Incidence and public health burden of sunburn among beachgoers in the United States.

The beach environment creates many barriers to effective sun protection, putting beachgoers at risk for sunburn, a well-established risk factor for skin cancer. Our objective was to estimate incidence of sunburn among beachgoers and evaluate the relationship between sunburn incidence and sun-protective behaviors. A secondary analysis, of prospective cohorts at 12 locations within the U.S. from 2003 to 2009 (n = 75,614), were pooled to evaluate sunburn incidence 10-12 days after the beach visit. Behavioral and environmental conditions were cross-tabulated with sunburn incidence. Multivariable logistic regression was used to estimate the association between new sunburn and sun-protective behaviors. Overall, 13.1% of beachgoers reported sunburn. Those aged 13-18 years (16.5%), whites (16.0%), and those at beach locations along the Eastern Seaboard (16.1%), had the highest incidence of sunburn. For those spending ≥5 h in the sun, the use of multiple types of sun protection reduced odds of sunburn by 55% relative to those who used no sun protection (Odds Ratio = 0.45 (95% Confidence Interval:0.27-0.77)) after adjusting for skin type, age, and race. Acute health effects of sunburn tend to be mild and self-limiting, but potential long-term health consequences are more serious and costly. Efforts to encourage and support proper sun-protective behaviors, and increase access to shade, protective clothing, and sunscreen, can help prevent sunburn and reduce skin cancer risk among beachgoers.

Acute Illness Among Surfers After Exposure to Seawater in Dry- and Wet-Weather Conditions.

Rainstorms increase levels of fecal indicator bacteria in urban coastal waters, but it is unknown whether exposure to seawater after rainstorms increases rates of acute illness. Our objective was to provide the first estimates of rates of acute illness after seawater exposure during both dry- and wet-weather periods and to determine the relationship between levels of indicator bacteria and illness among surfers, a population with a high potential for exposure after rain. We enrolled 654 surfers in San Diego, California, and followed them longitudinally during the 2013-2014 and 2014-2015 winters (33,377 days of observation, 10,081 surf sessions). We measured daily surf activities and illness symptoms (gastrointestinal illness, sinus infections, ear infections, infected wounds). Compared with no exposure, exposure to seawater during dry weather increased incidence rates of all outcomes (e.g., for earache or infection, adjusted incidence rate ratio (IRR) = 1.86, 95% confidence interval (CI): 1.27, 2.71; for infected wounds, IRR = 3.04, 95% CI: 1.54, 5.98); exposure during wet weather further increased rates (e.g., for earache or infection, IRR = 3.28, 95% CI: 1.95, 5.51; for infected wounds, IRR = 4.96, 95% CI: 2.18, 11.29). Fecal indicator bacteria measured in seawater (Enterococcus species, fecal coliforms, total coliforms) were strongly associated with incident illness only during wet weather. Urban coastal seawater exposure increases the incidence rates of many acute illnesses among surfers, with higher incidence rates after rainstorms.

Coliphages and Gastrointestinal Illness in Recreational Waters: Pooled Analysis of Six Coastal Beach Cohorts.

BACKGROUND: Coliphages have been proposed as indicators of fecal contamination in recreational waters because they better mimic the persistence of pathogenic viruses in the environment and wastewater treatment than fecal indicator bacteria. We estimated the association between coliphages and gastrointestinal illness and compared it with the association with culturable enterococci. METHODS: We pooled data from six prospective cohort studies that enrolled coastal beachgoers in California, Alabama, and Rhode Island. Water samples were collected and gastrointestinal illness within 10 days of the beach visit was recorded. Samples were tested for enterococci and male-specific and somatic coliphages. We estimated cumulative incidence ratios (CIR) for the association between swimming in water with detectable coliphage and gastrointestinal illness when human fecal pollution was likely present, not likely present, and under all conditions combined. The reference group was unexposed swimmers. We defined continuous and threshold-based exposures (coliphage present/absent, enterococci >35 vs. ≤35 CFU/100 ml). RESULTS: Under all conditions combined, there was no association between gastrointestinal illness and swimming in water with detectable coliphage or enterococci. When human fecal pollution was likely present, coliphage and enterococci were associated with increased gastrointestinal illness, and there was an association between male-specific coliphage level and illness that was somewhat stronger than the association between enterococci and illness. There were no substantial differences between male-specific and somatic coliphage. CONCLUSIONS: Somatic coliphage and enterococci had similar associations with gastrointestinal illness; there was some evidence that male-specific coliphage had a stronger association with illness than enterococci in marine waters with human fecal contamination.

Acute Gastroenteritis and Recreational Water: Highest Burden Among Young US Children.

OBJECTIVES: To provide summary estimates of gastroenteritis risks and illness burden associated with recreational water exposure and determine whether children have higher risks and burden. METHODS: We combined individual participant data from 13 prospective cohorts at marine and freshwater beaches throughout the United States (n = 84 411). We measured incident outcomes within 10 days of exposure: diarrhea, gastrointestinal illness, missed daily activity (work, school, vacation), and medical visits. We estimated the relationship between outcomes and 2 exposures: body immersion swimming and Enterococcus spp. fecal indicator bacteria levels in the water. We also estimated the population-attributable risk associated with these exposures. RESULTS: Water exposure accounted for 21% of diarrhea episodes and 9% of missed daily activities but was unassociated with gastroenteritis leading to medical consultation. Children aged 0 to 4 and 5 to 10 years had the most water exposure, exhibited stronger associations between levels of water quality and illness, and accounted for the largest attributable illness burden. CONCLUSIONS: The higher gastroenteritis risk and associated burden in young children presents important new information to inform future recreational water quality guidelines designed to protect public health.

Impact of Stormwater Discharges on Water Quality in Coastal Marine Protected Areas.

Marine protected areas worldwide limit harvest to protect sensitive fisheries, but rarely do they address water quality goals that may have equally demonstrable impacts. California has over 500 coastal shoreline miles of marine protected areas designated as Areas of Special Biological Significance (ASBS), but receives untreated wet weather runoff discharges from over 1600 storm drain outfalls. The goal of this study was to assess the extent and magnitude of water quality impacts in ASBS following storm events. A stratified probabilistic design was used for sampling receiving water shorelines near (discharge) and far (non-discharge) from storm drain outfalls. In general, reasonably good water quality exists in California's ASBS following storm events. Many of the target analytes measured did not exceed water quality standards. The post-storm concentrations of most constituents in discharge and non-discharge strata of ASBS were similar. The three potentially problematic parameters identified were total PAH, chromium, and copper.

Correspondence of biological condition models of California streams at statewide and regional scales.

We used boosted regression trees (BRT) to model stream biological condition as measured by benthic macroinvertebrate taxonomic completeness, the ratio of observed to expected (O/E) taxa. Models were developed with and without exclusion of rare taxa at a site. BRT models are robust, requiring few assumptions compared with traditional modeling techniques such as multiple linear regression. The BRT models were constructed to provide baseline support to stressor delineation by identifying natural physiographic and human land use gradients affecting stream biological condition statewide and for eight ecological regions within the state, as part of the development of numerical biological objectives for California's wadeable streams. Regions were defined on the basis of ecological, hydrologic, and jurisdictional factors and roughly corresponded with ecoregions. Physiographic and land use variables were derived from geographic information system coverages. The model for the entire state (n = 1,386) identified a composite measure of anthropogenic disturbance (the sum of urban, agricultural, and unmanaged roadside vegetation land cover) within the local watershed as the most important variable, explaining 56% of the variance in O/E values. Models for individual regions explained between 51 and 84% of the variance in O/E values. Measures of human disturbance were important in the three coastal regions. In the South Coast and Coastal Chaparral, local watershed measures of urbanization were the most important variables related to biological condition, while in the North Coast the composite measure of human disturbance at the watershed scale was most important. In the two mountain regions, natural gradients were most important, including slope, precipitation, and temperature. The remaining three regions had relatively small sample sizes (n ≤ 75 sites) and had models that gave mixed results. Understanding the spatial scale at which land use and land cover affect taxonomic completeness is imperative for sound management. Our results suggest that invertebrate taxonomic completeness is affected by human disturbance at the statewide and regional levels, with some differences among regions in the importance of natural gradients and types of human disturbance. The construction and application of models similar to the ones presented here could be useful in the planning and prioritization of actions for protection and conservation of biodiversity in California streams.

Assessing the defecation practices of unsheltered individuals and their contributions to microbial water quality in an arid, urban watershed.

Outdoor defecation by people experiencing homelessness is frequently perceived as a potentially large source of human fecal pollution and a significant source of health risk in urban waterbodies with recreational contact. The goal of this study was to count the number of people experiencing homelessness and quantifies their sanitation habits in an urban river corridor setting, then use this information for estimating human fecal pollutant loading on a watershed scale. Two types of census counts were conducted including periodic point-in-time counts over six years and weekly counts of encampments. While the population census varied from count-to-count, the range of population estimates in the river corridor varied from 109 to 349 individuals during the six-year span, which mirrored the weekly counts of encampments. A face-to-face survey of people experiencing homelessness assessed the sanitation habits of the unsheltered population (N = 63), including outdoor defecation frequency and containment practices. Overall, 95 % of survey respondents reported defecating outdoors; 36 % practiced outdoor defecation between 4 and 7 days/week and 27 % practiced outdoor defecation <1 day/week. Of those that did practice outdoor defecation, 75 % contained their feces in a bucket or bag, thereby limiting fecal material contributions to the river; 6.7 % reported defecating on low ground near the river that could wash off when flood waters rise during a storm event. Only a single survey respondent reported defecating directly into the river. Based on literature values for average HF183 output for an adult human, and the average rainfall in the urban watershed, the total watershed contribution of HF183 averaged 1.2 × 1010 gene copies per storm event (95 % CI: 0.9 × 1010-1.6 × 1010) along the 41 km stretch of river in this study. This human fecal loading estimate is at least two orders of magnitude less than cumulative HF183 loading from all human sources measured at the bottom of the watershed.

Swimmer illness associated with marine water exposure and water quality indicators: impact of widely used assumptions.

BACKGROUND: Studies of health risks associated with recreational water exposure require investigators to make choices about water quality indicator averaging techniques, exposure definitions, follow-up periods, and model specifications; however, investigators seldom describe the impact of these choices on reported results. Our objectives are to report illness risk from swimming at a marine beach affected by nonpoint sources of urban runoff, measure associations between fecal indicator bacteria levels and subsequent illness among swimmers, and investigate the sensitivity of results to a range of exposure and outcome definitions. METHODS: In 2009, we enrolled 5674 people in a prospective cohort at Malibu Beach, a coastal marine beach in California, and measured daily health symptoms 10-19 days later. Concurrent water quality samples were analyzed for indicator bacteria using culture and molecular methods. We compared illness risk between nonswimmers and swimmers, and among swimmers exposed to various levels of fecal indicator bacteria. RESULTS: Diarrhea was more common among swimmers than nonswimmers (adjusted odds ratio = 1.88 [95% confidence interval = 1.09-3.24]) within 3 days of the beach visit. Water quality was generally good (fecal indicator bacteria levels exceeded water quality guidelines for only 7% of study samples). Fecal indicator bacteria levels were not consistently associated with swimmer illness. Sensitivity analyses demonstrated that overall inference was not substantially affected by the choice of exposure and outcome definitions. CONCLUSIONS: This study suggests that the 3 days following a beach visit may be the most relevant period for health outcome measurement in recreational water studies. Under the water quality conditions observed in this study, fecal indicator bacteria levels were not associated with swimmer illness.

Correlation between quantitative PCR and culture-based methods for measuring Enterococcus spp. over various temporal scales at three California marine beaches.

Several studies have examined how fecal indicator bacteria (FIB) measurements compare between quantitative PCR (qPCR) and the culture methods it is intended to replace. Here, we extend those studies by examining the stability of that relationship within a beach, as affected by time of day and seasonal variations in source. Enterococcus spp. were quantified at three southern California beaches in the morning and afternoon using two qPCR assays, membrane filtration, and defined-substrate testing. While qPCR and culture-based measurements were consistently and significantly correlated, strength of the correlation varied both among and within beaches. Correlations were higher in the morning (0.45 < ρ < 0.74 [P < 0.002]) than in the afternoon (0.18 < ρ < 0.45 [P < 0.021]) and higher when the fecal contamination was concentrated (0.38 < ρ < 0.83 [P < 0.001]) than when it was diffuse (0.19 < ρ < 0.34 [P < 0.003]). The ratios of culture-based and qPCR results (CFU or most probable number [MPN] per calibrator cell equivalents [CCE]) also varied spatially and temporally. Ratios ranged between 0.04 and 0.85 CFU or MPN per CCE and were lowest at the beach affected by diffuse pollution. Patterns in the ratios over the course of the day were dissimilar across beaches, increasing with time at one beach and decreasing at another. The spatial and temporal variability we observed indicate that the empirical relationship between culture-based and qPCR results is not universal, even within a beach.

Comparing volunteer and professionally collected monitoring data from the rocky subtidal reefs of Southern California, USA.

Volunteer-based citizen monitoring has increasingly become part of the natural resources monitoring framework, but it is often unclear whether the data quality from these programs is sufficient for integration with traditional efforts conducted by professional scientists. At present, the biological and physical characteristics of California's rocky reef kelp forests are concurrently monitored by two such groups, using similar methodologies--underwater visual census (UVC) of fish, benthic invertebrates, and reef habitat, though the volunteer group limits their sampling to transects close to the reef surface and they use a more constrained list of species for enumeration and measurement. Here, we compared the data collected from 13 reefs that were sampled by both programs in 2008. These groups described relatively similar fish communities, total fish abundance and abundance of the dominant fish species but there were some differences in the measured size distributions of the dominant fish species. Descriptions of the benthic invertebrate community were also similar, though there were some differences in relative abundance that may have resulted from the less detailed subsampling protocols used by the volunteers. The biggest difference was in characterization of the physical habitat of the reefs, which appeared to result from selection bias of transect path by the volunteer program towards more complex structured sections of a reef. Changes to address these differences are relatively simple to implement and if so, offer the promise of better integration of the trained volunteer monitoring with that of professional monitoring groups.

Scrutinizing surficial sediment along a 600-km-long urban coastal zone: Occurrence and risk assessment of fipronil and its three degradates.

Contamination in the coastal zone is closely linked to urbanization and has become a global issue. The coastal aquatic environment is the terminal sink for many chemicals; however, little is known about the occurrence and variation among habitats as well as integrative toxicity for pesticides, i.e., fipronil, and its three major degradates (-desulfinyl, -sulfide, and -sulfone, fiproles hereafter) in sediments in urban coastlines. In the present study, we report results of a random stratified survey for fiproles in surficial sediments in five embayment habitats (strata) along the Southern California Bight (SCB), USA coastline. Fiproles were present in a small areal extent (6.8%) of the SCB embayment, and detected in 14 out of 174 stations with a total concentration of the four analytes ranging from 0.50 to 17.5 µg/kg dry weight. The area-weighted mean concentrations were 3.16 ± 3.37, 0.584 ± 0.558, 0.071 ± 0.103, and 0.005 ± 0.009 µg/kg in brackish estuaries, estuaries, bays, and marinas, respectively, with the results below the detection limits in ports. Fipronil sulfone had the greatest detection frequency (8.05%) and highest mean concentration (3.24 ± 3.36 µg/kg) among the four compounds. A screening-level deterministic risk assessment for invertebrates found that, region-wide, fiproles generally posed an insignificant to low acute risk to the amphipod Eohaustorius estuarius in 7.36% of the SCB embayment area. In addition, high risk to the midge Chironomus dilutus was found in 77.5% of the fiproles-detectable area in the brackish estuary stratum that is a part of the Los Angeles River. Fipronil sulfone was identified as the major contributor of these effects. The results of this study establish a baseline of occurrence and toxicity potential for fiproles in coastal sediments of southern California.

Levels and patterns of fecal indicator bacteria in stormwater runoff from homogenous land use sites and urban watersheds.

Routine stormwater monitoring programs focus on quantification of average fecal indicator bacteria (FIB) concentration at the terminal watershed discharge point. While important for permit compliance, such monitoring provides little insight into relative bacteria levels from different land use types or the mechanisms that influence FIB concentrations. The goal of this study was to quantify the relative levels and flux patterns of Escherichia coli, enterococci, and total coliforms from representative land use (LU) types. Bacteria concentrations were measured over the entire storm duration from 8 different LU types over 13 storm events in 5 southern California watersheds during the 2000-2005 storm seasons. In addition, runoff samples were collected from 8 bottom of the watershed mass emission (ME) sites. Intra-storm and intra-season patterns were investigated in order to identify mechanisms that influence patterns of FIB concentrations. Mean FIB event mean concentrations (EMCs) at LU sites ranged from 10(3) to 10(5) MPN/100 mi. Recreational (horse stables) LU sites contributed significantly higher storm EMCs than other LU types. Early season storms repeatedly produced higher EMCs than comparably sized late season storms. For most storms sampled, the highest bacterial concentrations occurred during the early phases of stormwater runoff with peak concentrations usually preceding peak flow.

Regional assessment of contaminant bioaccumulation in sport fish tissue in the Southern California Bight, USA.

Marine recreational fisheries in California are economically and culturally important; however, consumption of contaminated seafood may be a human health risk. The California Environmental Protection Agency Office of Environmental Health Hazard Assessment developed Advisory Tissue Levels (ATLs) to be used in developing consumption recommendations protecting the health of fish consumers. This study characterizes extent and magnitude of bioaccumulation of contaminants in sport fish in Southern California relative to ATLs. Most zones exceeded the ATL for mercury corresponding to consumption of not more than 3 servings per week in one or more target species. A third of zones exceeded the ATL for total polychlorinated biphenyls (PCBs) corresponding to consumption of not more than 7 servings per week. However, neither mercury nor total PCBs exceeded the most restrictive, "do not consume", thresholds in measured tissues. Contaminant concentrations in fish tissues have remained the same or decreased since a similar survey in 2009.

Exchange of polycyclic aromatic hydrocarbons among the atmosphere, water, and sediment in coastal embayments of southern California, USA.

The present study investigated cross-media transport between both the sediment and the water column and between the water column and the atmosphere, to understand the role of each compartment as a source or a sink of polycyclic aromatic hydrocarbons (PAH) in southern California, USA, coastal waters. Concentrations of PAH were measured in the atmosphere, water column, and sediment at four water-quality-impaired sites in southern California: Ballona Creek Estuary, Los Angeles Harbor, Upper Newport Bay, and San Diego Bay. These concentrations were used to calculate site-specific sediment-water and atmosphere-water exchange fluxes. The net sediment-water exchange of total PAH (t-PAH) was positive, indicating that sediments were a source to the overlying water column. Furthermore, the net atmosphere-water exchange (gas exchange + dry particle deposition) of t-PAH was typically positive also, indicating the water column was a net source of PAH to the surrounding atmosphere through gas exchange. However, in all cases, the magnitude of the diffusive flux of PAH out of the sediments and into the water column far exceeded input or output of PAH through air/water exchange processes. These results demonstrate the potential importance of contaminated sediments as a source of PAH to the water column in coastal waters of southern California.

Bioassessment tools in novel habitats: an evaluation of indices and sampling methods in low-gradient streams in California.

Biomonitoring programs are often required to assess streams for which assessment tools have not been developed. For example, low-gradient streams (slopeor=450) to calculate the SCIBI in 28 of 45 samples and often collected fewer than 100 individuals, suggesting it is inappropriate for low-gradient streams in California; failures for the other methods were less common (TRC, 16 samples; MCM, 11 samples). Within-site precision, measured as the minimum detectable difference (MDD) was poor but similar across methods for the SCIBI (ranging from 19 to 22). However, RWB had the lowest MDD for O/E scores (0.20 versus 0.24 and 0.28 for MCM and TRC, respectively). Mantel correlations showed that assemblages were more similar within sites among methods than within methods among sites, suggesting that the sampling methods were collecting similar assemblages of organisms. Statistically significant disagreements among methods were not detected, although O/E scores were higher for RWB samples than TRC. Index scores suggested impairment at all sites in the study. Although index scores did not respond strongly to several measurements of disturbance in the watershed, percent agriculture showed a significant, negative relationship with O/E scores.

Benthic habitat condition of the continental shelf surrounding oil and gas platforms in the Santa Barbara Channel, Southern California.

The continental shelf of southern California is an important location for the extraction of petroleum and natural gas. Many platforms in the region have been operating for more than four decades and are being targeted for decommissioning. Information on the condition of surrounding habitats to the platforms will be important for regulators. The condition of sediments near (250 m-2 km) four active oil/gas platforms was evaluated with measures of macrobenthic infauna, toxicity, and chemical composition using standardized assessment indices and compared to that of equivalent locations across the region without platforms. Assessment scores indicated that the sediments surrounding the oil platforms were in a relatively good state, with reference-condition infauna, minimal levels of chemical exposure, and five instances (25% of samples) of low-level toxicity. Samples from around the oil platforms were in overall similar condition to the region, with slightly better condition infauna, nearly identical chemistry, and slightly worse toxicity.

Watershed and land use-based sources of trace metals in urban storm water.

Trace metal contributions in urban storm water are of concern to environmental managers because of their potential impacts on ambient receiving waters. The mechanisms and processes that influence temporal and spatial patterns of trace metal loading in urban storm water, however, are not well understood. The goals of the present study were to quantify trace metal event mean concentration (EMC), flux, and mass loading associated with storm water runoff from representative land uses; to compare EMC, flux, and mass loading associated with storm water runoff from urban (developed) and nonurban (undeveloped) watersheds; and to investigate within-storm and within-season factors that affect trace metal concentration and flux. To achieve these goals, trace metal concentrations were measured in 315 samples over 11 storm events in five southern California, USA, watersheds representing eight different land use types during the 2000 through 2005 storm seasons. In addition, 377 runoff samples were collected from 12 mass emission sites (end of watershed) during 15 different storm events. Mean flux at land use sites ranged from 24 to 1,238, 0.1 to 1,272, and 6 to 33,189 g/km(2) for total copper, total lead, and total zinc, respectively. Storm water runoff from industrial land use sites contained higher EMCs and generated greater flux of trace metals than other land use types. For all storms sampled, the highest metal concentrations occurred during the early phases of storm water runoff, with peak concentrations usually preceding peak flow. Early season storms produced significantly higher metal flux compared with late season storms at both mass emission and land use sites.

Seabirds as regional biomonitors of legacy toxicants on an urbanized coastline.

Seabirds are often cited as sentinels of the marine environment, but are rarely used in traditional ocean and coastal contaminant monitoring. Four classes of persistent organic pollutants (POPs, n=68) and three trace elements (mercury, selenium, and arsenic) were measured in the eggs of California least terns (Sterna antillarum browni), caspian terns (Hydroprogne caspia), double-crested cormorants (Phalacrocorax auritus), and western gulls (Larus occidentalis) that nest in the Southern California Bight. Building on a periodic five year regional monitoring program, we measured contaminant exposure and assessed the utility of seabirds as regional contaminant biomonitors. We found that the eggs of larger, more piscivorous species generally had the highest concentrations of POPs and trace elements while California least terns had the lowest concentrations, except for mercury which was higher in least terns. As expected, DDT concentrations were elevated near the Palos Verdes Superfund site. However, we also detected a previously unknown latitudinal pattern in PBDE concentrations in least terns. POP congener profiles also confirmed differences in contamination in urban least tern colonies closest to urban centers. Though toxicants were at detectable levels across species and sites, concentrations were below those known to cause adverse effects in avian taxa and are steady or declining compared to previous studies in this region. Our results suggest that regional seabird monitoring can inform site-specific remediation and support management and protection of regionally-threatened wildlife and coastal systems. Integration of seabird contaminant data with traditional sediment, water, bivalve and fish monitoring is needed to further our understanding of exposure pathways and food web contaminant transfer.

Quantification of pathogens and markers of fecal contamination during storm events along popular surfing beaches in San Diego, California.

Along southern California beaches, the concentrations of fecal indicator bacteria (FIB) used to quantify the potential presence of fecal contamination in coastal recreational waters have been previously documented to be higher during wet weather conditions (typically winter or spring) than those observed during summer dry weather conditions. FIB are used for management of recreational waters because measurement of the bacterial and viral pathogens that are the potential causes of illness in beachgoers exposed to stormwater can be expensive, time-consuming, and technically difficult. Here, we use droplet digital Polymerase Chain Reaction (digital PCR) and digital reverse transcriptase PCR (digital RT-PCR) assays for direct quantification of pathogenic viruses, pathogenic bacteria, and source-specific markers of fecal contamination in the stormwater discharges. We applied these assays across multiple storm events from two different watersheds that discharge to popular surfing beaches in San Diego, CA. Stormwater discharges had higher FIB concentrations as compared to proximal beaches, often by ten-fold or more during wet weather. Multiple lines of evidence indicated that the stormwater discharges contained human fecal contamination, despite the presence of separate storm sewer and sanitary sewer systems in both watersheds. Human fecal source markers (up to 100% of samples, 20-12440 HF183 copies per 100 ml) and human norovirus (up to 96% of samples, 25-495 NoV copies per 100 ml) were routinely detected in stormwater discharge samples. Potential bacterial pathogens were also detected and quantified: Campylobacter spp. (up to 100% of samples, 16-504 gene copies per 100 ml) and Salmonella (up to 25% of samples, 6-86 gene copies per 100 ml). Other viral human pathogens were also measured, but occurred at generally lower concentrations: adenovirus (detected in up to 22% of samples, 14-41 AdV copies per 100 ml); no enterovirus was detected in any stormwater discharge sample. Higher concentrations of avian source markers were noted in the stormwater discharge located immediately downstream of a large bird sanctuary along with increased Campylobacter concentrations and notably different Campylobacter species composition than the watershed that had no bird sanctuary. This study is one of the few to directly measure an array of important bacterial and viral pathogens in stormwater discharges to recreational beaches, and provides context for stormwater-based management of beaches during high risk wet-weather periods. Furthermore, the combination of culture-based and digital PCR-derived data is demonstrated to be valuable for assessing hydrographic relationships, considering delivery mechanisms, and providing foundational exposure information for risk assessment.