A prospective study of marine phytoplankton and reported illness among recreational beachgoers in Puerto Rico, 2009
Lin, C., Tim Wade, E. Sams, A. Dufour, A. Chapman, AND E Hilborn. A prospective study of marine phytoplankton and reported illness among recreational beachgoers in Puerto Rico, 2009. ENVIRONMENTAL HEALTH PERSPECTIVES. National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, NC, 124(4):477-483, (2016).
This study finds an association between low concentrations of marine phytoplankton and adverse health effects among recreational water users at a tropical beach. Phytoplankton concentrations are expected to increase if nutrient inputs continue and as waters warm during climate change. Marine phytoplankton may be a marker of other associated but unmeasured marine contaminants.
BACKGROUND: Blooms of marine phytoplankton may adversely affect human health. The potential public health impact of low-level exposures is not well established, and few prospective cohort studies of recreational exposures to marine phytoplankton have been conducted.OBJECTIVE: We evaluated the association between phytoplankton cell counts and subsequent illness among recreational beachgoers.METHODS:We recruited beachgoers at Boquer6n Beach, Puerto Rico, during the summer of 2009. We conducted interviews at three time points to assess baseline health, water activities, and subsequent illness. Daily water samples were quantitatively assayed for phytoplankton cell count. Logistic regression models, adjusted for age and sex, were used to assess the association between exposure to three categories of phytoplankton concentration and subsequent illness.RESULTS: During 26 study days, 15,726 individuals successfully completed all three interviews. Daily total phytoplankton cell counts ranged from 346 to 2,012 cells/ml (median, 712 cells/ml). The category with the highest (≥75th percentile) total phytoplankton cell count was associated with eye irritation [adjusted odds ratio (OR) = 1.30; 95% confidence interval (Cl): 1.01, 1.66], rash (OR = 1.27; 95% Cl: 1.02, 1.57), and earache (OR = 1.25; 95% Cl: 0.88, 1.77). In phytoplankton group-specific analyses, the category with the highest Cyanobacteria counts was associated with respiratory illness (OR = 1.37; 95% Cl: 1.12, 1.67), rash (OR = 1.32; 95% Cl: 1.05, 1.66), eye irritation (OR = 1.25; 95% Cl: 0.97, 1.62), and earache (OR = 1.35; 95% Cl: 0.95, 1.93CONCLUSIONS: We found associations between recreational exposure to marine phytoplankton and reports of eye irritation, respiratory illness, and rash. We also found that associations varied by phytoplankton group, with Cyanobacteria having the strongest and most consistent associations.