Indicators of Recreational Water Contamination and Illness

描述（由申请人提供）：2002 年，NAS/NRC 要求我们小组审查所有将水质指标与人类健康联系起来的证据。我们将这些结果作为荟萃分析发表（Wade et al. 2003）。传统指标（总大肠菌群、粪大肠菌群和肠球菌）存在问题，因为较长的分析时间（18-96 小时）使得及时发出警告变得困难。微生物技术的进步现已显而易见，并证明了将当前指标与更快速测量的新指标进行比较的合理性。此外，统计方法的重要进展（例如使用暴露权重的逆概率估计多元剂量反应函数）尚未用于研究这些指标与健康和预测的重要多元关系的可能性。作为准备，我们于 2003 年在圣地亚哥的 6 个海滩进行了一项研究。我们招募了 12,458 名海滩使用者，记录了详细的游泳历史并收集了 14 天的疾病数据。我们每小时在与游泳者地点相关的地点收集水样。我们对该试点数据的分析表明，我们有能力检测游泳风险，并且与试点中使用的 1 种新型指标（F 大肠杆菌噬菌体）的健康结果密切相关。我们最新发布的 EPA 数据显示，胃肠道 (GI) 疾病与通过快速 QPCR（我们使用的方法相同）在淡水地点测得的肠球菌之间存在很强的相关性。我们建议，在 4 个夏天的时间里，使用相同的设计，在 Doheny 海滩（加利福尼亚州污染最严重的公共海滩之一）招募至少 17,600 名海滩用户，并扩大我们的指标测试范围，以包括快速方法和来自与每个游泳者在空间上相关的水样本的病毒剂。我们 2003 年的试点研究团队完好无损（加州大学伯克利分校、SCCWRP、哈佛大学、UNO、OHSU），现在 NOAA Hollings 海洋实验室也加入了。关于关闭海滩的决定具有巨大的经济影响。如果成功，我们将量化传统指标和病毒指标的健康与新型快速方法之间的关系。

DESCRIPTION (provided by applicant): In 2002, our group was asked by NAS/NRC to review all evidence linking water quality indicators to human health. We published these results as a meta-analysis (Wade et al. 2003). Traditional indicators (total coliform, fecal coliform, and Enterococcus) are problematic because prolonged analysis times (18-96 hours) make timely warnings difficult. Advances in microbiologic techniques are now pronounced and justify a comparison of current indicators with more rapidly measured new indicators. Additionally, important advances in statistical methods (such as the estimation of multivariate dose-response functions using inverse-probability of exposure weighting) have not been used to investigate the possibility of important multivariate relationships of these indicators to health and prediction. As preparation, we conducted a study at 6 San Diego beaches in 2003. We enrolled 12,458 beach users, recorded detailed swimming histories and collected illness data for 14 days. We collected hourly water samples at sites linked to the swimmer locations. We present analyses of this pilot data showing our ability to detect risk from swimming and a strong association with health outcomes of 1 novel indicator (F+ coliphage) used in the pilot. We present newly released EPA data showing a strong correlation between gastrointestinal (Gl) illness and Enterococcus measured by rapid QPCR (same method we use) in a freshwater site. We propose, over 4 summers, to enroll at least 17,600 beach users at Doheny Beach (one of California's most contaminated public beaches) using the same design and expanding our indicator testing to include rapid methods and viral agents from water samples spatially linked to each swimmer. Our 2003 pilot study research team is entirely intact (UC Berkeley, SCCWRP, Harvard, UNO, OHSU) and now has been joined by the NOAA Hollings Marine Lab. Decisions about beach closures have enormous economic implications. If successful, we will quantify the relationship between health and novel rapid methods for traditional indicators as well as viral indicators.