The University of Wisconsin-Eau Claire Environmental Public Health Program, 239 Water Street Eau Claire, WI 54703, USA E-mail:
The University of Arizona Department of Soil, Water & Environmental Science Gould-Simspon Building Room 611, 1040 East 4th Street Tucson, AZ 85721, USA.
J Water Health. 2014 Jun;12(2):269-79. doi: 10.2166/wh.2013.123.
Enteric pathogens in pool water can be unintentionally ingested during swimming, increasing the likelihood of acute gastrointestinal illness (AGI). AGI cases in outbreaks are more likely to submerge heads than non-cases, but an association is unknown since outbreak data are self-reported and prone to bias. In the present study, head submersion frequency and duration were observed and analyzed for associations with pool water ingestion measured using ultra high pressure liquid chromatography - tandem mass spectrometry. Frequency of splashes to the face was also quantified. Reliable tools that assess activities associated with pool water ingestion are needed to identify ingestion risk factors and at-risk populations. Objectives were to determine if the observed activities were associated with ingestion, and to test environmental sensor and videography assessment tools. Greater frequency and duration of head submersion were not associated with ingestion, but frequency of splashes to the face, leisurely swimming, and being ≤18 were. Videography was validated for assessing swimmer head submersion frequency. Results demonstrate ingestion risk factors can be identified using videography and urine analysis techniques. Expanding surveys to include questions on leisure swimming participation and frequency of splashes to the face is recommended to improve exposure assessment during outbreak investigations.
泳池水中的肠道病原体可能在游泳过程中被无意摄入，增加急性胃肠道疾病 (AGI) 的可能性。暴发中的 AGI 病例更有可能将头部浸入水中，而非病例，但由于暴发数据是自我报告的，容易出现偏差，因此尚不清楚两者之间存在关联。在本研究中，观察并分析了头部浸入频率和持续时间与使用超高压液相色谱-串联质谱法测量的泳池水摄入之间的关联。还量化了面部溅水的频率。需要可靠的工具来评估与泳池水摄入相关的活动，以确定摄入风险因素和高危人群。研究目的是确定观察到的活动是否与摄入有关，并测试环境传感器和录像评估工具。头部浸入的频率和持续时间增加与摄入无关，但面部溅水的频率、悠闲游泳以及年龄≤18 岁与摄入有关。录像被验证可用于评估游泳者头部浸入的频率。研究结果表明，可使用录像和尿液分析技术识别摄入风险因素。建议扩大调查范围，纳入有关休闲游泳参与和面部溅水频率的问题，以改善暴发调查期间的暴露评估。
