MARINE WATERS CONTAMINATED WITH DOMESTIC SEWAGE - NONENTERIC ILLNESSES ASSOCIATED WITH BATHER EXPOSURE IN THE UNITED-KINGDOM

Objectives. This study identified possible dose-response relationships among bathers exposed to marine waters contaminated with domestic sew age and subsequent risk of nonenteric illness. Methods. Four intervent ion follow-up studies were conducted within the United Kingdom. Health y volunteers (n = 1273) were randomized into bather and nonbather grou ps. Intensive water-quality monitoring was used to assign five bacteri ological indices of water quality to individual bathers. Illnesses stu died were acute febrile respiratory illness, and eye, ear, and skin ai lments. Results. Fecal streptococci exposure was predictive of acute f ebrile respiratory illness, while fecal coliform exposure was predicti ve of ear ailments. Estimated thresholds of effect occurred at bather exposures above 60 fecal streptococci and 100 fecal coliform per 100 m l of water, respectively. Although no relationship was found between e ye ailments adn indicator organism exposure, compared with nonbathers, bathers were at higher risk for eye ailments. Conclusions. Nonenteric illness can be transmitted via recreational contact with marine water s contaminated with sewage. These results argue against the use of a s ingle indicator to establish water quality standards.