SynthesisInternational journal of epidemiology2018
Is it safe to go back into the water? A systematic review and meta-analysis of the risk of acquiring infections from recreational exposure to seawater.
Synthesis in International journal of epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 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
22 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Substance Use and Non-Suicidal Self-Injury among Adolescents: A Meta-Analysis of Association Patterns and Moderating Factors.Journal of youth and adolescence · 2026Pooled it
- The use of faecal indicator organisms to manage microbial health risks in recreational waterways not impacted by point sources of sewage: a systematic review of the epidemiological evidence.Journal of water and health · 2025Pooled it
- Evaluating health risks associated with exposure to ambient surface waters during recreational activities: A systematic review and meta-analysis.Water research · 2020Pooled it
- Building the Tools for Enhanced Waterway Surveillance: Prediction of Antimicrobial-ResistantJournal of the Royal Society of New Zealand · 2026Article
- Risk perceptions and behaviours of beachgoers toward recreational water quality in Canada: a qualitative study.BMC public health · 2026Article
- Seaweed exposure modulatesMicrobiology (Reading, England) · 2025Article
- Environmental faecal contamination and associated health risks along multiple exposure pathways in Yatta Sub-County, Machakos County, Kenya.Journal of water and health · 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
- Microbial Contamination in Urban Marine Sediments: Source Identification Using Microbial Community Analysis and Fecal Indicator Bacteria.Microorganisms · 2025Article
- Evaluation of Three Viral Capsid Integrity qPCR Methods for Wastewater-Based Viral Surveillance.Food and environmental virology · 2025Article
- Re-thinking human interactions with the oceans.Royal Society open science · 2024Article
- Canadian beach cohort study: protocol of a prospective study to assess the burden of recreational water illness.BMC public health · 2024Article
- Recreational water exposures and illness outcomes at a freshwater beach in Toronto, Canada: A prospective cohort pilot study.PloS one · 2023Article
- Recreational water illness in Canada: a changing risk landscape in the context of climate change.Canadian journal of public health = Revue canadienne de sante publique · 2022Article
- Establishing a marine monitoring programme to assess antibiotic resistance: A case study from the Gulf Cooperation Council (GCC) region.Environmental advances · 2022Article
- Carbapenem Resistance among Marine Bacteria-An Emerging Threat to the Global Health Sector.Microorganisms · 2021Review
- Bathing Water Quality Monitoring Practices in Europe and the United States.International journal of environmental research and public health · 2021Review
- Microbial Indicators of Fecal Pollution: Recent Progress and Challenges in Assessing Water Quality.Current environmental health reports · 2020Review
- Diversity and Genetic Basis for Carbapenem Resistance in a Coastal Marine Environment.Applied and environmental microbiology · 2020Article
- Children Exposure-Related Behavior Patterns and Risk Perception Associated with Recreational Beach Use.International journal of environmental research and public health · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Numerous illnesses are associated with bathing in natural waters, although it is assumed that the risk of illness among bathers exposed to relatively clean waters found in high-income countries is negligible. A systematic review was carried out to quantify the increased risk of experiencing a range of adverse health outcomes among bathers exposed to coastal water compared with non-bathers. Methods: In all 6919 potentially relevant titles and abstracts were screened, and from these 40 studies were eligible for inclusion in the review. Odds ratios (OR) were extracted from 19 of these reports and combined in random-effect meta-analyses for the following adverse health outcomes: incident cases of any illness, ear infections, gastrointestinal illness and infections caused by specific microorganisms. Results: There is an increased risk of experiencing symptoms of any illness [OR = 1.86, 95% confidence interval (CI): 1.31 to 2.64, P = 0.001] and ear ailments (OR = 2.05, 95% CI: 1.49 to 2.82, P < 0.001) in bathers compared with non-bathers. There is also an increased risk of experiencing gastrointestinal ailments (OR = 1.29, 95% CI: 1.12 to 1.49, P < 0.001). Conclusions: This is the first systematic review to evaluate evidence on the increased risk of acquiring illnesses from bathing in seawater compared with non-bathers. Our results support the notion that infections are acquired from bathing in coastal waters, and that bathers have a greater risk of experiencing a variety of illnesses compared with non-bathers.
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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.