Reif John S, Koszalinski Rebecca, McFarland Malcolm M, Parsons Michael L, Schinbeckler Rachael, Kociolek Judyta, Rockenstyre Alex, Schaefer Adam M
Department of Environmental and Radiological Health Sciences, Colorado School of Public Health, Colorado State University, Fort Collins, CO 80523, USA.
College of Nursing, University of Central Florida, Orlando, FL 32826, USA.
Toxins (Basel). 2025 Jun 6;17(6):287. doi: 10.3390/toxins17060287.
Algal blooms produced by cyanobacteria liberate microcystins and other toxins that create a public health hazard. During the 2018 bloom of in Florida, USA, residential and recreational exposures were associated with an increased risk of self-reporting respiratory, gastrointestinal, or ocular symptoms for 125 participants. Subsequently, 207 persons were interviewed between 2019 and 2024 in the absence of large-scale algal blooms and were considered non-exposed. Analyses of cyanotoxins and brevetoxins in water and air showed only intermittent, background levels of toxins during the non-bloom period. The purpose of this report was to compare symptom reporting between active bloom and non-bloom periods. The assessment of information bias from self-reported symptoms is an important issue in epidemiologic studies of harmful algal blooms. During the non-bloom period, no statistically significant associations with residential, recreational, or occupational exposures were found for any symptom group. Estimated risks for respiratory, gastrointestinal, and ocular symptoms, headache, and skin rash were significantly higher for persons sampled during the bloom than the non-bloom period with odds ratios (ORs) of 2.3 to 8.3. ORs for specific respiratory symptoms were also significantly elevated. After adjustment for confounders and multiple exposures in multivariable analyses, the differences in symptom reporting between bloom and non-bloom periods remained statistically significant. In summary, the use of self-reported symptoms in this epidemiologic study of exposure to a cyanobacterial algal bloom did not appear to introduce substantial information bias.
蓝藻产生的藻华会释放微囊藻毒素和其他毒素，对公众健康构成危害。在美国佛罗里达州2018年的藻华期间，125名参与者的居住和娱乐接触与自我报告的呼吸道、胃肠道或眼部症状风险增加有关。随后，在2019年至2024年期间，在没有大规模藻华的情况下对207人进行了访谈，这些人被视为未接触者。对水和空气中蓝藻毒素和短裸甲藻毒素的分析表明，在非藻华期毒素仅为间歇性的背景水平。本报告的目的是比较藻华活跃期和非藻华期的症状报告情况。在有害藻华的流行病学研究中，对自我报告症状的信息偏倚评估是一个重要问题。在非藻华期，未发现任何症状组与居住、娱乐或职业接触有统计学显著关联。藻华期间采样的人员出现呼吸道、胃肠道、眼部症状、头痛和皮疹的估计风险显著高于非藻华期，比值比（OR）为2.3至8.3。特定呼吸道症状的OR也显著升高。在多变量分析中对混杂因素和多种暴露进行调整后，藻华期和非藻华期症状报告的差异仍具有统计学显著性。总之，在这项关于接触蓝藻藻华的流行病学研究中，使用自我报告症状似乎并未引入实质性的信息偏倚。
