Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
Environmental Engineering and Disaster Management Program, School of Multidisciplinary, Mahidol University, Kanchanaburi Campus, Kanchanaburi 71150, Thailand.
Sci Total Environ. 2024 Nov 10;950:175234. doi: 10.1016/j.scitotenv.2024.175234. Epub 2024 Aug 3.
Concerns are rising about the contamination of recreational waters from human and animal waste, along with associated risks to public health. However, existing guidelines for managing pathogens in these environments have not yet fully integrated risk-based pathogen-specific criteria, which, along with recent advancements in indicators and markers, are essential to improve the protection of public health. This study aimed to establish risk-based critical concentration benchmarks for significant enteric pathogens, i.e., norovirus, rotavirus, adenovirus, Cryptosporidium spp., Giardia lamblia, Campylobacter jejuni, Salmonella spp., and Escherichia coli O157:H7. Applying a 0.036 risk benchmark to both marine and freshwater environments, the study identified the lowest critical concentrations for children, who are the most susceptible group. Norovirus, C. jejuni, and Cryptosporidium presented lowest median critical concentrations for virus, bacteria, and protozoa, respectively: 0.74 GC, 1.73 CFU, and 0.39 viable oocysts per 100 mL in freshwater for children. These values were then used to determine minimum sample volumes corresponding to different recovery rates for culture method, digital polymerase chain reaction and quantitative PCR methods. The results indicate that for children, norovirus required the largest sample volumes of freshwater and marine water (52.08 to 178.57 L, based on the 5th percentile with a 10 % recovery rate), reflecting its low critical concentration and high potential for causing illness. In contrast, adenovirus and rotavirus required significantly smaller volumes (approximately 0.24 to 1.33 L). C. jejuni and Cryptosporidium, which required the highest sampling volumes for bacteria and protozoa, needed 1.72 to 11.09 L and 4.17 to 25.51 L, respectively. Additionally, the presented risk-based framework could provide a model for establishing pathogen thresholds, potentially guiding the creation of extensive risk-based criteria for various pathogens in recreational waters, thus aiding public health authorities in decision-making, strengthening pathogen monitoring, and improving water quality testing accuracy for enhanced health protection.
人们对人类和动物粪便污染娱乐水域以及由此对公共健康带来的相关风险表示担忧。然而,现有的管理这些环境中病原体的指南尚未完全纳入基于风险的病原体特定标准,而这些标准以及最近在指标和标志物方面的进展,对于改善公共卫生保护至关重要。本研究旨在为重要的肠道病原体(即诺如病毒、轮状病毒、腺病毒、隐孢子虫属、蓝氏贾第鞭毛虫、空肠弯曲菌、沙门氏菌和大肠杆菌 O157:H7)建立基于风险的临界浓度基准。本研究将 0.036 的风险基准应用于海洋和淡水环境,确定了最易受感染的儿童群体的最低临界浓度。对于病毒、细菌和原生动物,诺如病毒、空肠弯曲菌和隐孢子虫分别呈现出最低的中位数临界浓度:儿童在淡水中分别为 0.74 基因组拷贝数(GC)、1.73 菌落形成单位(CFU)和 0.39 个有活力的卵囊/100 毫升。然后,这些值被用于确定与培养方法、数字聚合酶链反应和定量聚合酶链反应方法的不同回收率相对应的最小样本量。结果表明,对于儿童,诺如病毒在淡水和海水中需要的样本量最大(基于 5%分位数和 10%回收率,分别为 52.08 到 178.57 升),反映出其临界浓度低且有很大的致病潜力。相比之下,腺病毒和轮状病毒需要的样本量要小得多(约 0.24 到 1.33 升)。空肠弯曲菌和隐孢子虫是细菌和原生动物中需要采集最大样本量的病原体,分别需要 1.72 到 11.09 升和 4.17 到 25.51 升。此外,本研究提出的基于风险的框架可以为建立病原体阈值提供一个模型,可能为娱乐水中各种病原体的广泛基于风险的标准的制定提供指导,从而帮助公共卫生当局进行决策,加强病原体监测,并提高水质检测的准确性,以增强健康保护。