Water Recreational Activities Research Articles

Health-related Quality of Life in Children with Vernal Keratoconjunctivitis in Malaysia.

There has been a lack of data on health-related quality of life (HRQoL) in children with vernal keratoconjunctivitis (VKC) from Southeast Asia. This study evaluated the levels (mean total score and subscales score) of HRQoL, comparing the VKC and normal children groups, and within the VKC severity groups. A cross-sectional study was conducted in two tertiary hospitals, specifically the pediatric ophthalmology services at Hospital Selayang and Universiti Sains Malaysia, spanning from 2019 to 2020. Participants aged between 8 and 15 years were categorized into two groups: those diagnosed with VKC and healthy children serving as the control group. Each participant completed the Quality of Life in Children with Vernal Keratoconjunctivitis (QUICK) questionnaire, consisting of 16 questions, divided into two subscales: 12 questions focusing on symptoms and four questions for daily activities. A total of 240 children took part in the study, with 120 children diagnosed with VKC and another 120 in the control group. The mean age of participants with VKC was 11.21 ± 1.91 years, with a male predominance of 4:1 compared to female. Tearing (98.4%) and itchiness (98.3%) emerged as the most prevalent symptoms affecting HRQoL, while the most challenging activities were outdoor play (36.6%) and participation in recreational water activities (34.2%). The mean total score was significantly higher in the VKC group compared to the control group. Additionally, both the mean total score and all subscale scores were significantly higher in the severe type compared to the mild-moderate type. VKC significantly reduce the HRQoL among Malaysian children, and the negative impact increases with the disease severity.

Assessing the impact of Escherichia coli on recreational water safety using quantitative microbial risk assessment

ABSTRACT Recreational water activities have become an integral part of society for entertainment, health, and fitness. The water quality for these activities plays an integral role in the health and safety of the participants. This study aimed to monitor the presence of Escherichia coli in selected recreational water bodies, specifically rowing in the Gauteng Province of South Africa. Water samples were collected (upstream, midstream, and downstream) from three recreational water sites, i.e., Klip Rivier, Wemmer Pan, and Germiston Lake, monthly from May to October 2022. The presence of E. coli was determined using the Colilert® Quanti-Tray®/2,000 (IDEXX) assay and ChromoSelect agar. Pathotypes were confirmed using a multiplex PCR. The MPN for E. coli from all the samples exceeded the recommended guidelines of <2,000 microbes/100 mL. Pathogenic E. coli was detected in all three sites, with EPEC, ETEC, EAEC being most prevalent. The E. coli isolates showed 66% ESBL resistance and 94% carbapenemase resistance. Risk assessment showed recreational activities (rowing and swimming) posed a significant health risk as exceeded the annual risk benchmark limit of 1 × 104. The results obtained provide insights into the health risk associated with recreational activities within these water bodies and highlight the need for seasonal monitoring.

Student and public perceptions of stormwater runoff and its impact on public health in a Southern California coastal community

Ventura, California’s 2023 winter storm activity underscored the impact that runoff has on recreational water quality and public health. To examine public perception of stormwater runoff, coastal water quality, and community decision-making toward recreating in polluted water, an online survey of the Ventura River watershed community determined local residents’ understanding of watershed knowledge, or geoliteracy, health and well-being, and social responsibility. Administered through Qualtrics XM Software ® via direct weblink, the survey was available on public online social media platforms and distributed to public high school Earth Science students. Analysis of participants’ (N = 143) responses and their self-reported water activity, water activity frequency, and perceptions of Ventura River’s discharge and stormwater runoff revealed the community’s behavior regarding exposure to hazardous water quality and, ultimately, the survey participants’ level of geoliteracy concerning their local watershed. A statistical analysis between categorical variables of survey questions found that most survey participants regularly enjoy recreational water activities. However, a person’s awareness of the impacts on water quality from urban stormwater runoff (geoliteracy) does not necessarily indicate that they will wait longer to recreate in polluted water. A majority (88.2%) would avoid polluted water whether or not they had experienced waterborne illness, though individuals who reported a waterborne illness were not more likely to avoid stormwater-impacted water. However, participants who understand that urban runoff leads to poor water quality exhibited greater social responsibility. Our results indicate that Ventura Watershed’s community geoliteracy can be improved, with more research needed to determine community awareness of local environmental issues.

Two risk assessments: Evaluating the use of indicator HF183 Bacteroides versus pathogen measurements for modelling recreational illness risks in an urban watershed

The purpose of this study was to evaluate the performance of HF183 Bacteroides for estimating pathogen exposures during recreational water activities. We compared the use of Bacteroides-based exposure assessment to exposure assessment that relied on pathogen measurements. We considered two types of recreational water sites: those impacted by combined sewer overflows (CSOs) and those not impacted by CSOs. Samples from CSO-impacted and non-CSO-impacted urban creeks were analysed by quantitative polymerase chain reaction (qPCR) for HF183 Bacteroides and eight human gastrointestinal pathogens. Exposure assessment was conducted two ways for each type of site (CSO-impacted vs. non-CSO impacted): 1) by estimating pathogen concentrations from HF183 Bacteroides concentrations using published ratios of HF183 to pathogens in sewage and 2) by estimating pathogen concentrations from qPCR measurements. QMRA (quantitative microbial risk assessment) was then conducted for swimming, wading, and fishing exposures. Overall, mean risk estimates varied from 0.27 to 53 illnesses per 1,000 recreators depending on exposure assessment, site, activity, and norovirus dose-response model. HF183-based exposure assessment identified CSO-impacted sites as higher risk, and the recommended HF183 risk-based threshold of 525 genomic copies per 100 mL was generally protective of public health at the CSO-impacted sites but was not as protective at the non-CSO-impacted sites. In the context of our urban watershed, HF183-based exposure assessment over- and under-estimated risk relative to exposure assessment based on pathogen measurements, and the etiology of predicted pathogen-specific illnesses differed significantly. Across all sites, the HF183 model overestimated risk for norovirus, adenovirus, and Campylobacter jejuni, and it underestimated risk for E. coli and Cryptosporidium. To our knowledge, this study is the first to directly compare health risk estimates using HF183 and empirical pathogen measurements from the same waterways. Our work highlights the importance of site-specific hazard identification and exposure assessment to decide whether HF183 is applicable for monitoring risk.

Serosurvey for Japanese encephalitis virus antibodies following an outbreak in an immunologically naïve population, Victoria, 2022: a cross-sectional study.

To investigate the distribution and prevalence of Japanese encephalitis virus (JEV) antibody (as evidence of past infection) in northern Victoria following the 2022 Japanese encephalitis outbreak, seeking to identify groups of people at particular risk of infection; to investigate the distribution and prevalence of antibodies to two related flaviviruses, Murray Valley encephalitis virus (MVEV) and West Nile virus Kunjin subtype (KUNV). Cross-sectional serosurvey (part of a national JEV serosurveillance program). Three northern Victorian local public health units (Ovens Murray, Goulburn Valley, Loddon Mallee), 8 August - 1 December 2022. People opportunistically recruited at pathology collection centres and by targeted recruitment through community outreach and advertisements. People vaccinated against or who had been diagnosed with Japanese encephalitis were ineligible for participation, as were those born in countries where JEV is endemic. Seroprevalence of JEV IgG antibody, overall and by selected factors of interest (occupations, water body exposure, recreational activities and locations, exposure to animals, protective measures). 813 participants were recruited (median age, 59 years [interquartile range, 42-69 years]; 496 female [61%]); 27 were JEV IgG-seropositive (3.3%; 95% confidence interval [CI], 2.2-4.8%) (median age, 73 years [interquartile range, 63-78 years]; 13 female [48%]); none were IgM-seropositive. JEV IgG-seropositive participants were identified at all recruitment locations, including those without identified cases of Japanese encephalitis. The only risk factors associated with JEV IgG-seropositivity were age (per year: prevalence odds ratio [POR], 1.07; 95% CI, 1.03-1.10) and exposure to feral pigs (POR, 21; 95% CI, 1.7-190). The seroprevalence of antibody to MVEV was 3.0% (95% CI, 1.9-4.5%; 23 of 760 participants), and of KUNV antibody 3.3% (95% CI, 2.1-4.8%; 25 of 761). People living in northern Victoria are vulnerable to future JEV infection, but few risk factors are consistently associated with infection. Additional prevention strategies, including expanding vaccine eligibility, may be required to protect people in this region from Japanese encephalitis.

Algae in Recreational Waters: An Overview within a One Health Perspective

Recreational water activities are widely recognized to have a positive impact on our physical and mental well-being. However, recreational water sources and their management are also a risk factor for human health due to different agents, including the overgrowth of cyanobacteria and algae. The presence of cyanobacteria and algae in recreational waters represents a One Health threat because of their potential release and the overuse of biocides. These organisms have the potential to metabolize organic matter and produce thermophilic and thermotolerant toxins. Moreover, different species of algae are involved in biofilm formation processes, thus impacting water quality and safety and also posing risks to the environment and animal and human health. Different species of algae participate in biofilm formation and have an impact on managing water and equipment maintenance. By searching literature databases, e.g., PubMed, we reviewed the state of the art, providing basic definitions, taxonomy, and epidemiological or medical issues related to the recreational uses of water. Methods of treatments and monitoring were summarized, considering both traditional and innovative strategies. Public health and surveillance approaches focus on the detection of toxins, the formation of biofilms, and the understanding of the benthonic and planktonic components as part of the larger microbial biodiversity. The review process allowed us to acknowledge that this is the first comprehensive overview of algae in recreational waters carried out within a wider One Health outlook.

Naegleria fowleri in 2023: A rising threat to Pakistan.

Madam, Naegleria fowleri, i.e., brain-eating amoeba, is a single-cell, free-living parasite that resides in soil and warm freshwater bodies such as lakes, rivers, and hot springs. It enters the nasal cavity from contaminated water, uses the olfactory nerve to reach the brain, and causes a deadly infection called primary amoebic meningoencephalitis (PAM), with a mortality rate higher than 97% even with treatment. (1,2) It causes symptoms similar to those of other bacterial and viral meningitis, such as fever, headache, vomiting, altered level of consciousness and coma, followed by death in the span of a week to 10 days. (1) There are 20 strains of Naegleria world worldwide, but only N. fowleri is dangerous to humans. (1) In 2008, the first case was reported from Karachi, Pakistan. (2) By 2019, the number had reached 146, (2) and the cases have been increasing until now. In 2023, eight cases have been reported from May to August, among which seven are from the province of Sindh and one from Punjab. (3, 4, 6) The available data shows that two deaths were due to recreational water activities and others because of contaminated tap water.(3,4) This pathogenic amoeba commonly infects men, and the majority of cases were in people aged 26 to 45 years.(1) Of all the reported cases this year, one was a 32-year-old female, and seven were males in the aged 19-45 years.(3,4, 6) The increasing global warming and higher authorities’ negligence towards WHO recommended chlorination (0.1-10 mg/L) of domestic water supply are contributing factors to the higher burden of Naegleria fowleri cases in Karachi, the largest metropolitan city of Pakistan .(5) The new lethal strain of N. fowleri, named as Karachi-NF001, has been found in one patient who traveled from Saudi Arabia to Karachi in 2019. (2) These emerging cases concern strict actions against this problem and the need to alert the Karachi Water and Sewerage Board (KWSB) regarding consistent chlorination from April to October. (5) The monsoon season (May to September) is the best time to spread awareness regarding its prevention and update the current status of N. fowleri in our country. The general public should be encouraged to use boiled or sterilised water for ablution and avoid aquatic activities in non-chlorinated water during the summer season. (3) Besides that, all underground and overhead water tanks in homes, hospitals, shopping malls, schools, offices, etc. should be cleaned once a year. (3)

Profile of the demand for Adventure Tourism in Ecuador with a focus on Sustainability

For the research, the general objective was established, which was to determine the profile of the demand for adventure tourism in Ecuador, the research approach is mixed, the methodology that was applied was the market study with simple random sampling, applying 385 forms of 22 questions, the study resulted in the profile of adventure tourism, characterized by the choice of the destinations they choose are from the Andean Region and the Amazon, they have preference in adventure modalities on land such as hiking, in water recreational activities, motorized boats. and air activities with paragliding. The frequency of visits is 1 to 2 times, they are informed through social networks, in the development of adventure activities, accessibility measures such as exclusive bathroom areas for people with disabilities have been prioritized. For the development of adventure activities they opt for equipment brands such as Petzl, Black Diamond and in relation to clothing to develop adventure activities they prefer brands such as Columbia, Adidas, they opt for attributes such as quality. Finally, the development of the Adventure Tourism Plan is prioritized, thereby aiming to improve economic income for the communities.

Cyanobacterial bloom-associated lipopolysaccharides induce pro-inflammatory processes in keratinocytes in vitro

Our previous studies have shown that CyanoHAB LPS (lipopolysaccharides) and LPS from cyanobacterial cultures induce pro-inflammatory effects on intestinal epithelial and immune cells in vitro. To expand our understanding, we investigated their impact on human keratinocytes, which are targeted during water recreational activities. LPS samples were isolated from CyanoHAB biomasses dominated by Microcystis, Aphanizomenon, Planktothrix, and Dolichospermum, or from axenic cultures of these genera. We identified two CyanoHAB biomasses containing a high proportion of Gram-negative bacteria, including potentially pathogenic genera. These biomasses showed the highest induction of interleukin (IL) 8, IL-6, C-C motif chemokine ligand (CCL) 2 (also known as MCP-1), and CCL20 production by HaCaT cells. Interestingly, all CyanoHAB-derived LPS and LPS from axenic cultures (except for Microcystis) accelerated cell proliferation and migration. Our findings highlight the role of G- bacteria composition and LPS structural disparities in influencing these effects, with implications for skin health during recreational activities.

Case History of Random Material Shear Strength Evaluation using In-situ Large Scale Direct Shear Test in the Construction of the Longest Dam in the Southeast Asian

A modern dam offers many benefits to society, including water conservation, farming sustainability, energy source, and recreational activities. In Indonesia, more than 50 dams are constructed as strategic national projects within the last decade. A zoned earth-fill dam, built using soil and rock materials, is one of the most common dam types in Indonesia. This dam allows a specific material type to be placed in a particular zone, including random material fill zone. A random material is usually obtained from dam excavation work as well as borrow area. It normally contains wide range of grain sizes and a variety of weathering degree. On one hand, this material is very economic. On the other hand, it introduces a challenge in shear strength assessment. Random material frequently contains large size grain that inhibits regular laboratory test use. A catastrophic Indonesian dam construction failure in 2021 was partly attributed to inadequacy in assessing shear strength of random material. This case history highlighted the importance of a proper random material shear strength evaluation. The other dams coincidentally under construction at that time then experienced rigorous shear strength evaluations, including Semantok Dam in Nganjuk, East Java. This dam, designed to be approximately 33-m max high and 3.1-km long, is the current longest dam in the Southeast Asian. An in-situ large scale direct shear device as large as 80 cm × 80 cm × 30 cm was developed to test random material in Semantok Dam. Eight locations in random fill zones were selected. Three series of direct shear test were conducted in each location. Testing results based on 24-large size sample showed a great variability in Mohr-Coulomb parameters. The angle of internal friction ranged from 11.4° to 36.7° with average value of 27.8°, whereas the cohesion varied from 25.3 kPa to 138.6 kPa with average value of 85.2 kPa. High variation in shear strength parameters showed that such test should be performed to verify the design parameter. This in-situ large scale direct shear test provides an appealing method to assess shear strength of random material. This large-scale test is strongly recommended for a common practice in dam construction.

APPLICATION OF QMRA TO EVALUATE THE POTENTIAL HEALTH RISKS ASSOCIATED WITH BACTERIAL CONTAMINATION OF WATERS IN ROYAL BELUM STATE PARK, MALAYSIA

Temenggor Lake located in Royal Belum State Park is an important water resource for indigenous people, an ecosystem for aqua organisms and a place for water recreational activities for visitors. The aim of this research was to use a quantitative microbial risk assessment (QMRA) approach to calculate the probability of potential pathogen infection risk to the visitors and the indigenous community. Thirty-six water samples were collected from the surface waters of Temenggor Lake from recreational water activity and indigenous people activity sites from November 2020 till December 2021. Membrane filtration technique was used for bacterial quantification. The risk was estimated using the calculation of the daily risk of infection, annual risk of infection, and risk of illness per annum and per event. The water quality during sampling periods at year-end showed higher bacterial concentrations related to rainfall events. Bacterial concentrations at visitor water activity areas were within Category A allowing for recreational activities with full body contact while water quality at indigenous people water activity areas were classified as Category B to be used mainly for secondary body contact and hence not allowed for swimming and bathing. Notably, indigenous people's settlement areas recorded a higher risk of illness for both E. coli and Salmonella spp., mainly at station A03 (Kg. Sungai Tiang). It has been revealed that water quality in indigenous people and visitor water activity areas were significantly different due to being affected by different types of human activity and other factors such as geohydrological conditions, topography, land use, environmental conditions and events. This study provides baseline data to help in future management strategies to ensure the conservation of the natural landscape and economic viability, in addition to the protection of the local community.

Identification and quantification of Acanthamoeba spp. within seawater at four coastal lagoons on the east coast of Australia

Acanthamoeba is an opportunistic free-living heterotrophic protist that is the most predominant amoeba in diverse ecological habitats. Acanthamoeba causes amoebic keratitis (AK), a painful and potentially blinding corneal infection. Major risk factors for AK have been linked to non-optimal contact lens hygiene practices and Acanthamoeba contamination of domestic and recreational water. This study investigated the incidence and seasonal variation of Acanthamoeba spp. within coastal lagoons located on the eastern coast of Australia and then examined the association between Acanthamoeba and water abiotic factors and bacterial species within the water.Water samples were collected from four intermittently closed and open lagoons (ICOLLs) (Wamberal, Terrigal, Avoca and Cockrone) every month between August 2019 to July 2020 except March and April. qPCR was used to target the Acanthamoeba 18S rRNA gene, validated by Sanger sequencing. Water abiotic factors were measured in situ using a multiprobe metre and 16S rRNA sequencing (V3-V4) was performed to characterise bacterial community composition. Network analysis was used to gauge putative associations between Acanthamoeba incidence and bacterial amplicon sequence variants (ASVs).Among 206 water samples analysed, 79 (38.3%) were Acanthamoeba positive and Acanthamoeba level was significantly higher in summer compared with winter, spring, or autumn (p = 0.008). More than 50% (23/45) water samples of Terrigal were positive for Acanthamoeba which is a highly urbanised area with extensive recreational activities while about 32% (16/49) samples were positive from Cockrone that is the least impacted lagoon by urban development. All sequenced strains belonged to the pathogenic genotype T4 clade except two which were of genotype clades T2 and T5. Water turbidity, temperature, intl1 gene concentration, and dissolved O2 were significantly associated with Acanthamoeba incidence (p < 0.05). The ASVs level of cyanobacteria, Pseudomonas spp., Candidatus spp., and marine bacteria of the Actinobacteria phylum and Acanthamoeba 18S rRNA genes were positively correlated (Pearson's r ≥ 0.14). The presence of Acanthamoeba spp. in all lagoons, except Wamberal, was associated with significant differences in the composition of bacterial communities (beta diversity).The results of this study suggest that coastal lagoons, particularly those in urbanised regions with extensive water recreational activities, may pose an elevated risk to human health due to the relatively high incidence of pathogenic Acanthamoeba in the summer. These findings underscore the importance of educating the public about the rare yet devastating impact of AK on vision and quality of life, highlighting the need for collaborative efforts between public health officials and educators to promote awareness and preventive measures, especially focusing lagoons residents and travellers.

Quantitative microbial risk assessment of the gastrointestinal risks to swimmers at Southeast Asian urban beaches using site-specific and combined autochthonous and fecal bacteria exposure data

Recreational exposure to microbial pollution at urban beaches poses a health risk to beachgoers. The accurate quantification of such risks is crucial in managing beaches effectively and establishing warning guidelines. In this study, we employed a quantitative microbial risk assessment (QMRA) framework to assess marine water quality and estimate the risks associated with Vibrio parahaemolyticus, an autochthonous pathogen that causes gastrointestinal illnesses, and enterococci, a traditional fecal bacteria indicator. The microbial contamination levels of V. parahaemolyticus and enterococci were determined from 48 water samples collected at two beaches in Thailand during dry and wet seasons. The accidentally ingested water volumes were obtained through a survey involving 438 respondents. The probability of illness (Pill) was estimated using dose–response models and Monte Carlo simulation. The results revealed that enterococci posed a higher risk of illness than V. parahaemolyticus at all seven study sites. The median combined gastrointestinal (GI) risk from both bacteria at all sites met the US EPA risk benchmark of 0.036 and the 0.05 benchmark set by the WHO, but the 95th percentile risk data at all sites exceeded the benchmarks. This emphasizes the need for the continuous monitoring and management of microbial pollution at these sites. The site-specific exposure data showed higher estimated risks with increased variations compared to the WHO-referenced values, which highlights the significance of locally measured microbial concentrations and survey exposure data to avoid underestimation. Estimating the risks from recreational exposure to waterborne bacteria can inform beach management policies aimed at reducing public health risks to swimmers. The study findings improve the understanding of the risks associated with water recreation activities at Southeast Asian beaches and offer valuable insights for the development of water quality guidelines, which are crucial for the sustainable development of the blue economy.

Designing a cercosporin-bioinspired bifunctional algicide with flocculation and photocatalysis for efficiently controlling harmful cyanobacterial blooms

Harmful cyanobacterial blooms (HCBs) are spreading in freshwater ecosystems worldwide, adversely affecting drinking water supplies, aquatic production, recreational and tourism activities. Therefore, the efficient and environmentally friendly method is still of interest to be developed to effectively control HCBs. Inspired by the excellent algicidal activity of cercosporin (CP), a novel metal-free algaecide SiO2@EDU@CP (EDU, N-ethyl-N′-(3-dimethylaminopropyl)urea) with flocculation and photoremoval functions, was successfully designed and prepared in one-step to simultaneously introduce CP and EDU on SiO2 nanoparticles. It could rapidly form algae flocs in 20 min with 97.1% flocculation rate, and remove Microcystis aeruginosa within 12 h with 91.0% algicidal rate under 23 W compact fluorescent light irradiation without any leaked CP detected. Additionally, odorant β-cyclocitral and toxin microcystin-LR were both photodegraded after treatment of SiO2@EDU@CP. Further mechanistic studies showed that the introduction of EDU significantly reversed the zeta potential of SiO2-COOH to achieve the flocculation through neutral charge, and the photophysical characterization of SiO2@EDU@CP revealed the improved charge separation ability to generate reactive oxygen species. More importantly, the utility of SiO2@EDU@CP was well demonstrated by its effectiveness for algae from Taihu Lake under natural sunlight and inability to regrow after treatment. This study not only establishes a bifunctional algicide SiO2@EDU@CP to efficiently control HCBs, but also provides design possibilities to develop more novel and efficient algicides for the better control of practical HCBs.

Environmental surveillance of Pseudomonas aeruginosa in recreational waters in tourist facilities of the Balearic Islands, Spain (2016–2019)

BackgroundPseudomonas aeruginosa is a major opportunistic human pathogen commonly connected with recreational water activities. Spain is a tourist destination where most of the establishments have swimming pool. Nevertheless, the prevalence of P. aeruginosa in public swimming pools in our country is unknown. This works aimed to survey the P. aeruginosa presence in tourist Spanish recreational waters. MethodTourist recreational water in hotels in the Balearic Islands were visited for four years (2016–2019). The levels of selected parameters were determined, and their correlation with P. aeruginosa contamination investigated. ResultsWe evaluated 11,014 samples from 254 facilities. Unacceptable levels of at least one legislated parameter were detected in 30.7% of cases, implicating closure in 15.9%, being P. aeruginosa the leading cause of closure. The prevalence of the pathogen was 14.2%, with lower presence in outer swimming pools. Disinfectant levels influence P. aeruginosa contamination, and bromine-maintained pools were more often contaminated than those treated with chlorine. Prevalence remained constant over the years, although it increased in 2019. ConclusionsP. aeruginosa prevalence in our recreational waters is similar to other countries, and the contamination rates depend on the installations and type and disinfectant levels. Corrective measures are still needed to improve pathogen control.

Recreational water exposures and illness outcomes at a freshwater beach in Toronto, Canada: A prospective cohort pilot study.

Swimming and other recreational water activities in surface waters are popular in Canada during the summer. However, these activities can also increase the risk of recreational water illness. While routine monitoring of beach water quality is conducted by local authorities each summer, little research is available in Canada about beach exposures and illness risks. We conducted a pilot of a prospective cohort study at a popular beach in Toronto, Ontario, Canada, in 2022 to determine characteristics of beachgoers, common water and sand exposures, the incidence of recreational water illness, and the feasibility for a larger, national cohort study. We enrolled beachgoers on-site and surveyed about their exposures at the beach and conducted a follow-up survey 7 days following their beach visit to ascertain acute gastrointestinal, respiratory, skin, ear, and eye illness outcomes. We descriptively tabulated and summarized the collected data. We enrolled 649 households, consisting of 831 beachgoers. Water contact activities were reported by 56% of beachgoers, with swimming being the most common activity (44% of participants). Similarly, 56% of beachgoers reported digging in the sand or burying themselves in the sand. Children (≤14 years) and teenagers (15-19 years) were most likely to report engaging in water contact activities and swallowing water, while children were most likely to report sand contact activities and getting sand in their mouth. Boys and men were more likely than women and girls to report swallowing water (15.2% vs. 9.4%). Water and sand exposures also differed by household education level and participant ethno-racial identity. E. coli levels in beach water were consistently low (median = 20 CFU/100 mL, range = 10-58). The incidence of illness outcomes was very low (0.3-2.8%) among the 287 participants that completed the follow-up survey. The identified beach exposure patterns can inform future risk assessments and communication strategies. Excellent water quality was observed at the studied beach, likely contributing to the low incidence of illnesses. A larger, national cohort study is needed in Canada to examine risks of illness at beaches at higher risk of fecal contamination.

Motorboat propeller-related head injuries: A systematic literature review with a case illustration.

Propeller-related injuries from motorboats are a major cause of injury in recreational water activities including severe and multiple lacerations that can promote scarring, blood loss, traumatic, or surgical amputations. The real incidence of these accidents is still unclear. The authors here present a systematic review of the literature, focusing on head injury, and related recommendations for its evaluation and management, also reporting a case of a female patient injured by a motorboat propeller. A systematic literature review was conducted according to the preferred reporting items for systematic reviews and meta-analyses statement, with no limits in terms of publication date. The following Mesh and free text terms were identified: "motorboat and propeller and injuries" (107 results). A total of 12 papers were included in this systematic review. Only few case reports describing traumatic brain injury (TBI) have been documented. Out of a total of 90 cases analyzed, only five cases with TBI were reported. The authors also reported a case of a 12-year-old female, that during a boat trip, reported a severe polytrauma with concussive head trauma from a penetrating left fronto-temporo-parietal lesion, left mammary gland trauma and fracture of the left hand from falling into the water and impact with a motorboat propeller. She underwent an urgent left fronto-temporo-parietal decompressive craniectomy and then surgery with a multidisciplinary team. At the end of the surgical procedure, the patient was transferred to the pediatric intensive care unit. She was discharged on postoperative day 15. The patient was able to walk without assistance, with mild right hemiparesis and persistence of aphasia nominum. Motorboat propeller injuries can result in extensive damage to soft tissue and bones with severe functional disability, amputations, and high mortality. There are still no recommendations and protocols for the management of motorboat propeller related injuries. Although there are several potential solutions that aim to prevent or ease motorboat-propeller injuries, there are still lack of consistent regulations.

IMPACT OF SUSPENDED SEDIMENT ON PAHANG RIVER DEVELOPMENT USING GEOGRAPHIC INFORMATION SYSTEM

The measurement of different characteristics of a stream, including integrated water resource management, is dependent on sediment transport mechanisms. On the Pahang River, studies explored the spatial interpolation pattern of suspended sediment (SS) and water resource management. Sedimentation issues in the Pahang River have a significant impact on water resource management in the Pahang River basin. Furthermore, it may have an impact on local water consumption, recreational activities, and other factors, causing the river to become shallow and finally flood. This study was conducted to determine the SS pattern in the Pahang River with the approach of the Geographic Information System (GIS) technique and its significant colour based on spatial analysis. In addition, this study also evaluates the factors and effects of sedimentation through water source management. Three sampling stations from the Department of Irrigation and Drainage (DID) for three years (2000, 2004 and 2008) were selected along the Pahang River, where the parameter measured was suspended sediment (ton/year). The results obtained showed that the Pahang River receives a high amount of SS each year, where the higher amount was at the upper station (Sg. Yap), with an amount of 1876575 ton/year (2000), 613850.1 ton/year (2004) and 3458097 ton/year where it may be affected by sediment re-suspension and runoff from two outlets. Meanwhile, the downstream station (Lubuk Paku) received the least amount of SS, while the midstream station (Temerloh) received the most. The transit's speed and current may have an impact. This study's findings are critical in river and water resource management, especially of water resources for domestic use, ecotourism, river biodiversity, and hydrology.

Abundance and diversity of waterbirds around the Begnas Lake of Pokhara Valley, Nepal

We studied the seasonal abundance and diversity of waterbirds around the Begnas lake of Pokhara Valley. The status of waterbirds in Begnas wetland is not documented so; we monitored the waterbirds using the point count method in 12 different plots around the lake and compared the seasonal abundance and diversity during the 2019 Summer and 2020 winter with 24 hours of observation in each plot. A total of 585 individuals of 25 waterbird species from 10 families were recorded during the study period. Among the recorded species two species were globally threatened and the remaining were the least concerned categories. The greater abundance of waterbirds was recorded during winter (t = -5.98, p &lt; 0.001). The abundance of all feeding guilds was found higher during winter. Cattle egret was recorded with the greatest abundance (N = 85) and Relative abundance (RA = 14.52), it was followed by great cormorant (N = 57, RA = 9.74) and common pochard was the least abundant (N = 2, RA = 0.34). There was no seasonal variation in the Shannon Wiener index (H’) and species evenness however, the species richness was higher during winter (W = 16.5, p &lt; 0.01). Distance to the forest, road, and settlement did not affect the abundance and diversity of waterbirds however, the abundance of insectivore birds was increased with the decrease of distance to croplands (t = -3.13, p &lt; 0.05). The Begnas wetland was found with a lower abundance and diversity of waterbirds in comparison to the Phewa and other wetlands of the Terai region of Nepal. The lake water pollution, infrastructural development, anthropogenic activities, recreational activities, and infestation of invasive plants like water hyacinth were the main threats to the waterbirds around Begnas lake. An awareness program about the conservation of waterbirds and regular monitoring of waterbirds in Begnas was recommended.

Adventure Recreation in Blue Spaces and the Wellbeing of Young Polish Adults

The aim of this study was to assess the wellbeing of 248 young Polish adults between 18 and 26 years old (M = 22.35; SD = 2.20) involved in adventure blue space recreational activities. The adventure water recreational activities were measured by using a questionnaire specially designed for the purpose of this study. This questionnaire consisted of two subscales: adventure recreation associated with water risks and adventure recreation associated with weather risks. In turn, wellbeing was measured using six scales loaded in two factors: hedonic wellbeing and eudaimonic wellbeing. The regression analysis indicated that wellbeing (hedonic and eudaimonic) was positively predicted by adventure recreation associated with water risks. In turn, eudaimonic wellbeing was negatively predicted by adventure recreation associated with weather risks. Additionally, the cluster analysis revealed three distinct clusters of recreationists characterized by diverse results on the scales of adventure recreation dealing with water and weather risks: soft adventurers (low water risks/high weather risks), hard adventurers (high water risks/high water risks) and avoiders (low water risks/low weather risks). The hard adventurers had significantly higher means on hedonic wellbeing than that of the soft adventurers and the avoiders. Surprisingly, the soft adventurers had a significantly lower mean on eudaimonic wellbeing than that of the group of hard adventurers and the group avoiding risky activity in an aquatic environment.