[Health hazards through bathing in coastal waters of the North Sea].
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Research of virus in the sea water has been made by the concentrated method of adsorption-elution on glass powder. --This method has enabled us to strike the balance on the concentration of virus in the sea water, from the emission to the bank. The frequency of isolation of virus in the bathing zone considered as healthy is very high. The concentration of virus is practically constant in the length of an axis, 200 m distant in comparison with the bank.--The increase of particles of virus in the sea, in the estuary of the emission, reflects in the same way in the bathing zone, 5 m away from the bank. The phenomenon of dilution of the effluent in the sea water doesn't seem to play a part.
In the summer season 1999 an integrated epidemiological surveillance system (involving mobile emergency medical services, first aid and tourist stations, hyperbaric medical centres, bathing attendants) of sea-bathing-related accidents was set up on the coasts of Tuscany, central Italy, aimed at health promotion and education. The pilot phase allowed to collect a first set of information on periods and time with highest incidence of events, type of assistance delivered, kind of accident (trauma or illness) and seriousness of the event as codified by emergency medical services. The pilot experience also pointed out the changes to detection tools needed in order to obtain more precise and comparable data. Such corrections, introduced during the summer season 2000, could contribute to the creation of a model with potential applications in other Italian and European coastal regions.
The study to an analyse of 726 samples of sea water, taken monthly (1977-1978) at 23 stations. At the basis of the data concerning the NPP of total coliformas, 75,5% of the samples point out a clean water for the bathing place, 11,04% = "acceptable" and 9,96% = "dirty". Considering the data about the MPP of fecal coliformas and of fecal streptocques, the sanitary state is reported in 94,23% "clean for the bathing place", 1,77% "acceptable" and 4% dirty.
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The Authors examined bacteriological characteristics of the coast waters in the district of Catania. Contrary to initial expectations, the conditions of the coast of Catania, can be regarded more than satisfactory as regards sea-bathing, especially if these data are compared with those noticed from other Authors in different italian seaside resorts.
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There are many elements and factors that intervene to affect the quality of the coastal areas as all and none of them, taken individually, seems fundamental in defining the characteristics and to determine in a coherent way the risk associated to its use. Despite evident successes in the protection of public health, the present approach to the regulation of bathing water quality suffers several limitations. Difficulties in risk assessment due to the use of indicators of faecal contamination as parameters stated by law are discussed.
Several countries fail to systematically collect statistical data on accidents in bathing waters of recreational areas. Yet, drowning, near-drowning, head trauma and spinal chord injuries are important causes of mortality and morbidity throughout the world. In Italy, the available statistical data are circumscribed to drowning, and show that between 1969 and 1997 the mortality dropped from some 1,200 to some 500 cases/year, and its rate from 21 to 7.5 deaths per million resident/year. The mortality for drowning is much higher in males than in females, but in the period examined it halved in both the sexes. From 1969 to 1997, the mortality rates considerably decreased in all the age subgroups, but particularly in that of young people. The analysis of these data indicates that some general factors have played an important role, like a better education and information, a greater surveillance by adults and a better organisation of summer resorts. A national strategy aimed at preventing recreational accidents would provide much better results than those obtained without any planning.
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Since the introduction and strict application of EC guidelines on the monitoring of bathing waters began in Lower Saxony in 1989, it has been possible for the first time to reach a comprehensive evaluation of the water quality on the North Sea coast and in the rivers and lakes of this state. The 7648 samples which were analysed in this period produced the most favourable results on the East Friesian Islands, followed by the vast majority of the mainland bathing resorts and some lakes. On the lower stretches of the River Weser and in a few lakes levels were registered at times which exceeded the limits to such an extent that bathing was impossible. In 1991 extreme germination of total coliform bacteria was observed for the first time, presumably due to eutrophic conditions in combination with high water temperatures.
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This paper presents a preliminary attempt at obtaining an order-of-magnitude estimate of the global burden of disease (GBD) of human infectious diseases associated with swimming/bathing in coastal waters polluted by wastewater, and eating raw or lightly steamed filter-feeding shellfish harvested from such waters. Such diseases will be termed thalassogenic--caused by the sea. Until recently these human health effects have been viewed primarily as local phenomena, not generally included in the world agenda of marine scientists dealing with global marine pollution problems. The massive global scale of the problem can be visualized when one considers that the wastewater and human body wastes of a significant portion of the world's population who reside along the coastline or in the vicinity of the sea are discharged daily, directly or indirectly, into the marine coastal waters, much of it with little or no treatment. Every cubic metre of raw domestic wastewater discharged into the sea can carry millions of infectious doses of pathogenic microorganisms. It is estimated that globally, foreign and local tourists together spend some 2 billion man-days annually at coastal recreational resorts and many are often exposed there to coastal waters polluted by wastewater. Annually some 800 million meals of potentially contaminated filter-feeding shellfish/bivalves and other sea foods, harvested in polluted waters are consumed, much of it raw or lightly steamed. A number of scientific studies have shown that swimmers swallow significant amounts of polluted seawater and can become ill with gastrointestinal and respiratory diseases from the pathogens they ingest. Based on risk assessments from the World Health Organization (WHO) and academic research sources the present study has made an estimate that globally, each year, there are in excess of 120 million cases of gastrointestinal disease and in excess of 50 million cases of more severe respiratory diseases caused by swimming and bathing in wastewater-polluted coastal waters. Filter-feeding shellfish/bivalves, which are often harvested from wastewater-polluted areas of the sea, can effectively filter out and concentrate the microbial pathogens in the seawater. It can be roughly estimated that annually there are some 4 million cases of infectious hepatitis A and E (HAV/HEV), with some 40 thousand deaths and 40 thousand cases of long-term disability, mainly chronic liver damage, from consuming raw or lightly steamed filter-feeding shellfish/molluscs harvested globally from polluted coastal waters. The total global health impact of the thalassogenic diseases--human infectious diseases associated with pathogenic microorganisms from land-based wastewater pollution of the seas--is estimated to be about 3 million 'disability-adjusted life years' (DALY)/year, with an estimated economic loss of some 12 billion dollars per year. Due to the preliminary nature of the estimates in this study it is appropriate to assume that all of the above figures are no more than first approximations and that the true figures may be 50% higher or lower. Nevertheless, it is the author's belief that this study indicates that wastewater pollution of the sea results in a multi-billion dollar per year health burden and that preventing wastewater pollution of the sea is worthy of inclusion on the global agenda of marine pollution prevention and control.
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