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The incidence and health burden of earaches attributable to recreational swimming in natural waters: A prospective cohort study
Citation:
Wade, Tim, E. Sams, M. Beach, S. Collier, AND A. Dufour. The incidence and health burden of earaches attributable to recreational swimming in natural waters: A prospective cohort study. ENVIRONMENTAL HEALTH. Academic Press Incorporated, Orlando, FL, 21:12-67, (2013).
Impact/Purpose:
Earaches and outer ear infections are a common health symptom associated with swimming. In this study, we used estimates from a survey of over 50,000 beachgoers at nine beaches across the United States to estimate the excess risk and health burden of earaches associated with swimming in natural fresh and marine waters. We found that for every 1000 swimming events there were 7 excess cases of earache. These results will contribute to national estimates of waterborne disease.
Description:
Background: Earaches and outer ear infections are a common health symptom associated with swimming. In this study, we used estimates from a survey of over 50,000 beachgoers at nine beaches across the United States to estimate the excess risk and health burden of earaches associated with swimming in natural fresh and marine waters. Results: The overall incidence of self-reported earache was 1.6% in the 10-12 days after the beach visit. Earaches were more frequent in head immersion swimmers compared to non-swimmers across all beach sites and age groups. Earaches were unassociated with water sample measures of fecal contamination and turbidity. After adjustment for covariates, we calculated 7.12 excess earaches among head immersion swimmers per 1,000 swimming events. Twenty-four percent of those with earache reported missing their regular activities; 28% visited a doctor; 4% visited the emergency room; and 31% and 40% used prescription and non-prescription medications, respectively. Conclusions: swimming events at freshwater and marine beach sites. For every 1,000 swimming events there were 1.7 earaches that resulted in missed work or activity; 1.0 that resulted in a phone call to a doctor; 2.0 in visits to a doctor and 0.31 in visits to an emergency room. Since it is estimated that there are over 128 million swimming events in natural waters annually, the population burden of earaches resulting from swimming exposure is considerable and could be responsible for at least 900,000 excess earaches, 260,000 visits to the doctor, 39,900 visits to the emergency room and nearly $4 million dollars spent on prescription and over-the-counter medications. More accurate estimates of swimming exposure are needed to improve population burden and associated cost estimates.