title: Routine screening of harmful microorganisms in beach sands: implications to public health.
abstract: Beaches worldwide provide recreational opportunities to hundreds of millions of people and serve as important components of coastal economies. Beach water is often monitored for microbiological quality to detect the presence of indicators of human sewage contamination so as to prevent public health outbreaks associated with water contact. However, growing evidence suggests that beach sand can harbor microbes harmful to human health, often in concentrations greater than the beach water. Currently, there are no standards for monitoring, sampling, analyzing, or managing beach sand quality. In addition to indicator microbes, growing evidence has identified pathogenic bacteria, viruses, and fungi in a variety of beach sands worldwide. The public health threat associated with these populations through direct and indirect contact is unknown because so little research has been conducted relating to health outcomes associated with sand quality. In this manuscript, we present the consensus findings of a workshop of experts convened in Lisbon, Portugal to discuss the current state of knowledge on beach sand microbiological quality and to develop suggestions for standardizing the evaluation of sand at coastal beaches. The expert group at the "Microareias 2012" workshop recommends that 1) beach sand should be screened for a variety of pathogens harmful to human health, and sand monitoring should then be initiated alongside regular water monitoring; 2) sampling and analysis protocols should be standardized to allow proper comparisons among beach locations; and 3) further studies are needed to estimate human health risk with exposure to contaminated beach sand. Much of the manuscript is focused on research specific to Portugal, but similar results have been found elsewhere, and the findings have worldwide implications.
authors.affiliation: Reference Unit for Systemic Infections and Zoonosis, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Portugal.
authors.forename: R
authors.initials: R
authors.lastname: Sabino
authors.affiliation: Microbiology Laboratory, Department of Environmental Health, National Institute of Health Dr. Ricardo Jorge, Portugal.
authors.forename: R
authors.initials: R
authors.lastname: Rodrigues
authors.affiliation: Laboratory of Molecular Biology, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon, Portugal.
authors.forename: I
authors.initials: I
authors.lastname: Costa
authors.affiliation: REQUIMTE/Centro de Química Fina e Biotecnologia, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Carneiro
authors.affiliation: Portuguese Environment Agency, Environment Reference Laboratory, Portugal.
authors.forename: M
authors.initials: M
authors.lastname: Cunha
authors.affiliation: Faculty of Pharmacy, iMed.UL-Research Institute for Medicines and Pharmaceutical Sciences, University of Lisboa, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Duarte
authors.affiliation: Microbiology Laboratory, Department of Environmental Health, National Institute of Health Dr. Ricardo Jorge, Portugal.
authors.forename: N
authors.initials: N
authors.lastname: Faria
authors.affiliation: Microbiology Laboratory, Department of Environmental Health, National Institute of Health Dr. Ricardo Jorge, Portugal.
authors.forename: F C
authors.initials: FC
authors.lastname: Ferreira
authors.affiliation: Reference Unit for Systemic Infections and Zoonosis, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Portugal.
authors.forename: M J
authors.initials: MJ
authors.lastname: Gargaté
authors.affiliation: Reference Unit for Gastro-intestinal Infections, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Júlio
authors.affiliation: Unit of Medical Microbiology, Instituto de Higiene e Medicina Tropical-Centro de Recursos Microbiológicos (CREM), Universidade Nova de Lisboa (UNL), Portugal.
authors.forename: M L
authors.initials: ML
authors.lastname: Martins
authors.affiliation: United States Geological Survey, Great Lakes Science Center, Porter, IN, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Nevers
authors.affiliation: Laboratory of Molecular Biology, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisbon, Portugal.
authors.forename: M
authors.initials: M
authors.lastname: Oleastro
authors.affiliation: Department of Civil, Architectural, and Environmental Engineering, University of Miami, Coral Gables, FL, USA.
authors.forename: H
authors.initials: H
authors.lastname: Solo-Gabriele
authors.affiliation: Reference Unit for Systemic Infections and Zoonosis, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Veríssimo
authors.affiliation: Lisbon School of Health Technology, Polytechnic Institute of Lisboa, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Viegas
authors.affiliation: United States Geological Survey, Great Lakes Science Center, Porter, IN, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Whitman
authors.affiliation: Reference Unit for Systemic Infections and Zoonosis, Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Portugal. Electronic address: joao.brandao@insa.min-saude.pt.
authors.forename: J
authors.initials: J
authors.lastname: Brandão
mesh_terms: D001493:Bathing Beaches; D004784:Environmental Monitoring / Q000379:methods* / Q000592:standards; D058735:Environmental Policy; D019015:Geologic Sediments / Q000382:microbiology*; D006291:Health Policy; D006801:Humans; D011174:Portugal; D011634:Public Health; D018570:Risk Assessment; D012623:Seawater / Q000382:microbiology*; D014871:Water Microbiology
keywords: Beach sand; Microorganisms; Public health