Background: Blooms of marine phytoplankton may adversely affect human health. The potential public health impact of low-level exposures is not well established, and few prospective cohort studies of recreational exposures to marine phytoplankton have been conducted.
Objective: We evaluated the association between phytoplankton cell counts and subsequent illness among recreational beachgoers.
Methods: We recruited beachgoers at Boquerón Beach, Puerto Rico, during the summer of 2009. We conducted interviews at three time points to assess baseline health, water activities, and subsequent illness. Daily water samples were quantitatively assayed for phytoplankton cell count. Logistic regression models, adjusted for age and sex, were used to assess the association between exposure to three categories of phytoplankton concentration and subsequent illness.
Results: During 26 study days, 15,726 individuals successfully completed all three interviews. Daily total phytoplankton cell counts ranged from 346 to 2,012 cells/mL (median, 712 cells/mL). The category with the highest (≥ 75th percentile) total phytoplankton cell count was associated with eye irritation [adjusted odds ratio (OR) = 1.30; 95% confidence interval (CI): 1.01, 1.66], rash (OR = 1.27; 95% CI: 1.02, 1.57), and earache (OR = 1.25; 95% CI: 0.88, 1.77). In phytoplankton group-specific analyses, the category with the highest Cyanobacteria counts was associated with respiratory illness (OR = 1.37; 95% CI: 1.12, 1.67), rash (OR = 1.32; 95% CI: 1.05, 1.66), eye irritation (OR = 1.25; 95% CI: 0.97, 1.62), and earache (OR = 1.35; 95% CI: 0.95, 1.93).
Conclusions: We found associations between recreational exposure to marine phytoplankton and reports of eye irritation, respiratory illness, and rash. We also found that associations varied by phytoplankton group, with Cyanobacteria having the strongest and most consistent associations.
1Oak Ridge Institute for Science and Education (ORISE) Research Participation Program at the U.S. Environmental Protection Agency (EPA), Chapel Hill, North Carolina, USA; 2Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA; 3Environmental Public Health Division, National Health and Environmental Effects Research Laboratory, Office of Research and Development, U.S. EPA, Research Triangle Park, North Carolina, USA; 4Microbial Chemical Environmental Assessment Research Division, National Exposure Research Laboratory, Office of Research and Development, U.S. EPA, Cincinnati, Ohio, USA; 5GreenWater Laboratories, Palatka, Florida, USA
Recommended Citation:
Cynthia J. Lin,1,2 Timothy J. Wade,et al. A Prospective Study of Marine Phytoplankton and Reported Illness Among Recreational Beachgoers in Puerto Rico, 2009[J]. Environmental Health Perspectives,2016-01-01,Volume 124(Issue 4):477