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Contact with beach sand among beach-goers and risk of illness
Citation:
Heaney, C. D., T. J. WADE, E. A. SAMS, R. L. CALDERON, M. Beach, AND A. P. DUFOUR. Contact with beach sand among beach-goers and risk of illness. AMERICAN JOURNAL OF EPIDEMIOLOGY. Johns Hopkins Bloomberg School of Public Health, 170(2):164-172, (2009).
Impact/Purpose:
research results
Description:
Background: Recently, numerous studies of fecal contamination of beach sand have triggered interest among scientists, the news media, and the general public. Evidence shows that beach sand harbors higher concentrations of fecal indicator organisms (microbes considered to indicate the potential presence of fecal pathogens) than nearby bathing waters. Although fecal pathogens have also been isolated from beach sand, the risk of illness associated with beach sand contact is not well understood. Methods: Beach visitors at seven beaches were enrolled in the study and asked about sand contact the day of their visit to the beach (digging in the sand; body buried in the sand). Ten to twelve days after the beach visit participants were telephoned to answer questions about health symptoms experienced since the visit. Results: We completed a total of 27,365 interviews. Digging in the sand was positively associated with gastrointestinal (GI) illness (adjusted incidence proportion ratio [aIPR]=1.14, 95% CI 1.02–1.26) and diarrhea (aIPR=1.20, 95% CI 1.05–1.36). The association was stronger among those who had their body buried in the sand and GI illness (aIPR=1.22, 95% CI 1.04–1.42) and diarrhea (aIPR=1.23, 95% CI 1.01-1.51). Non-enteric illnesses did not show a consistent association with sand contact activities. Variation in beach specific results suggest site-specific factors may be important in the risk of illness following sand exposure. Conclusions: Sand contact activities were associated with enteric illness at beach sites but there was variability in the effect across beach sites.
