ArticleEnvironmental health : a global access science source2018
Estimate of incidence and cost of recreational waterborne illness on United States surface waters.
Article in Environmental health : a global access science source, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 3 syntheses or guidelines pooled it, 151 citations in OpenAlex.
- Systematic review of predictive models of microbial water quality at freshwater recreational beaches.PloS one · 2021Pooled it
- Investigating the public health risks of low impact developments at residential, neighbourhood, and municipal levels.The Science of the total environment · 2020Pooled it
- Evaluating health risks associated with exposure to ambient surface waters during recreational activities: A systematic review and meta-analysis.Water research · 2020Pooled it
- Risk perceptions and behaviours of beachgoers toward recreational water quality in Canada: a qualitative study.BMC public health · 2026Article
- Differential Effects of Zooplankton on Sunlight Inactivation of Viruses.Environmental science & technology · 2026Article
- Article
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- Relationship of Tijuana River Flow and Ocean Bacteria Counts and Emergency Department Diarrhea Cases.The western journal of emergency medicine · 2025Article
- Novel High-Throughput Electrochemical Detection of Staphylococcus Aureus, Bacillus Cereus, or Micrococcus Luteus Using AuNPs@TiSmall (Weinheim an der Bergstrasse, Germany) · 2025Article
- Acute gastrointestinal illness burden associated with water recreation in high-income countries: A scoping review.Canadian journal of public health = Revue canadienne de sante publique · 2025Article
- Population Ecology-Quantitative Microbial Risk Assessment (QMRA) Model for Antibiotic-Resistant and SusceptibleEnvironmental science & technology · 2025Article
- Climate change will amplify the impacts of harmful microorganisms in aquatic ecosystems.Nature microbiology · 2025Review
- You can bring plankton to fecal indicator organisms, but you cannot make the plankton graze: particle contribution tomSphere · 2024Article
- Environmental Quality, Extreme Heat, and Healthcare Expenditures.International journal of environmental research and public health · 2024Article
- Canadian beach cohort study: protocol of a prospective study to assess the burden of recreational water illness.BMC public health · 2024Article
- A fecal score approximation model for analysis of real-time quantitative PCR fecal source identification measurements.Water research · 2024Article
- Association between Combined Sewer Overflow Events and Gastrointestinal Illness in Massachusetts Municipalities with and without River-Sourced Drinking Water, 2014-2019.Environmental health perspectives · 2024Article
- Quantitative microbial risk assessment for ingestion of antibiotic resistance genes from private wells contaminated by human and livestock fecal sources.Applied and environmental microbiology · 2024Article
- Satellite Remote Sensing: A Tool to Support Harmful Algal Bloom Monitoring and Recreational Health Advisories in a California Reservoir.GeoHealth · 2024Article
- Hydrometeorology and geography affect hospitalizations for waterborne infectious diseases in the United States: A retrospective analysis.PLOS water · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundActivities such as swimming, paddling, motor-boating, and fishing are relatively common on US surface waters. Water recreators have a higher rate of acute gastrointestinal illness, along with other illnesses including respiratory, ear, eye, and skin symptoms, compared to non-water recreators. The quantity and costs of such illnesses are unknown on a national scale.
methodsRecreational waterborne illness incidence and severity were estimated using data from prospective cohort studies of water recreation, reports of recreational waterborne disease outbreaks, and national water recreation statistics. Costs associated with medication use, healthcare provider visits, emergency department (ED) visits, hospitalizations, lost productivity, long-term sequelae, and mortality were aggregated.
resultsAn estimated 4 billion surface water recreation events occur annually, resulting in an estimated 90 million illnesses nationwide and costs of $2.2- $3.7 billion annually (central 90% of values). Illnesses of moderate severity (visit to a health care provider or ED) were responsible for over 65% of the economic burden (central 90% of values: $1.4- $2.4 billion); severe illnesses (result in hospitalization or death) were responsible for approximately 8% of the total economic burden (central 90% of values: $108- $614 million).
conclusionRecreational waterborne illnesses are associated with a substantial economic burden. These findings may be useful in cost-benefit analysis for water quality improvement and other risk reduction initiatives.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.