Université Laval, Faculté de médecine, Département de médecine sociale et préventive, 945 Ave. Wolfe, Quebec, Quebec G1V 5B3, Canada; Institut national de santé publique du Québec, 945 Ave. Wolfe, Quebec, Quebec G1V 5B3, Canada; Centre de recherche du CHU de Québec, Axe Santé des populations et pratiques optimales en santé, Edifice Delta 2, Bureau 600, 2875 Blvd. Laurier, Quebec, Quebec G1V 2M2, Canada.
Sci Total Environ. 2014 Jan 1;466-467:397-403. doi: 10.1016/j.scitotenv.2013.07.045. Epub 2013 Aug 7.
We conducted a study to investigate the relationship between exposure to cyanobacteria and microcystins and the incidence of symptoms in humans living in close proximity to lakes affected by cyanobacteria. The design was a prospective study of residents living around three lakes (Canada), one of which has a water treatment plant supplying potable water to local residents. Participants had to keep a daily journal of symptoms and record contact (full or limited) with the water body. Samples were collected to document cyanobacteria and microcystin concentrations. Symptoms potentially associated with cyanobacteria (gastrointestinal: 2 indices (GI1: diarrhea or abdominal pain or nausea or vomiting; GI2: diarrhea or vomiting or [nausea and fever] or [abdominal cramps and fever]); upper and lower respiratory tract; eye; ear; skin; muscle pain; headaches; mouth ulcers) were examined in relation with exposure to cyanobacteria and microcystin by using Poisson regression. Only gastrointestinal symptoms were associated with recreational contact. Globally, there was a significant increase in adjusted relative risk (RR) with higher cyanobacterial cell counts for GI2 (<20,000 cells/mL: RR=1.52, 95% CI=0.65-3.51; 20,000-100,000 cells/mL: RR=2.71, 95% CI=1.02-7.16; >100,000 cells/mL: RR=3.28, 95% CI=1.69-6.37, p-trend=0.001). In participants who received their drinking water supply from a plant whose source was contaminated by cyanobacteria, an increase in muscle pain (RR=5.16; 95% CI=2.93-9.07) and gastrointestinal (GI1: RR=3.87; 95% CI=1.62-9.21; GI2: RR=2.84; 95% CI=0.82-9.79), skin (RR=2.65; 95% CI=1.09-6.44) and ear symptoms (RR=6.10; 95% CI=2.48-15.03) was observed. The population should be made aware of the risks of gastrointestinal symptoms associated with contact (full or limited) with cyanobacteria. A risk management plan is needed for water treatment plants that draw their water from a source contaminated with cyanobacteria.
我们进行了一项研究，以调查暴露于蓝藻和微囊藻与生活在受蓝藻影响的湖泊附近的人类症状发生率之间的关系。该设计是对三个湖泊（加拿大）周围的居民进行的前瞻性研究，其中一个湖泊有一个水处理厂为当地居民提供饮用水。参与者必须每天记录症状并记录与水体的接触（完全或有限）。采集样本以记录蓝藻和微囊藻的浓度。通过泊松回归，检查了与蓝藻和微囊藻暴露相关的潜在与蓝藻相关的症状（胃肠道：2 个指数（GI1：腹泻或腹痛或恶心或呕吐；GI2：腹泻或呕吐或[恶心和发烧]或[腹痛和发烧]）；上呼吸道和下呼吸道；眼睛；耳朵；皮肤；肌肉疼痛；头痛；口腔溃疡）。仅胃肠道症状与娱乐接触有关。总体而言，GI2 的蓝藻细胞计数较高时，调整后的相对风险（RR）显著增加（<20,000 个细胞/mL：RR=1.52，95%CI=0.65-3.51；20,000-100,000 个细胞/mL：RR=2.71，95%CI=1.02-7.16；>100,000 个细胞/mL：RR=3.28，95%CI=1.69-6.37，p-trend=0.001）。在从被蓝藻污染的水源获得饮用水供应的参与者中，肌肉疼痛（RR=5.16；95%CI=2.93-9.07）和胃肠道（GI1：RR=3.87；95%CI=1.62-9.21；GI2：RR=2.84；95%CI=0.82-9.79）、皮肤（RR=2.65；95%CI=1.09-6.44）和耳症状（RR=6.10；95%CI=2.48-15.03）增加。应该让人们意识到与蓝藻接触（完全或有限）相关的胃肠道症状的风险。需要为从受蓝藻污染的水源取水的水处理厂制定风险管理计划。
