title: Risk behaviors and self-reported illnesses among Pacific Northwest surfers.
abstract: Although surfers have high incidental exposure to marine waters, no studies have investigated if surfer risk behaviors (such as surfing during advisories, near an outfall, during a rain event, or use of personal protective equipment) increase or decrease the risk of acquiring waterborne illnesses. We used a web-based survey to assess the association between risk-based behaviors and self-reported illnesses among Pacific Northwest surfers. Commonly reported illnesses include: ear infection or discharge (38%), sore throat or a cough (28%), diarrhea (16%), fever (10.5%), and vomiting (7%). Surfing often during rain events was associated with an increased likelihood of diarrhea (OR = 2.7; 95% CI: 1.4-5.47), sore throat (OR = 1.26; 95% CI: 1.01-2.05), and ear infection (OR = 1.39; 95% CI: 1.01-2.32). Surfing during a health advisory was associated with increased likelihood of diarrhea (OR = 1.94; 95% CI: 1.03-4.64) and sore throat (OR = 2.32; 95% CI: 1.23-4.40). Other behaviors associated with increased illnesses include body surfing, surfing near an outfall, frequency of surfing, and use of ear plugs. Approximately 40% of surfers were unaware if they had surfed during an active health advisory and 29% knowingly surfed during advisories, suggesting the need to engage this population about potential harm and behaviors that may increase health risk.
authors.affiliation: School of Biological and Population Health Sciences, College of Public Health and Human Sciences, 100 Milam Hall, Oregon State University, Corvallis, OR, 97331, USA E-mail: anna.harding@oregonstate.edu.
authors.forename: Anna K
authors.initials: AK
authors.lastname: Harding
authors.affiliation: Department of Environmental and Molecular Toxicology, 327 Weniger Hall, Oregon State University, Corvallis, OR, 97331, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Stone
authors.affiliation: School of Biological and Population Health Sciences, College of Public Health and Human Sciences, 100 Milam Hall, Oregon State University, Corvallis, OR, 97331, USA E-mail: anna.harding@oregonstate.edu.
authors.forename: Andres
authors.initials: A
authors.lastname: Cardenas
authors.affiliation: Department of Statistics, Survey Research Center, 46 Kidder Hall, Oregon State University, Corvallis, OR, 97331, USA.
authors.forename: Virginia
authors.initials: V
authors.lastname: Lesser
mesh_terms: D000293:Adolescent; D000328:Adult; D003967:Diarrhea / Q000453:epidemiology*; D004427:Ear Diseases / Q000453:epidemiology; D004430:Ear Protective Devices; D005260:Female; D005334:Fever / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015205:Northwestern United States / Q000453:epidemiology; D016017:Odds Ratio; D010612:Pharyngitis / Q000453:epidemiology*; D011891:Rain; D012309:Risk-Taking; D012623:Seawater; D057566:Self Report; D013177:Sports; D014839:Vomiting / Q000453:epidemiology; D055815:Young Adult