Coastal waters, fresh water and other untreated recreational water venues

Recreational water venues such as oceans, lakes, and rivers, attract large numbers of users. Usage is higher in the summer months, although recreational water activities such as swimming, water skiing, surfing, wakeboarding etc., can take place year-round. These venues are not subject to specific legislation the way that man-made treated recreational water venues such as swimming pools and hot tubs are. However, broader public health legislation could be applied where a health hazard exists. Partaking in activities in untreated recreational water can present public health risks that may result in injury, illness, or death, and include:

• Physical hazards e.g., rocks, logs or other debris, as well as the bottom of shallow water bodies that can result in injury or drowning;
• Biological hazards e.g., pathogenic bacteria, viruses, and protozoa. E. coli is the most common cause of outbreaks associated with untreated recreational water (CDC, 2017);
• Chemical hazards e.g., contaminants introduced by a spill or discharge, or exposure to cyanobacterial toxins.

The resources presented below provide information on hazard identification, water quality monitoring, and public notification. When these aspects are addressed using best practices, the risks to users are reduced.

NCCEH Resources

• Cyanobacteria in Freshwater (2017)
  This webpage links to information and resources related to cyanobacteria and cyanotoxins in recreational and drinking water sources.

Selected External Resources

• Models for Predicting Beach Water Quality (USEPA, 2017)
  This webpage provides information and resources related to predictive modelling, including how to develop a model, how to use predictive models for notifications, and a list of existing models.
   
• Quantitative microbial risk assessment: Application for water safety management (WHO, 2016)
  These guidelines provide a QMRA framework that can be applied to a number of contexts, including recreational water safety.
   
• Climate Impacts on Water-Related Illness. The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment (Trtanj et al. 2016)
  This book chapter examines the health risks associated with changes in natural marine, coastal, and freshwater systems due to climate change. 
   
• Review of coliphages as possible indicators of fecal contamination for ambient water quality (USEPA, 2015)
  This document reviews water quality monitoring using bacteriological indicators such as E. coli (fresh water) or Enterococci (marine water) for evidence of unacceptable levels of fecal contamination.
   
• Guidelines for Canadian Recreational Water Quality (Health Canada, 2012)
  These guidelines provide information on safe recreational water quality in Canada, including suggested indicators and guideline values for microbiological quality of marine and fresh waters.
   
• 2012 Recreational Water Quality Criteria (USEPA, 2012)
  This webpage provides information and resources related to recreational water criteria in the United States, including links to the most recent guideline document, appendices, and other related materials.
   
• Assessing the effectiveness of beaches environmental assessment and coastal health (BEACH) act notification program (USEPA, 2011)
  This report includes information on risk communication, notification effectiveness, and good practices for the format and content of notifications.
   
• Guidelines for safe recreational water environments volume 1, Coastal and fresh waters (WHO, 2003)
  These guidelines provide a comprehensive review of the injury and illness risks associated with recreational use of natural waters, and measures to monitor and control these risks.

Peer-Reviewed Articles

• Assessment of the microbiological quality of recreational waters: indicators and methods (Rodrigues and Cunha 2017)
  This article reviews the literature on traditional and innovative methodologies for assessing health protection indicators in recreational waters.

• Recreational water and infection: A review of recent findings (Fewtrell and Kay, 2015)
  This article reviews the risk of infection from recreational water exposure using latest epidemiological studies and quantitative microbial risk assessments.

• Rapidly measured indicators of recreational water quality and swimming-associated illness at marine beaches: a prospective cohort study (Wade et al., 2010)
  This article provides rapid detection methods for Enterococci (marine water) that can yield same day results, developed as an alternative to bacterial culturing methods, thus helping to rapidly detect unacceptable levels of fecal contamination and reduce risk to beach users.

This list is not intended to be exhaustive. Omission of a resource does not preclude it from having value.