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Equivalency of risk for a modified health endpoint: a case from recreational water epidemiology studies
Citation:
WYMER, L. J., T. J. WADE, AND A. P. DUFOUR. Equivalency of risk for a modified health endpoint: a case from recreational water epidemiology studies. BMC PUBLIC HEALTH. BioMed Central Ltd, London, Uk, 13(459):1-8, (2013).
Impact/Purpose:
To inform the public.
Description:
The United States Environmental Protection Agency (US EPA) and its predecessors have conducted three distinct series of epidemiological studies beginning in 1948 on the relationship between bathing water quality and swimmers' illnesses. Keeping pace with advances in microbial technologies, these studies differed in their respective microbial indicators of water quality. Another difference, however, has been their specific health endpoints. The latest round of studies, the National Epidemiological Assessment of Recreational (NEEAR) Water studies initiated in 2002, used a case definition, termed "NEEAR GI illness" (NGI), for gastrointestinal illness corresponding closely to classifications employed by contemporary researchers, and to that proposed by the World Health Organization. NGI differed from the previous definition of "highly credible gastrointestinal illness" (HCGI), upon which the US EPA's 1986 bathing water criteria had been based, primmarily by excluding fever as a prerequisite.
