Abstract
BackgroundEaraches and outer ear infections are commonly associated with swimming. In this study, we estimated the excess risk and health burden of earaches due to swimming in natural fresh and marine waters using results from a survey of over 50,000 beachgoers at nine beaches across the United States.MethodsProspective cohort studies were conducted at four freshwater and five marine sites in the United States and Puerto Rico. Beach visitors were enrolled on summer weekends and holidays. Ten to twelve days after the beach visit, respondents answered questions about health symptoms, including earaches or ear infections experienced since the beach visit. Economic and physical burdens were also obtained. Fixed slope, random intercept (beach site) multivariate logistic regression models were used to estimate the relationship between head immersion swimming exposure and earaches. Model results were used to calculate excess risk for earaches attributable to swimming.ResultsThe overall incidence of self-reported earache was 1.6% in the 10–12 days after the beach visit. Earaches were more frequent in head immersion swimmers compared to non-swimmers for all beach sites and age groups. Earaches were unassociated with water sample measures of fecal contamination and turbidity. After adjustment for covariates, we calculated 7.12 excess earaches among head immersion swimmers per 1,000 swimming events. Twenty-four percent of those with earache reported missing their regular activities; 28% visited a doctor; 4% visited the emergency room; and 31% and 40% used prescription and non-prescription medications, respectively.ConclusionsThere are at least 128 million swimming events in natural waters annually. Such frequent exposures could result in 900,000 excess earaches, 260,000 visits to the doctor, 39,900 visits to the emergency room, nearly $4 million dollars in out-of-pocket expenditures on prescription and over-the-counter medications, and close to 75,000 hours of clinician time. More accurate estimates of swimming exposure are needed to improve population burden and associated cost estimates.
Highlights
Earaches and outer ear infections are commonly associated with swimming
To develop estimates of the incidence and health burden of earache directly attributable to swimming in natural waters, we used data from over 50,000 beachgoers enrolled in the National Environmental and Epidemiological Assessment of Recreational Water Study (NEEAR Water Study) at nine beach sites (4 marine, 5 freshwater) [16,17,18]
Excluding those with earache at baseline (N = 717), those with missing responses for earache (N = 176), and earaches due to allergy (N = 95), the overall incidence of earache was 1.6% (N = 829/53,262) in the 10–12 day follow up period
Summary
We estimated the excess risk and health burden of earaches due to swimming in natural fresh and marine waters using results from a survey of over 50,000 beachgoers at nine beaches across the United States. Otitis media is the most common cause of ear pain, occurs primarily in young children, peaks during the winter months and is associated with respiratory infections [3]. To develop estimates of the incidence and health burden of earache directly attributable to swimming in natural waters, we used data from over 50,000 beachgoers enrolled in the National Environmental and Epidemiological Assessment of Recreational Water Study (NEEAR Water Study) at nine beach sites (4 marine, 5 freshwater) [16,17,18]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
