Recreational Water and Infection: A Review of Recent Findings

Lorna Fewtrell, David Kay

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This paper reviews the latest evidence provided by epidemiological studies and quantitative microbial risk assessments (QMRAs) of infection risk from recreational water use. Studies for review were selected following a PubMed search for articles published between January 2010 and April 2014. Epidemiological studies show a generally elevated risk of gastrointestinal illness in bathers compared to non-bathers but often no clear association with water quality as measured by faecal indicator bacteria; this is especially true where study sites are impacted by non-point source pollution. Evidence from QMRAs support the lack of a consistent water quality association for non-point source-impacted beaches. It is suggested that source attribution, through quantified microbial source apportionment, linked with appropriate use of microbial source tracking methods should be employed as an integral part of future epidemiological surveys
Original languageEnglish
Pages (from-to)85-94
Number of pages10
JournalCurrent environmental health reports
Publication statusPublished - Mar 2015


  • epidemiology
  • quantitative microbial risk assessment
  • exposure
  • gastrointestinal illness
  • water quality
  • point and non-point source pollution


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