ArticleEpidemiology (Cambridge, Mass.)2012
Fecal indicators in sand, sand contact, and risk of enteric illness among beachgoers.
Article in Epidemiology (Cambridge, Mass.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Evaluating health risks associated with exposure to ambient surface waters during recreational activities: A systematic review and meta-analysis.Water research · 2020Pooled it
- Wave-driven resuspension as the dominant environmental predictor of enterococci at Chicago beaches.Environmental monitoring and assessment · 2026Article
- Risk perceptions and behaviours of beachgoers toward recreational water quality in Canada: a qualitative study.BMC public health · 2026Article
- Sand Quality on Portuguese Blue Flagged Beaches: Fungal and Faecal Contamination Across Two Bathing Seasons.Microorganisms · 2026Article
- A Review of the Human Health Risks from Microbial Hazards in Recreational Beach Sand.International journal of environmental research and public health · 2025Review
- Quantitative microbial risk assessment of acute gastrointestinal illness attributable to freshwater recreation in Ontario.Canadian journal of public health = Revue canadienne de sante publique · 2025Article
- Canadian beach cohort study: protocol of a prospective study to assess the burden of recreational water illness.BMC public health · 2024Article
- Correlation Between Microbial Community and Hatching Failure in Loggerhead Sea Turtle Caretta caretta.Microbial ecology · 2023Article
- Strategies for Monitoring Microbial Life in Beach Sand for Protection of Public Health.International journal of environmental research and public health · 2023Review
- Growth and Decay of Fecal Indicator Bacteria and Changes in the Coliform Composition on the Top Surface Sand of Coastal Beaches during the Rainy Season.Microorganisms · 2023Article
- Recreational water exposures and illness outcomes at a freshwater beach in Toronto, Canada: A prospective cohort pilot study.PloS one · 2023Article
- Microbial Source Tracking as a Method of Determination of Beach Sand Contamination.International journal of environmental research and public health · 2022Article
- Climate Change Impacts on Microbiota in Beach Sand and Water: Looking Ahead.International journal of environmental research and public health · 2022Review
- Plant debris are hotbeds for pathogenic bacteria on recreational sandy beaches.Scientific reports · 2021Article
- Soil, Hand, and Body Adherence Measures across Four Beach Areas: Potential Influence on Exposure to Oil Spill Chemicals.International journal of environmental research and public health · 2020Article
- Children Exposure-Related Behavior Patterns and Risk Perception Associated with Recreational Beach Use.International journal of environmental research and public health · 2019Article
- Occurrence, antifungal susceptibility, and virulence factors of opportunistic yeasts isolated from Brazilian beaches.Memorias do Instituto Oswaldo Cruz · 2019Article
- Multi-tiered approach utilizing microbial source tracking and human associated-IMS/ATP for surveillance of human fecal contamination in Baja California, Mexico.The Science of the total environment · 2018Article
- Exposure to Human-Associated Chemical Markers of Fecal Contamination and Self-Reported Illness among Swimmers at Recreational Beaches.Environmental science & technology · 2018Article
- Child environmental exposures to water and sand at the beach: Findings from studies of over 68,000 subjects at 12 beaches.Journal of exposure science & environmental epidemiology · 2018Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundBeach sand can harbor fecal indicator organisms and pathogens, but enteric illness risk associated with sand contact remains unclear.
methodsIn 2007, visitors at 2 recreational marine beaches were asked on the day of their visit about sand contact. Ten to 12 days later, participants answered questions about health symptoms since the visit. F+ coliphage, Enterococcus, Bacteroidales, fecal Bacteroides, and Clostridium spp. in wet sand were measured using culture and molecular methods.
resultsWe analyzed 144 wet sand samples and completed 4999 interviews. Adjusted odds ratios (aORs) were computed, comparing those in the highest tertile of fecal indicator exposure with those who reported no sand contact. Among those digging in sand compared with those not digging in sand, a molecular measure of Enterococcus spp. (calibrator cell equivalents/g) in sand was positively associated with gastrointestinal (GI) illness (aOR = 2.0 [95% confidence interval (CI) = 1.2-3.2]) and diarrhea (2.4 [1.4-4.2]). Among those buried in sand, point estimates were greater for GI illness (3.3 [1.3-7.9]) and diarrhea (4.9 [1.8-13]). Positive associations were also observed for culture-based Enterococcus (colony-forming units/g) with GI illness (aOR digging = 1.7 [1.1-2.7]) and diarrhea (2.1 [1.3-3.4]). Associations were not found among nonswimmers with sand exposure.
conclusionsWe observed a positive relationship between sand-contact activities and enteric illness as a function of concentrations of fecal microbial pollution in beach sand.
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