title: Symptomatology of children in contact with sea water contaminated with sewage.
abstract: OBJECTIVE
  The aim was to determine whether or not there was a measurable risk of ill health associated with contact with sea water for children between the ages of 6 and 11 years old.
  
  
  METHODS
  This was a prospective survey carried out on Blackpool beach. Parents of children between the ages of 6 and 11 years were interviewed over a seven week period during July, August, and September, 1990. Respondents were followed up 10-14 d after the original interview by either telephone or post. Water samples were collected on each day of the survey.
  
  
  METHODS
  939 interviews with parents or guardians were completed on the beach; 857 (91.9%) of these persons agreed to a follow up interview. The results of this study are based on 703 cases of matched data, of good quality, collected for each child on the beach and during a follow up interview.
  
  
  RESULTS
  Non-compliance with the European Community microbiological imperative standards for recreational waters at Blackpool Tower and South Pier sampling sites, respectively, ranged between: 6% and 7% for total coliforms; 13% and 25% for faecal coliforms; 69% and 80% for faecal streptococci (Guide standard); 50% and 67% for salmonellae and 73% and 88% for enteroviruses. There was a significant overall increase in the mean number of symptoms reported for each child (p < 0.001). However, the prevalence of certain symptoms increased significantly only in those children who had been in contact with the water on the day of the beach interview. These symptoms included vomiting (p < 0.0009), diarrhoea (p < 0.0001), itchy skin (p < 0.0009), fever (p < 0.0013), lack of energy (p < 0.0007), and loss of appetite (p < 0.0227). None of the other variables investigated could account for the significant increase in the reported symptom experience of those children in contact with sea water contaminated with sewage.
  
  
  CONCLUSIONS
  Children who come into contact with contaminated sea water are likely to develop symptoms as a result.
authors.affiliation: Environmental Epidemiology Research Unit, Lancaster University, United Kingdom.
authors.forename: L M
authors.initials: LM
authors.lastname: Alexander
authors.forename: A
authors.initials: A
authors.lastname: Heaven
authors.forename: A
authors.initials: A
authors.lastname: Tennant
authors.forename: R
authors.initials: R
authors.lastname: Morris
mesh_terms: D000208:Acute Disease; D002648:Child; D004739:England; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012623:Seawater; D012722:Sewage / Q000009:adverse effects*; D014871:Water Microbiology; D014876:Water Pollution / Q000009:adverse effects*
chemical_list: D012722:Sewage