SynthesisWater research2020
Evaluating health risks associated with exposure to ambient surface waters during recreational activities: A systematic review and meta-analysis.
Synthesis in Water research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 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
21 citing papers in PubMed, 2 syntheses or guidelines pooled 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
- Effect of virtual water trade on freshwater pollution in trading partners: a systematic literature review.Environmental science and pollution research international · 2021Pooled it
- Risk perceptions and behaviours of beachgoers toward recreational water quality in Canada: a qualitative study.BMC public health · 2026Article
- Development and evaluation of a recreational water quality index for the Red Sea Coastline, Saudi Arabia.Scientific reports · 2026Article
- Turbidity and streamflow as real-time indicators of microbial risk for aquatic recreators.Environmental monitoring and assessment · 2026Article
- Unintentional Water Intake During Swimming and Post-Race Gastrointestinal Illness in Triathletes: Results from 6 Triathlons and 1294 Athletes.International journal of environmental research and public health · 2026Article
- A manually driven centrifugal microfluidic LAMP platform for rapid visual detection of waterborne pathogens in aquatic sports.Scientific reports · 2025Article
- Quantitative Microbial Risk Assessment ofToxics · 2025Article
- 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
- Bacterial communities profiles of soil in Hulu Langat recreational parks, Selangor.BMC research notes · 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
- Climate change will amplify the impacts of harmful microorganisms in aquatic ecosystems.Nature microbiology · 2025Review
- Canadian beach cohort study: protocol of a prospective study to assess the burden of recreational water illness.BMC public health · 2024Article
- Benefits and Challenges of Applying Bacteriophage Biocontrol in the Consumer Water Cycle.Microorganisms · 2024Review
- 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
- 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
- Detangling Seasonal Relationships of Fecal Contamination Sources and Correlates with Indicators in Michigan Watersheds.Microbiology spectrum · 2022Article
- Shedding of SARS-CoV-2 in feces and urine and its potential role in person-to-person transmission and the environment-based spread of COVID-19.The Science of the total environment · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
Recreational water quality guidelines protect the public from health risks associated with water recreation by helping to prevent unacceptable concentrations of pathogenic organisms in ambient water. However, illness risk is associated with both the concentration of pathogens in the water and the degree of contact with those pathogens. Different recreational activities can result in different levels of contact with ambient water containing water-borne pathogens. We conducted a systematic literature review and meta-analysis to evaluate risks of illness associated with different recreational activities and different levels of contact to ambient surface waters. We screened 8,618 potentially relevant studies for quantitative measures of risk using inclusion/exclusion criteria established in advance. We categorized recreational activities as swimming, sports-related contact, minimal contact, and sand contact. We combined relative risks using a random effects meta-analysis for adverse health outcome categories representing gastrointestinal illness, respiratory illness, skin, eye, ear, nose, throat, and cold/flu illness. We identified 92 studies meeting our inclusion criteria. Pooled risk estimates indicate significant elevation of gastrointestinal illness with the recreational activity categories swimming (2.19, 95% CI: 1.82, 2.63) and sports-related contact (2.69, 95% CI: 1.04, 6.92), and nonsignificant elevation of gastrointestinal illness with minimal contact (1.27, 95% CI: 0.74, 2.16). We also found a significant elevation of respiratory illness with swimming (1.78, 95% CI: 1.38, 2.29) and sports-related contact (1.49, 95% CI: 1.00, 2.24), and no elevation of respiratory illness with minimal contact (0.90, 95% CI: 0.71, 1.14). This study suggests that exposures associated with different types of recreational activities are important characteristics of the exposure pathway when assessing illness risk associated with recreation in ambient surface waters.
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What OpenQuestion holds
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.