American Journal of Epidemiology Advance Access published online on June 18, 2009
American Journal of Epidemiology, doi:10.1093/aje/kwp152
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Original Contribution |
Contact With Beach Sand Among Beachgoers and Risk of Illness
Correspondence to Dr. Christopher D. Heaney, Campus Box 7435, Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27599-7435 (e-mail: cheaney{at}email.unc.edu).
Received for publication February 2, 2009. Accepted for publication May 6, 2009.
Recent studies of beach sand fecal contamination have triggered interest among scientists and in the media. Although evidence shows that beach sand can harbor high concentrations of fecal indicator organisms, as well as fecal pathogens, illness risk associated with beach sand contact is not well understood. Beach visitors at 7 US beaches were enrolled in the National Epidemiological and Environmental Assessment of Recreational Water (NEEAR) Study during 2003–2005 and 2007 and asked about sand contact on the day of their visit to the beach (digging in the sand, body buried in the sand). Then, 10–12 days after their visit, participants were telephoned to answer questions about any health symptoms experienced since the visit. The authors completed 27,365 interviews. Digging in the sand was positively associated with gastrointestinal illness (adjusted incidence proportion ratio (aIPR) = 1.13, 95% confidence interval (CI): 1.02, 1.25) and diarrhea (aIPR = 1.20, 95% CI: 1.05, 1.36). The association was stronger between those buried in the sand and gastrointestinal illness (aIPR = 1.23, 95% CI: 1.05, 1.43) and diarrhea (aIPR = 1.24, 95% CI: 1.01, 1.52). Nonenteric illnesses did not show a consistent association with sand contact activities. Sand contact activities were associated with enteric illness at beach sites. Variation in beach-specific results suggests that site-specific factors may be important in the risk of illness following sand exposure.
bathing beaches; diarrhea; disease transmission, infectious; environmental pollution; fomites; fresh water; oceans and seas; sewage
Abbreviations: aIPR, adjusted incidence proportion ratio; CI, confidence interval; NEEAR, National Epidemiological and Environmental Assessment of Recreational Water
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