Health Risks of Limited-Contact Water Recreation
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Date
2012-02Author
Dorevitch, Samuel
Pratap, Preethi
Wroblewski, Meredith
Hryhorczuk, Daniel O.
Li, Hong
Liu, Li C.
Scheff, Peter A.
Publisher
National Institute of Environmental Health SciencesMetadata
Show full item recordAbstract
BACKGROUND: Wastewater-impacted waters that do not support swimming are often used for
boating, canoeing, fishing, kayaking, and rowing. Little is known about the health risks of these limited-contact water recreation activities.
OBJECTIVES: We evaluated the incidence of illness, severity of illness, associations between water exposure and illness, and risk of illness attributable to limited-contact water recreation on waters dominated
by wastewater effluent and on waters approved for general use recreation (such as swimming).
METHODS: The Chicago Health, Environmental Exposure, and Recreation Study was a prospective cohort study that evaluated five health outcomes among three groups of people: those who engaged in limited-contact water recreation on effluent-dominated waters, those who engaged in limitedcontact
recreation on general-use waters, and those who engaged in non–water recreation. Data
analysis included survival analysis, logistic regression, and estimates of risk for counterfactual exposure scenarios using G-computation.
RESULTS: Telephone follow-up data were available for 11,297 participants. With non–water recreation as the reference group, we found that limited-contact water recreation was associated with the development of acute gastrointestinal illness in the first 3 days after water recreation at both effluentdominated waters [adjusted odds ratio (AOR) 1.46; 95% confidence interval (CI): 1.08, 1.96] and general-use waters (1.50; 95% CI: 1.09, 2.07). For every 1,000 recreators, 13.7 (95% CI: 3.1, 24.9) and 15.1 (95% CI: 2.6, 25.7) cases of gastrointestinal illness were attributable to limited-contact
recrea tion at effluent-dominated waters and general-use waters, respectively. Eye symptoms were associated with use of effluent-dominated waters only (AOR 1.50; 95% CI: 1.10, 2.06). Among water recreators, our results indicate that illness was associated with the amount of water exposure.
CONCLUSIONS: Limited-contact recreation, both on effluent-dominated waters and on waters designated for general use, was associated with an elevated risk of gastrointestinal illness.