Enteric pathogens in pool water can be unintentionally ingested during swimming, increasing the risk of Acute Gastrointestinal Illness. Swimmer activities and behaviors influence pool water ingestion rates, and can be quantified for use in risk assessment. Enteric infection risk estimates help identify data gaps, areas to focus resources, and research needs. Primary objectives of this study were to develop electronic, self-administered "exposure" and "pool operations" questionnaires; to gather swimmer behavior and activity data for use in risk assessment; and to estimate Cryptosporidium parvum infection risk in swimmers. Results were used to identify data gaps and future research needs relative to treated recreational water. To achieve these objectives, 126 swimmers were recruited at four pool sites in Tucson, Arizona, video-taped, and asked to complete a post-swim questionnaire. Forty-six of the 126 swimmers submitted a 24 hr post-swim urine sample for quantifying pool water ingestion. Head submersion frequency and duration and splashes to the face were observed and quantified in video analysis, and activities and behaviors were reported on the exposure questionnaire. Variable data were analyzed for associations with pool water ingestion estimated by urinalysis. Results indicate questionnaires can be self-administered electronically; the exposure questionnaire can be used to estimate ingestion magnitude in place of urinalysis; leisure swimming activities (diving, playing, splashing, wading, sitting) and frequency of face splashes are ingestion exposure factors; and that Cryptosporidium infection risk is greatest among leisure swimmers. Other activities observed and suspected of having associations with ingestion were short submersion durations (<1 sec), and spitting and spouting water. More research and resources focused on improving treated recreational water environments and reducing risks among swimmers are needed. Developing an indicator organism test representative of Cryptosporidium, a monitoring program for treated recreational water, education aimed at leisure swimmer, and routine engineering and administrative controls are recommended. Swimming is a unique activity that can be enjoyed by people of all ages and abilities. Controlling hazards in pool environments reduces Recreational Waterborne Illness risks associated with pool water ingestion and improves the health and safety of swimmers.
| Identifer | oai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/293495 |
| Date | January 2013 |
| Creators | Suppes, Laura Michele |
| Contributors | Reynolds, Kelly A., O'Rourke, Mary Kay, Gerba, Charles P., Reynolds, Kelly A. |
| Publisher | The University of Arizona. |
| Source Sets | University of Arizona |
| Language | English |
| Detected Language | English |
| Type | text, Electronic Dissertation |
| Rights | Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. |
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