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American Journal of Epidemiology Advance Access published online on November 11, 2009
American Journal of Epidemiology, doi:10.1093/aje/kwp297
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American Journal of Epidemiology © The Author 2009. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Original Contribution

Sporadic Gastroenteritis and Recreational Swimming in a Longitudinal Community Cohort Study in Melbourne, Australia

Katie Dale*, Rory Wolfe, Martha Sinclair, Margaret Hellard and Karin Leder

* Correspondence to Katie Dale, School of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia, 3004 (e-mail: kwebby{at}hotmail.com).

Received for publication March 30, 2009. Accepted for publication August 18, 2009.

The relation between sporadic gastroenteritis and recreational swimming was examined in a cohort of 2,811 people in Melbourne, Australia, over a 15-month period (September 1997–February 1999). Data from a prospective community-based study of gastroenteritis were used for a Poisson analysis of temporality between reported swimming (in public or private pools/spas and in marine or freshwater settings) and a highly credible gastroenteritis (HCG) event. Overall, HCG events were more likely in participants who had swum in a public pool/spa (incidence rate ratio (IRR) = 1.25, 95% confidence interval (CI): 1.10, 1.42; P = 0.001) or river/lake/dam (IRR = 1.77, 95% CI: 1.13, 2.79; P = 0.014) during the previous week or had swum in a public pool/spa (IRR = 1.29, 95% CI: 1.13, 1.46; P < 0.001) during the previous 2 weeks. Subanalysis by age showed that HCG episodes were also more likely in adults who had swum in a private pool/spa (IRR = 1.56, 95% CI: 1.02, 2.39; P = 0.042) during the previous week or swum at an ocean/beach (IRR = 1.78, 95% CI: 1.12, 2.81; P = 0.014) during the previous 2 weeks, demonstrating significant associations between all swimming locations and gastrointestinal symptoms. This study showed that although the incremental risk of recreational swimming is significant, it is relatively small.

bathing beaches; fresh water; gastroenteritis; gastrointestinal diseases; population surveillance; swimming; swimming pools

Abbreviations: CI, confidence interval; HCG, highly credible gastroenteritis; IRR, incidence rate ratio; OR, odds ratio


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