Predicting likelihood of gastroenteritis from sea bathing: results from randomised exposure
Summary The health effects of bathing in coastal waters is an area of scientific controversy. We conducted the first ever randomised "trial" of an environmental exposure to measure the health effects of this activity. The trial was spread over four summers in four UK resorts and 1216 adult...
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| Veröffentlicht in: | The Lancet (British edition) 1994-10, Vol.344 (8927), p.905-909 |
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| creator | Kay, D Jones, F Wyer, M.D Fleisher, J.M Salmon, R.L Godfree, A.F Zelenauch-Jacquotte, A Shore, R |
| description | Summary
The health effects of bathing in coastal waters is an area of scientific controversy. We conducted the first ever randomised "trial" of an environmental exposure to measure the health effects of this activity. The trial was spread over four summers in four UK resorts and 1216 adults took part. Detailed interviews were used to collect data on potential confounding factors and intensive water quality monitoring was used to provide more precise indices of exposure. 548 people were randomised to bathing, and the exposure included total immersion of the head. Crude rates of gastroenteritis were significantly higher in the exposed group (14·8 per 100) than the unexposed group (9·7 per 100; p=0·01).
Linear trend and multiple logistic regression techniques were used to establish relations between gastroenteritis and microbiological water quality. Of a range of microbiological indicators assayed only faecal streptococci concentration, measured at chest depth, showed a significant dose-response relation with gastroenteritis. Adverse health effects were identified when faecal streptococci concentrations exceeded 32 per 100 mL. This relation was independent of non-water-related predictors of gastroenteritis.
We do not suggest that faecal streptococci caused the excess of gastrointestinal symptoms in sea bathers but these microorganisms do seem to be a better indicator of water quality than the traditional coliform counts. Bathing water standards should be revised with these findings in mind. |
| doi_str_mv | 10.1016/S0140-6736(94)92267-5 |
| format | Article |
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The health effects of bathing in coastal waters is an area of scientific controversy. We conducted the first ever randomised "trial" of an environmental exposure to measure the health effects of this activity. The trial was spread over four summers in four UK resorts and 1216 adults took part. Detailed interviews were used to collect data on potential confounding factors and intensive water quality monitoring was used to provide more precise indices of exposure. 548 people were randomised to bathing, and the exposure included total immersion of the head. Crude rates of gastroenteritis were significantly higher in the exposed group (14·8 per 100) than the unexposed group (9·7 per 100; p=0·01).
Linear trend and multiple logistic regression techniques were used to establish relations between gastroenteritis and microbiological water quality. Of a range of microbiological indicators assayed only faecal streptococci concentration, measured at chest depth, showed a significant dose-response relation with gastroenteritis. Adverse health effects were identified when faecal streptococci concentrations exceeded 32 per 100 mL. This relation was independent of non-water-related predictors of gastroenteritis.
We do not suggest that faecal streptococci caused the excess of gastrointestinal symptoms in sea bathers but these microorganisms do seem to be a better indicator of water quality than the traditional coliform counts. Bathing water standards should be revised with these findings in mind.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(94)92267-5</identifier><identifier>PMID: 7934344</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>Adult ; Adults ; Bacteria ; Bacterial diseases ; Bacterial diseases of the digestive system and abdomen ; Bathing ; Biological and medical sciences ; Coastal waters ; Digestive system ; Enterococcus - isolation & purification ; Environmental Exposure - adverse effects ; Environmental monitoring ; Exposure ; Female ; Gastroenteritis ; Gastroenteritis - etiology ; Gastrointestinal symptoms ; Health risks ; Human bacterial diseases ; Humans ; Infectious diseases ; Logistic Models ; Male ; Medical disorders ; Medical research ; Medical sciences ; Microorganisms ; Oceans ; Oceans and Seas ; Randomization ; Risk Factors ; Submerging ; Swimming ; Water Microbiology - standards ; Water monitoring ; Water quality ; Water quality management ; Water quality standards</subject><ispartof>The Lancet (British edition), 1994-10, Vol.344 (8927), p.905-909</ispartof><rights>1994</rights><rights>1994 INIST-CNRS</rights><rights>Copyright Lancet Ltd. Oct 1, 1994</rights><rights>Copyright Elsevier Limited Oct 1, 1994</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491t-ad7c48227951b2219aaa8db64354ea399d768358500dd491830da5a0755b34b73</citedby><cites>FETCH-LOGICAL-c491t-ad7c48227951b2219aaa8db64354ea399d768358500dd491830da5a0755b34b73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2210000932?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974,64362,64366,72216</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4265320$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7934344$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kay, D</creatorcontrib><creatorcontrib>Jones, F</creatorcontrib><creatorcontrib>Wyer, M.D</creatorcontrib><creatorcontrib>Fleisher, J.M</creatorcontrib><creatorcontrib>Salmon, R.L</creatorcontrib><creatorcontrib>Godfree, A.F</creatorcontrib><creatorcontrib>Zelenauch-Jacquotte, A</creatorcontrib><creatorcontrib>Shore, R</creatorcontrib><title>Predicting likelihood of gastroenteritis from sea bathing: results from randomised exposure</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>Summary
The health effects of bathing in coastal waters is an area of scientific controversy. We conducted the first ever randomised "trial" of an environmental exposure to measure the health effects of this activity. The trial was spread over four summers in four UK resorts and 1216 adults took part. Detailed interviews were used to collect data on potential confounding factors and intensive water quality monitoring was used to provide more precise indices of exposure. 548 people were randomised to bathing, and the exposure included total immersion of the head. Crude rates of gastroenteritis were significantly higher in the exposed group (14·8 per 100) than the unexposed group (9·7 per 100; p=0·01).
Linear trend and multiple logistic regression techniques were used to establish relations between gastroenteritis and microbiological water quality. Of a range of microbiological indicators assayed only faecal streptococci concentration, measured at chest depth, showed a significant dose-response relation with gastroenteritis. Adverse health effects were identified when faecal streptococci concentrations exceeded 32 per 100 mL. This relation was independent of non-water-related predictors of gastroenteritis.
We do not suggest that faecal streptococci caused the excess of gastrointestinal symptoms in sea bathers but these microorganisms do seem to be a better indicator of water quality than the traditional coliform counts. Bathing water standards should be revised with these findings in mind.</description><subject>Adult</subject><subject>Adults</subject><subject>Bacteria</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the digestive system and abdomen</subject><subject>Bathing</subject><subject>Biological and medical sciences</subject><subject>Coastal waters</subject><subject>Digestive system</subject><subject>Enterococcus - isolation & purification</subject><subject>Environmental Exposure - adverse effects</subject><subject>Environmental monitoring</subject><subject>Exposure</subject><subject>Female</subject><subject>Gastroenteritis</subject><subject>Gastroenteritis - etiology</subject><subject>Gastrointestinal symptoms</subject><subject>Health risks</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical disorders</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Microorganisms</subject><subject>Oceans</subject><subject>Oceans and Seas</subject><subject>Randomization</subject><subject>Risk Factors</subject><subject>Submerging</subject><subject>Swimming</subject><subject>Water Microbiology - standards</subject><subject>Water monitoring</subject><subject>Water quality</subject><subject>Water quality management</subject><subject>Water quality 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likelihood of gastroenteritis from sea bathing: results from randomised exposure</title><author>Kay, D ; Jones, F ; Wyer, M.D ; Fleisher, J.M ; Salmon, R.L ; Godfree, A.F ; Zelenauch-Jacquotte, A ; Shore, R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c491t-ad7c48227951b2219aaa8db64354ea399d768358500dd491830da5a0755b34b73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Adult</topic><topic>Adults</topic><topic>Bacteria</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the digestive system and abdomen</topic><topic>Bathing</topic><topic>Biological and medical sciences</topic><topic>Coastal waters</topic><topic>Digestive system</topic><topic>Enterococcus - isolation & purification</topic><topic>Environmental Exposure - adverse effects</topic><topic>Environmental 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The health effects of bathing in coastal waters is an area of scientific controversy. We conducted the first ever randomised "trial" of an environmental exposure to measure the health effects of this activity. The trial was spread over four summers in four UK resorts and 1216 adults took part. Detailed interviews were used to collect data on potential confounding factors and intensive water quality monitoring was used to provide more precise indices of exposure. 548 people were randomised to bathing, and the exposure included total immersion of the head. Crude rates of gastroenteritis were significantly higher in the exposed group (14·8 per 100) than the unexposed group (9·7 per 100; p=0·01).
Linear trend and multiple logistic regression techniques were used to establish relations between gastroenteritis and microbiological water quality. Of a range of microbiological indicators assayed only faecal streptococci concentration, measured at chest depth, showed a significant dose-response relation with gastroenteritis. Adverse health effects were identified when faecal streptococci concentrations exceeded 32 per 100 mL. This relation was independent of non-water-related predictors of gastroenteritis.
We do not suggest that faecal streptococci caused the excess of gastrointestinal symptoms in sea bathers but these microorganisms do seem to be a better indicator of water quality than the traditional coliform counts. Bathing water standards should be revised with these findings in mind.</abstract><cop>London</cop><pub>Elsevier Ltd</pub><pmid>7934344</pmid><doi>10.1016/S0140-6736(94)92267-5</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0140-6736 |
| ispartof | The Lancet (British edition), 1994-10, Vol.344 (8927), p.905-909 |
| issn | 0140-6736 1474-547X |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; EBSCOhost Business Source Complete; ProQuest Central UK/Ireland |
| subjects | Adult Adults Bacteria Bacterial diseases Bacterial diseases of the digestive system and abdomen Bathing Biological and medical sciences Coastal waters Digestive system Enterococcus - isolation & purification Environmental Exposure - adverse effects Environmental monitoring Exposure Female Gastroenteritis Gastroenteritis - etiology Gastrointestinal symptoms Health risks Human bacterial diseases Humans Infectious diseases Logistic Models Male Medical disorders Medical research Medical sciences Microorganisms Oceans Oceans and Seas Randomization Risk Factors Submerging Swimming Water Microbiology - standards Water monitoring Water quality Water quality management Water quality standards |
| title | Predicting likelihood of gastroenteritis from sea bathing: results from randomised exposure |
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