The overall goal of the current ambient water quality criteria for bacteria in the United States is to provide public health protection from gastroenteritis (gastrointestinal (GI) illness) associated with exposure to fecal contamination during water-contact recreation. Because fecal matter can be a major source of pathogens in ambient water, and because it is not practical or feasible to monitor for the full spectrum of all pathogens that may occur in water, water quality criteria are specified throughout the world in terms of fecal indicator organism densities. For decades, these fecal indicator organisms have served as surrogates for potential pathogens and subsequent health risks in both recreational and drinking waters. The purpose of this white paper is to describe the existing knowledgebase available to characterize the relative risks of human illness from various sources of fecal contamination in recreational waters. Information related to human exposures to pathogens in fecally contaminated recreational and drinking waters was obtained by searching the scientific literature for epidemiological studies related to exposure to recreational waters and reports of outbreak investigations from both recreational and drinking waters.

Cover title. "EPA 822-R-09-001." "February 2009." Lead writer: Jeffery Soller. Includes bibliographical references (pages 68-83).