Quantitative microbial risk assessment of acute gastrointestinal illness attributable to freshwater recreation in Ontario.

Autor: Ngo H; Water, Health, and Applied Microbiology Lab (WHAM Lab), Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada., Parmley EJ; Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada., Ricker N; Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada., Winder C; Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada., Murphy HM; Water, Health, and Applied Microbiology Lab (WHAM Lab), Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada. heather.murphy@uoguelph.ca.
Jazyk: angličtina
Zdroj: Canadian journal of public health = Revue canadienne de sante publique [Can J Public Health] 2024 Dec 10. Date of Electronic Publication: 2024 Dec 10.
DOI: 10.17269/s41997-024-00969-4
Abstrakt: Objectives: The burden of disease associated with acute gastrointestinal illness (AGI) in Canada is estimated to be ~ 20 million cases/year. One known risk factor for developing AGI is recreation in freshwater bodies such as lakes. The proportion of cases attributable to freshwater recreation in Canada, however, is currently unknown. The study objective was to estimate the risk of developing AGI from exposure to Giardia, Cryptosporidium, Campylobacter, Escherichia coli O157:H7, norovirus, and Salmonella during freshwater recreation in Ontario, Canada.
Methods: A quantitative microbial risk assessment (QMRA) was conducted to estimate the number of AGI cases per 1000 recreational events associated with freshwater recreation. QMRA utilizes four steps: hazard identification, exposure assessment, dose-response modelling, and risk characterization. A probabilistic model was developed using the following inputs accounting for uncertainty and variability: published data on pathogen prevalence and concentration in freshwaters in Ontario (hazard identification), recreator water ingestion volumes (exposure), pathogen-specific dose-response models, and ratios between numbers of infections and symptomatic disease cases to estimate illness risks (risk characterization).
Results: The mean estimated AGI risk associated with recreation ranged from 0.8 to 36.7 cases per 1000 swimmers (5th-95th probability interval: 0-226.3 cases/1000) which is in line with previous studies conducted in Lake Ontario, as well as prior QMRAs of freshwater recreation. Upper range predicted values exceeded the Health Canada guideline of less than 20 cases per 1000 recreators.
Conclusion: This study shows that QMRA can be used to estimate disease risk in the absence of large-scale epidemiological studies. The results demonstrate a range of risk that is in line with exposure to pristine (low risk estimates) and more contaminated waters (high risk estimates) and capture the potential risk to vulnerable populations.
Competing Interests: Declarations. Ethics approval: N/A. Consent to participate: N/A. Consent for publication: N/A. Conflict of interest: Murphy is a member of the Health Professionals Advisory Board for the International Joint Commission that advises the Canadian and US governments on transboundary water issues related to health. She has also received funding from Drexel University’s Academy of Natural Science through the William Penn Foundation to conduct a risk assessment of recreational waterborne disease in the City of Philadelphia (Grant # ANS Award # DWRF-19–01). Her Canada Research Chair program also includes an area on studying recreational waterborne disease in Canada (Grant #950–232787). Parmley is engaged in research funded by the Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council, the Public Health Agency of Canada, and the Canadian Safety and Security Program. She is currently President of the Board of Directors of the Centre for Coastal Health, past president of the Canadian Association of Veterinary Epidemiology and Preventive Medicine, treasurer and member of the Board of Directors of the McEachran Institute, and a member of the Advisory Council for Research Directions: One Health. Prior to February 2019, she was employed by the Public Health Agency of Canada.
(© 2024. The Author(s) under exclusive license to The Canadian Public Health Association.)
Databáze: MEDLINE
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