Association of gastrointestinal illness and recreational water exposure at an inland U.S. beach

Recent epidemiology studies examining U.S. recreational water exposure and illness relationships have focused primarily on coastal and Great Lakes beaches. Human-made lakes in the U.S. have received little attention in epidemiology studies despite contributing to more waterborne disease epidemics annually than coastal U.S. waters. In a comprehensive beach cohort study, we examined relationships between water quality indicators and reported adverse health outcomes among users of a beach at an inland U.S. lake. Human health data was collected over 26 swimming days during the 2009 swimming season in conjunction with water quality measurements. Adverse health outcomes were reported 8-9 days post-exposure via a phone survey. Wading, playing or swimming in the water was observed to be a significant risk factor for GI illness (adjusted odds ratio (AOR) of 3.2; CI 1.1, 9.0). Among water users, Escherichia coli density was significantly associated with elevated GI illness risk where the highest E. coli quartile was associated with an AOR of 7.0 (CI 1.5, 32). GI illness associations are consistent with previous freshwater epidemiology studies. Our findings are unique in that our observations of positive associations with GI illness risk are based upon a single daily E. coli measurement. Lastly, this study focused on an understudied issue, illness risk at inland reservoirs. Our results support the usefulness of E. coli as a health-relevant indicator of water quality for this inland U.S. beach.     

Evaluation of public health risks at recreational beaches in Lake Michigan via detection of enteric viruses and a human-specific bacteriological marker

Each year the National Resource Defense Council addresses the quality of US beaches by routine bacterial indicators. In the Great Lakes region the indicator used is Escherichia coli and for 2007 more beaches were closed and impacted than ever before. In this study, water quality was addressed at two Lake Michigan Beaches over the 2004 swimming season by monitoring infectious enteric viruses by cell culture and integrated PCR and for a human sewage marker based on the Enterococcal Surface Protein (esp). Our goals for this study were to 1) examine the occurrence and variety of human enteric viruses present during peak usage of the beaches 2) determine key variables for development of predictive models for viruses; and 3) use quantitative risk assessment to estimate the potential health impact. Our results demonstrate that for both beaches predictive models of virus pollution were best described utilizing physical parameters like wind speed, wind direction and water temperature. The esp marker was not predictive of human viruses. The daily risk of acquiring a viral infection at either of the beaches ranged from 0.2 to 2.4/1000 swimmers using a quantitative microbial risk assessment model, with three swims during a day at the beach for children and over the season, the risk was 9-15/1000 swimmers using adenovirus as the model.Conclusions: Lake Michigan recreational beaches are being adversely impacted by human fecal pollution. Monitoring for the traditional indicators of water quality does not address viral risks and models can be developed and potentially used as real-time water quality forecasting tools.     

Fecal indicator bacteria are abundant in wet sand at freshwater beaches

Potential fecal contamination of sand in the wave-washed zone of public bathing beaches is overlooked in beach monitoring programs. Activity in this zone can bring pathogens to the sand surface or into the water, presenting a health risk to sensitive populations. On a unit weight basis (colony forming units per 100g), the mean summer abundance of the fecal indicator bacteria enterococci and Escherichia coli was 3-38 times higher in the top 20 cm of wet-sand cores than in the water column at six freshwater bathing beaches. E. coli were 4 times more abundant than enterococci in water but counts were similar in the sand. A correlation (r=0.60) existed between E. coli counts in the water and in the top 5 cm of sand only, whereas no relationship existed between enterococci abundance in water and sand. In general, enterococci were most numerous in the 5-10 cm sand stratum and E. coli in the 0-5 cm stratum. These preliminary data show that wet freshwater beach sand is a reservoir of fecal indicator bacteria. Enteric pathogens may also be present in beach sand.     

Efficacy of monitoring and empirical predictive modeling at improving public health protection at Chicago beaches

Efforts to improve public health protection in recreational swimming waters have focused on obtaining real-time estimates of water quality. Current monitoring techniques rely on the time-intensive culturing of fecal indicator bacteria (FIB) from water samples, but rapidly changing FIB concentrations result in management errors that lead to the public being exposed to high FIB concentrations (type II error) or beaches being closed despite acceptable water quality (type I error). Empirical predictive models may provide a rapid solution, but their effectiveness at improving health protection has not been adequately assessed. We sought to determine if emerging monitoring approaches could effectively reduce risk of illness exposure by minimizing management errors. We examined four monitoring approaches (inactive, current protocol, a single predictive model for all beaches, and individual models for each beach) with increasing refinement at 14 Chicago beaches using historical monitoring and hydrometeorological data and compared management outcomes using different standards for decision-making. Predictability (R²) of FIB concentration improved with model refinement at all beaches but one. Predictive models did not always reduce the number of management errors and therefore the overall illness burden. Use of a Chicago-specific single-sample standard—rather than the default 235 E. coli CFU/100 ml widely used—together with predictive modeling resulted in the greatest number of open beach days without any increase in public health risk. These results emphasize that emerging monitoring approaches such as empirical models are not equally applicable at all beaches, and combining monitoring approaches may expand beach access.     

Sustainable cities: The relationships between urban built forms and density indicators

The paper introduces a novel indicator of urban built form termed Form Signature. Generic models of four urban built forms are developed including pavilion, terrace, court and a newly introduced tunnel-court which are used to compare and contrast their land-use performance and density characteristics. Selecting plot ratio and site coverage as the most popular and appropriate density indicators, the simultaneous relationship to each of the considered urban built forms is shown graphically with the number of storeys, plan depth and cut-off angle as the main variables of interest. For existing urban areas, the resulting graphs provide a robust tool for statistical analysis of contexts such as climate, economy, energy and crime potential and establish their relationship to form and density. To show the value of the contribution, analysing 32 case studies from 19 cities in different global locations showed an insignificant relationship between climate and form/density of urban areas, while practically depicting that urban areas built in court form acquire higher cut-off angle compared to terrace form urban developments. For the planning of future urban areas, the resulting relationships provide an application-oriented urban planning tool to facilitate the most effective land-use method in order to achieve sustainable cities. Examples showing the potential of the tool for future statistical energy and social analysis of urban areas are provided. Finally, a relative comparison shows that the newly-introduced tunnel-court form achieves the greatest density while pavilion achieves the lowest.     

A water quality index for lake beaches

Discriminant analysis of ten years of data from seven beaches located on three lakes in Gatineau Park (Québec) leads to a canonical vector accounting for most of the variability of the three microbial count variables recorded. This discriminant axis orders the beaches along a cline of increasing pollution. It is then transformed into a microbial water quality index calibrated for the given set of beaches, which is in turn used to study the medium-term variability and the long-term evolution of water quality of the beaches.     

Persistence of fecal indicator bacteria in Santa Monica Bay beach sediments

Monitoring the water quality of recreational beaches is only one step toward understanding microbial contamination -- the primary cause of beach closings. The surf zone sediment reservoir is typically overlooked and may also be important. This study involved monitoring the fecal indicator bacteria (FIB) levels in water and sediment at three ocean beaches (two exposed and one enclosed) during a storm event, conducting laboratory microcosm experiments with sediment from these beaches, and surveying sediment FIB levels at 13 beaches (some exposed and some enclosed). Peaks in Escherichia coli and enterococci concentrations in water and sediment coincided with storm activity at the two exposed beaches, while levels of both FIB were consistently high and irregular at the enclosed beach. Results from microcosm experiments showing similar, dramatic growth of FIB in both overlying water and sediment from all beaches, as well as results from the beach survey, support the hypothesis that the quiescent environment rather than sediment characteristics can explain the elevated sediment FIB levels observed at enclosed beaches. This work has implications for the predictive value of FIB measurements, and points to the importance of the sediment reservoir.     

Nowcast modeling of Escherichia coli concentrations at multiple urban beaches of southern Lake Michigan

Predictive modeling for Escherichia coli concentrations at effluent-dominated beaches may be a favorable alternative to current, routinely criticized monitoring standards. The ability to model numerous beaches simultaneously and provide real-time data decreases cost and effort associated with beach monitoring. In 2004, five Lake Michigan beaches and the nearby Little Calumet River outfall were monitored for E. coli 7 days a week; on nine occasions, samples were analyzed for coliphage to indicate a sewage source. Ambient lake, river, and weather conditions were measured or obtained from independent monitoring sources. Positive tests for coliphage analysis indicated sewage was present in the river and on bathing beaches following heavy rainfall. Models were developed separately for days with prevailing onshore and offshore winds due to the strong influence of wind direction in determining the river's impact on the beaches. Using regression modeling, it was determined that during onshore winds, E. coli could be adequately predicted using wave height, lake chlorophyll and turbidity, and river turbidity (R2 = 0.635, N = 94); model performance decreased for offshore winds using wave height, wave period, and precipitation (R2 = 0.320, N = 124). Variation was better explained at individual beaches. Overall, the models only failed to predict E. coli levels above the EPA closure limit (235 CFU/100 ml) on five of eleven occasions, indicating that the model is a more reliable alternative to the monitoring approach employed at most recreational beaches.     

Modeling Enterococcus densities measured by quantitative polymerase chain reaction and membrane filtration using environmental conditions at four Great Lakes beaches

Data collected by the US Environmental Protection Agency (EPA) during the summer months of 2003 and 2004 at four US Great Lakes beaches were analyzed using linear regression analysis to identify relationships between meteorological, physical water characteristics, and beach characteristics data and the fecal indicator bacteria, Enterococcus. Water samples were analyzed for Enterococcus densities by quantitative polymerase chain reaction (qPCR) and membrane filtration (MF). This paper investigates the ability of regression models to accurately predict Enterococcus densities above or below a threshold value, using environmental data on a beach-by-beach basis for both methods. The ability to create statistical models for real-time water quality analysis would allow beach managers to make more accurate decisions regarding beach safety. Results from linear regression models indicate that environmental factors explain more of the variability in Enterococcus densities measured by MF than Enterococcus densities measured by qPCR. Results also show that models for both methods did not perform well at predicting occurrences in which water quality levels exceeded a threshold.     

Effects of the nuisance algae, Cladophora, on Escherichia coli at recreational beaches in Wisconsin

Recreational beaches constitute a large part of the 12 billion dollar per year tourism industry in Wisconsin. Beach closures due to microbial contamination are costly in terms of lost tourism revenue and adverse publicity for an area. Escherichia coli (E. coli), is used as an indicator of microbial contamination, as high concentrations of this organism should indicate a recent fecal contamination event that may contain other, more pathogenic, bacteria. An additional problem at many beaches in the state is the nuisance algae, Cladophora. It has been hypothesized that mats of Cladophora may harbor high concentrations of E. coli. Three beaches in Door County, WI were selected for study, based on tourist activity and amounts of algae present. Concentrations of E. coli were higher within Cladophora mats than in surrounding water. Beaches displayed an E. coli concentration gradient in water extending away from the Cladophora mats, although this was not statistically significant. Likewise, the amount of Cladophora observed on a beach did not correlate with E. coli concentrations found in routine beach monitoring samples. More work is needed to determine the impact of mats of Cladophora on beach water quality, as well as likely sources of E. coli found within the mats.