title: Contact with beach sand among beachgoers and risk of illness.
abstract: Recent studies of beach sand fecal contamination have triggered interest among scientists and in the media. Although evidence shows that beach sand can harbor high concentrations of fecal indicator organisms, as well as fecal pathogens, illness risk associated with beach sand contact is not well understood. Beach visitors at 7 US beaches were enrolled in the National Epidemiological and Environmental Assessment of Recreational Water (NEEAR) Study during 2003-2005 and 2007 and asked about sand contact on the day of their visit to the beach (digging in the sand, body buried in the sand). Then, 10-12 days after their visit, participants were telephoned to answer questions about any health symptoms experienced since the visit. The authors completed 27,365 interviews. Digging in the sand was positively associated with gastrointestinal illness (adjusted incidence proportion ratio (aIPR) = 1.13, 95% confidence interval (CI): 1.02, 1.25) and diarrhea (aIPR = 1.20, 95% CI: 1.05, 1.36). The association was stronger between those buried in the sand and gastrointestinal illness (aIPR = 1.23, 95% CI: 1.05, 1.43) and diarrhea (aIPR = 1.24, 95% CI: 1.01, 1.52). Nonenteric illnesses did not show a consistent association with sand contact activities. Sand contact activities were associated with enteric illness at beach sites. Variation in beach-specific results suggests that site-specific factors may be important in the risk of illness following sand exposure.
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27599-7435, USA. cheaney@email.unc.edu
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Heaney
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sams
authors.forename: Steve
authors.initials: S
authors.lastname: Wing
authors.forename: Steve
authors.initials: S
authors.lastname: Marshall
authors.forename: Kristen
authors.initials: K
authors.lastname: Brenner
authors.forename: Alfred P
authors.initials: AP
authors.lastname: Dufour
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Wade
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D018562:Disease Transmission, Infectious / Q000517:prevention & control / Q000706:statistics & numerical data*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009792:Oceans and Seas; D011446:Prospective Studies; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D012822:Silicon Dioxide / Q000009:adverse effects*; D012988:Soil Microbiology; D012989:Soil Pollutants / Q000009:adverse effects*; D014481:United States; D055815:Young Adult
chemical_list: D012989:Soil Pollutants; D012822:Silicon Dioxide