Elevated Bathing-Associated Disease Risks Despite Certified Water Quality: A Cohort Study

Papastergiou, Panagiotis; Mouchtouri, Varvara A.; Πινακά, Ουρανία; Katsiaflaka, Anna; Rachiotis, George; Hadjichristodoulou, Christos

doi:10.3390/ijerph9051548

Cited by 27 publications

(23 citation statements)

References 25 publications

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“…GM ENT cfu/100 ml Summer: 1.5 Autumn: 2.1 All ages Bathers vs non-bathers: AOR 0.88 (0.47-1.63) Very clean water. Greek bathers cohort study Papastergiou [ 20 , 21 ] Prospective cohort 3 beaches (A, B & C) in Greece with ‘excellent’ water quality, although there were some known non-point source sewage inputs Greek beach-goers attending study beaches. Non-bathers (non-beach-goers) were recruited through a random phone survey 3,796 bathers and 571 non-bathers 1 sample daily from 7 sites.…”

Section: Epidemiologymentioning

confidence: 99%

Recreational Water and Infection: A Review of Recent Findings

Fewtrell

Kay

2015

Curr Envir Health Rpt

128

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This paper reviews the latest evidence provided by epidemiological studies and quantitative microbial risk assessments (QMRAs) of infection risk from recreational water use. Studies for review were selected following a PubMed search for articles published between January 2010 and April 2014. Epidemiological studies show a generally elevated risk of gastrointestinal illness in bathers compared to non-bathers but often no clear association with water quality as measured by faecal indicator bacteria; this is especially true where study sites are impacted by non-point source pollution. Evidence from QMRAs support the lack of a consistent water quality association for non-point source-impacted beaches. It is suggested that source attribution, through quantified microbial source apportionment, linked with appropriate use of microbial source tracking methods should be employed as an integral part of future epidemiological surveys.

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Section: Epidemiologymentioning

confidence: 99%

Recreational Water and Infection: A Review of Recent Findings

Fewtrell

Kay

2015

Curr Envir Health Rpt

128

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“…A cohort study of bathers and non‐bathers has also shown that there are significant risks of gastrointestinal infections for those who take baths in the polluted water. Medical consultations and medication costs are higher among bathers, who are at an increased risk of morbidity (Papastergiou et al ). The situation gets worse when the level of pollutants in the water goes beyond permissible limits.…”

Section: Mechanisms—ritual Bathing To Health Implicationsmentioning

confidence: 99%

The Impact of Ritual Bathing in a Holy Hindu River on Waterborne Diseases

Chowdhury

Bohara²,

Katuwal

et al. 2019

The Developing Economies

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In this paper, we identify the role of religious practices on individual outcomes by examining if bathing in polluted river water for religious reasons affects the likelihood of missing days at work. To exploit the relationship, we use a primary survey (N = 1,200) of the residents of Kathmandu Valley, Nepal on their Bagmati River water usage. Probit and negative binomial estimation strategies reveal that bathing in river water, driven by traditional and cultural norms, is significantly associated with a higher probability of missing work. Among other factors, accessibility to personal sanitation facilities have a negative and significant correlation with the likelihood of missing work due to health reasons.

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“…Epidemiological studies have found that swimming, and to a lesser extent, rowing and canoeing, in open water is associated with an increased risk of gastrointestinal illness [11][12][13][14], even in locations that meet bathingwater standards [15][16][17]. As would be expected, given the range of 'open-water' settings, risk varies by location, largely determined by the source and catchment area.…”

Section: Illness Associated With Previous Open-water Swimsmentioning

confidence: 99%

A large outbreak of gastrointestinal illness at an open-water swimming event in the River Thames, London

et al. 2017

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Open-water swimming is increasingly popular, often in water not considered safe for bathing. Limited evidence exists on the associated health risks. We investigated gastrointestinal illness in 1100 swimmers in a River Thames event in London, UK, to describe the outbreak and identify risk factors. We conducted a retrospective cohort study. Our case definition was swimmers with any: diarrhoea, vomiting, abdominal cramps lasting ⩾48 h, nausea lasting ⩾48 h, with onset within 9 days after the event. We used an online survey to collect information on symptoms, demographics, pre- and post-swim behaviours and open-water experience. We tested associations using robust Poisson regression. We followed up case microbiological results. Survey response was 61%, and attack rate 53% (338 cases). Median incubation period was 34 h and median symptom duration 4 days. Five cases had confirmed microbiological diagnoses (four Giardia, one Cryptosporidium). Wearing a wetsuit [adjusted relative risk (aRR) 6·96, 95% confidence interval (CI) 1·04-46·72] and swallowing water (aRR 1·42, 95% CI 1·03-1·97) were risk factors. Recent river-swimming (aRR 0·78, 95% CI 0·67-0·92) and age >40 years (aRR 0·83, 95% CI 0·70-0·98) were protective. Action to reduce risk of illness in future events is recommended, including clarification of oversight arrangements for future swims to ensure appropriate risk assessment and advice is provided.

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Elevated Bathing-Associated Disease Risks Despite Certified Water Quality: A Cohort Study

Cited by 27 publications

References 25 publications

Recreational Water and Infection: A Review of Recent Findings

Recreational Water and Infection: A Review of Recent Findings

The Impact of Ritual Bathing in a Holy Hindu River on Waterborne Diseases

A large outbreak of gastrointestinal illness at an open-water swimming event in the River Thames, London

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