, 56% of beachgoers reported digging in the sand or burying themselves in the sand. Children (≤14 years) and teenagers (15-19 years) were most likely to report engaging in water contact activities and swallowing water, while children were most likely to report sand contact activities and getting sand in their mouth. Boys and men were more likely than women and girls to report swallowing water (15.2% vs. 9.4%). Water and sand exposures also differed by household education level and participant ethno-racial identity. E. coli levels in beach water were consistently low (median = 20 CFU/100 mL, range = 10-58). The incidence of illness outcomes was very low (0.3-2.8%) among the 287 participants that completed the follow-up survey.
The identified beach exposure patterns can inform future risk assessments and communication strategies. Excellent water quality was observed at the studied beach, likely contributing to the low incidence of illnesses. A larger, national cohort study is needed in Canada to examine risks of illness at beaches at higher risk of fecal contamination. |
| doi_str_mv | 10.1371/journal.pone.0286584 |
| format | Article |
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We conducted a pilot of a prospective cohort study at a popular beach in Toronto, Ontario, Canada, in 2022 to determine characteristics of beachgoers, common water and sand exposures, the incidence of recreational water illness, and the feasibility for a larger, national cohort study. We enrolled beachgoers on-site and surveyed about their exposures at the beach and conducted a follow-up survey 7 days following their beach visit to ascertain acute gastrointestinal, respiratory, skin, ear, and eye illness outcomes. We descriptively tabulated and summarized the collected data.
We enrolled 649 households, consisting of 831 beachgoers. Water contact activities were reported by 56% of beachgoers, with swimming being the most common activity (44% of participants). Similarly, 56% of beachgoers reported digging in the sand or burying themselves in the sand. Children (≤14 years) and teenagers (15-19 years) were most likely to report engaging in water contact activities and swallowing water, while children were most likely to report sand contact activities and getting sand in their mouth. Boys and men were more likely than women and girls to report swallowing water (15.2% vs. 9.4%). Water and sand exposures also differed by household education level and participant ethno-racial identity. E. coli levels in beach water were consistently low (median = 20 CFU/100 mL, range = 10-58). The incidence of illness outcomes was very low (0.3-2.8%) among the 287 participants that completed the follow-up survey.
The identified beach exposure patterns can inform future risk assessments and communication strategies. Excellent water quality was observed at the studied beach, likely contributing to the low incidence of illnesses. A larger, national cohort study is needed in Canada to examine risks of illness at beaches at higher risk of fecal contamination.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0286584</identifier><identifier>PMID: 37267237</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adolescents ; Amusements ; Analysis ; Bathing Beaches ; Beaches ; Biology and Life Sciences ; Child ; Children ; Cohort analysis ; Cohort Studies ; Consent ; Contamination ; Data collection ; E coli ; Ecology and Environmental Sciences ; Enrollments ; Environmental Monitoring ; Epidemiology ; Escherichia coli ; Exposure ; Fecal coliforms ; Feces ; Female ; Fresh Water ; Health aspects ; Health risks ; Households ; Humans ; Illnesses ; Kayaking ; Male ; Medicine and Health Sciences ; Onsite ; Ontario - epidemiology ; People and places ; Pilot Projects ; Prevention ; Prospective Studies ; Questionnaires ; Recreation ; Research and Analysis Methods ; Risk assessment ; Risk communication ; Sand ; Sand & gravel ; Sociodemographics ; Summer ; Surface water ; Surveys ; Surveys and Questionnaires ; Swallowing ; Swimming ; Water Microbiology ; Water quality ; Waterborne infections</subject><ispartof>PloS one, 2023-06, Vol.18 (6), p.e0286584-e0286584</ispartof><rights>Copyright: © 2023 Young et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Young et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Young et al 2023 Young et al</rights><rights>2023 Young et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c693t-48fb735c1f9387cbb3291163dc1eb164119fc54eac59c0617bc18750c651081c3</citedby><cites>FETCH-LOGICAL-c693t-48fb735c1f9387cbb3291163dc1eb164119fc54eac59c0617bc18750c651081c3</cites><orcidid>0000-0002-5575-5174 ; 0000-0002-1780-9856</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237503/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237503/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37267237$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Wade, Timothy J</contributor><creatorcontrib>Young, Ian</creatorcontrib><creatorcontrib>Sanchez, J Johanna</creatorcontrib><creatorcontrib>Desta, Binyam Negussie</creatorcontrib><creatorcontrib>Heasley, Cole</creatorcontrib><creatorcontrib>Tustin, Jordan</creatorcontrib><title>Recreational water exposures and illness outcomes at a freshwater beach in Toronto, Canada: A prospective cohort pilot study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Swimming and other recreational water activities in surface waters are popular in Canada during the summer. However, these activities can also increase the risk of recreational water illness. While routine monitoring of beach water quality is conducted by local authorities each summer, little research is available in Canada about beach exposures and illness risks.
We conducted a pilot of a prospective cohort study at a popular beach in Toronto, Ontario, Canada, in 2022 to determine characteristics of beachgoers, common water and sand exposures, the incidence of recreational water illness, and the feasibility for a larger, national cohort study. We enrolled beachgoers on-site and surveyed about their exposures at the beach and conducted a follow-up survey 7 days following their beach visit to ascertain acute gastrointestinal, respiratory, skin, ear, and eye illness outcomes. We descriptively tabulated and summarized the collected data.
We enrolled 649 households, consisting of 831 beachgoers. Water contact activities were reported by 56% of beachgoers, with swimming being the most common activity (44% of participants). Similarly, 56% of beachgoers reported digging in the sand or burying themselves in the sand. Children (≤14 years) and teenagers (15-19 years) were most likely to report engaging in water contact activities and swallowing water, while children were most likely to report sand contact activities and getting sand in their mouth. Boys and men were more likely than women and girls to report swallowing water (15.2% vs. 9.4%). Water and sand exposures also differed by household education level and participant ethno-racial identity. E. coli levels in beach water were consistently low (median = 20 CFU/100 mL, range = 10-58). The incidence of illness outcomes was very low (0.3-2.8%) among the 287 participants that completed the follow-up survey.
The identified beach exposure patterns can inform future risk assessments and communication strategies. Excellent water quality was observed at the studied beach, likely contributing to the low incidence of illnesses. A larger, national cohort study is needed in Canada to examine risks of illness at beaches at higher risk of fecal contamination.</description><subject>Adolescent</subject><subject>Adolescents</subject><subject>Amusements</subject><subject>Analysis</subject><subject>Bathing Beaches</subject><subject>Beaches</subject><subject>Biology and Life Sciences</subject><subject>Child</subject><subject>Children</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Consent</subject><subject>Contamination</subject><subject>Data collection</subject><subject>E coli</subject><subject>Ecology and Environmental Sciences</subject><subject>Enrollments</subject><subject>Environmental Monitoring</subject><subject>Epidemiology</subject><subject>Escherichia coli</subject><subject>Exposure</subject><subject>Fecal coliforms</subject><subject>Feces</subject><subject>Female</subject><subject>Fresh Water</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>Households</subject><subject>Humans</subject><subject>Illnesses</subject><subject>Kayaking</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Onsite</subject><subject>Ontario - epidemiology</subject><subject>People and places</subject><subject>Pilot Projects</subject><subject>Prevention</subject><subject>Prospective Studies</subject><subject>Questionnaires</subject><subject>Recreation</subject><subject>Research and Analysis Methods</subject><subject>Risk assessment</subject><subject>Risk communication</subject><subject>Sand</subject><subject>Sand & gravel</subject><subject>Sociodemographics</subject><subject>Summer</subject><subject>Surface water</subject><subject>Surveys</subject><subject>Surveys and Questionnaires</subject><subject>Swallowing</subject><subject>Swimming</subject><subject>Water Microbiology</subject><subject>Water quality</subject><subject>Waterborne 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Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Young, Ian</au><au>Sanchez, J Johanna</au><au>Desta, Binyam Negussie</au><au>Heasley, Cole</au><au>Tustin, Jordan</au><au>Wade, Timothy J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Recreational water exposures and illness outcomes at a freshwater beach in Toronto, Canada: A prospective cohort pilot study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-06-02</date><risdate>2023</risdate><volume>18</volume><issue>6</issue><spage>e0286584</spage><epage>e0286584</epage><pages>e0286584-e0286584</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Swimming and other recreational water activities in surface waters are popular in Canada during the summer. However, these activities can also increase the risk of recreational water illness. While routine monitoring of beach water quality is conducted by local authorities each summer, little research is available in Canada about beach exposures and illness risks.
We conducted a pilot of a prospective cohort study at a popular beach in Toronto, Ontario, Canada, in 2022 to determine characteristics of beachgoers, common water and sand exposures, the incidence of recreational water illness, and the feasibility for a larger, national cohort study. We enrolled beachgoers on-site and surveyed about their exposures at the beach and conducted a follow-up survey 7 days following their beach visit to ascertain acute gastrointestinal, respiratory, skin, ear, and eye illness outcomes. We descriptively tabulated and summarized the collected data.
We enrolled 649 households, consisting of 831 beachgoers. Water contact activities were reported by 56% of beachgoers, with swimming being the most common activity (44% of participants). Similarly, 56% of beachgoers reported digging in the sand or burying themselves in the sand. Children (≤14 years) and teenagers (15-19 years) were most likely to report engaging in water contact activities and swallowing water, while children were most likely to report sand contact activities and getting sand in their mouth. Boys and men were more likely than women and girls to report swallowing water (15.2% vs. 9.4%). Water and sand exposures also differed by household education level and participant ethno-racial identity. E. coli levels in beach water were consistently low (median = 20 CFU/100 mL, range = 10-58). The incidence of illness outcomes was very low (0.3-2.8%) among the 287 participants that completed the follow-up survey.
The identified beach exposure patterns can inform future risk assessments and communication strategies. Excellent water quality was observed at the studied beach, likely contributing to the low incidence of illnesses. A larger, national cohort study is needed in Canada to examine risks of illness at beaches at higher risk of fecal contamination.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>37267237</pmid><doi>10.1371/journal.pone.0286584</doi><tpages>e0286584</tpages><orcidid>https://orcid.org/0000-0002-5575-5174</orcidid><orcidid>https://orcid.org/0000-0002-1780-9856</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
| recordid | cdi_plos_journals_2821938135 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adolescent Adolescents Amusements Analysis Bathing Beaches Beaches Biology and Life Sciences Child Children Cohort analysis Cohort Studies Consent Contamination Data collection E coli Ecology and Environmental Sciences Enrollments Environmental Monitoring Epidemiology Escherichia coli Exposure Fecal coliforms Feces Female Fresh Water Health aspects Health risks Households Humans Illnesses Kayaking Male Medicine and Health Sciences Onsite Ontario - epidemiology People and places Pilot Projects Prevention Prospective Studies Questionnaires Recreation Research and Analysis Methods Risk assessment Risk communication Sand Sand & gravel Sociodemographics Summer Surface water Surveys Surveys and Questionnaires Swallowing Swimming Water Microbiology Water quality Waterborne infections |
| title | Recreational water exposures and illness outcomes at a freshwater beach in Toronto, Canada: A prospective cohort pilot study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-21T05%3A00%3A20IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Recreational%20water%20exposures%20and%20illness%20outcomes%20at%20a%20freshwater%20beach%20in%20Toronto,%20Canada:%20A%20prospective%20cohort%20pilot%20study&rft.jtitle=PloS%20one&rft.au=Young,%20Ian&rft.date=2023-06-02&rft.volume=18&rft.issue=6&rft.spage=e0286584&rft.epage=e0286584&rft.pages=e0286584-e0286584&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0286584&rft_dat=%3Cgale_plos_%3EA751520103%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2821938135&rft_id=info:pmid/37267237&rft_galeid=A751520103&rft_doaj_id=oai_doaj_org_article_5d2a48f227bd4fd087dc7c1c87503cea&rfr_iscdi=true |