Health risks of limited-contact water recreation.

BACKGROUND: Wastewater-impacted waters that do not support swimming are often used for boating, canoeing, fishing, kayaking, and rowing. Little is known about the health risks of these limited-contact water recreation activities. OBJECTIVES: We evaluated the incidence of illness, severity of illness, associations between water exposure and illness, and risk of illness attributable to limited-contact water recreation on waters dominated by wastewater effluent and on waters approved for general use recreation (such as swimming). METHODS: The Chicago Health, Environmental Exposure, and Recreation Study was a prospective cohort study that evaluated five health outcomes among three groups of people: those who engaged in limited-contact water recreation on effluent-dominated waters, those who engaged in limited-contact recreation on general-use waters, and those who engaged in non-water recreation. Data analysis included survival analysis, logistic regression, and estimates of risk for counterfactual exposure scenarios using G-computation. RESULTS: Telephone follow-up data were available for 11,297 participants. With non-water recreation as the reference group, we found that limited-contact water recreation was associated with the development of acute gastrointestinal illness in the first 3 days after water recreation at both effluent-dominated waters [adjusted odds ratio (AOR) 1.46; 95% confidence interval (CI): 1.08, 1.96] and general-use waters (1.50; 95% CI: 1.09, 2.07). For every 1,000 recreators, 13.7 (95% CI: 3.1, 24.9) and 15.1 (95% CI: 2.6, 25.7) cases of gastrointestinal illness were attributable to limited-contact recreation at effluent-dominated waters and general-use waters, respectively. Eye symptoms were associated with use of effluent-dominated waters only (AOR 1.50; 95% CI: 1.10, 2.06). Among water recreators, our results indicate that illness was associated with the amount of water exposure. CONCLUSIONS: Limited-contact recreation, both on effluent-dominated waters and on waters designated for general use, was associated with an elevated risk of gastrointestinal illness.

A comparison of rapid and conventional measures of indicator bacteria as predictors of waterborne protozoan pathogen presence and density.

E. coli and enterococci in recreational waters are monitored as indicators of fecal contamination, pathogen presence, and health risk. Quantitative polymerase chain reaction (qPCR) tests for fecal indicator bacteria can provide beach managers with same-day information about water quality, unlike culture methods which provide that information the following day. The abilities of qPCR measurements of indicator bacteria, as compared to culture measurements of indicator bacteria, as predictors of pathogen presence or density in surface waters are not well understood. The purpose of this study was to make such comparisons between water samples collected from Chicago area surface waters, including rivers, inland lakes, Lake Michigan, and the Chicago Area Waterways System, which is dominated by wastewater effluent. A total of 294 twenty-litre samples were collected and analyzed for Giardia and Cryptosporidium. qPCR and membrane filtration methods were used to quantify E. coli and enterococci. Correlation, logistic regression, and zero-inflated Poisson modeling were utilized to evaluate associations between indicators and parasites. qPCR and culture measures of the indicator bacteria were similar in their ability to predict parasite presence and density. Correlations between parasites and indicators were generally stronger at waters not dominated by effluent. Associations between indicator density and Giarida presence were observed more consistently than between indicator density and Cryptosporidium presence. Associations between enterococci and parasites were generally stronger than associations between E. coli and parasites. The use of qPCR monitoring in our setting would generate more timely results without compromising the ability to predict parasite presence or density.

Water ingestion during water recreation.

Quantitative risk assessments have estimated health risks of water recreation. One input to risk assessment models is the rate of water ingestion. One published study estimated rates of water ingestion during swimming, but estimates of water ingestion are not available for common limited contact water recreation activities such as canoeing, fishing, kayaking, motor boating, and rowing. In the summer of 2009 two related studies were conducted to estimate water ingestion during these activities. First, at Chicago area surface waters, survey research methods were utilized to characterize self-reported estimates of water ingestion during canoeing, kayaking, and fishing among 2705 people. Second, at outdoor swimming pools, survey research methods and the analysis of cyanuric acid, a tracer of swimming pool water, were used to characterize water ingestion among 662 people who engaged in a variety of full-contact and limited-contact recreational activities. Data from the swimming study was used to derive translation factors that quantify the volume of self-reported estimates. At surface waters, less than 2% of canoers and kayakers reported swallowing a teaspoon or more and 0.5% reported swallowing a mouthful or more. Swimmers in a pool were about 25-50 times more likely to report swallowing a teaspoon of water compared to those who participate in limited-contact recreational activities on surface waters. Mean and upper confidence estimates of water ingestion during limited-contact recreation on surface waters are about 3-4 mL and 10-15 mL, respectively. These estimates of water ingestion rates may be useful in modeling the health risks of water recreation.

Nonlinear regression adjustments of multiple continuous monitoring methods produce effective characterization of short-term fine particulate matter.

This study comprehensively characterizes hourly fine particulate matter (PM(2.5)) concentrations measured via a tapered element oscillating microbalance (TEOM), beta-gauge, and nephelometer from four different monitoring sites in U.S. Environment Protection Agency (EPA) Region 5 (in U.S. states Illinois, Michigan, and Wisconsin) and compares them to the Federal Reference Method (FRM). Hourly characterization uses time series and autocorrelation. Hourly data are compared with FRM by averaging across 24-hr sampling periods and modeling against respective daily FRM concentrations. Modeling uses traditional two-variable linear least-squares regression as well as innovative nonlinear regression involving additional meteorological variables such as temperature and humidity. The TEOM shows a relationship with season and temperature, linear correlation as low as 0.7924 and nonlinear model correlation as high as 0.9370 when modeled with temperature. The beta-gauge shows no relationship with season or meteorological variables. It exhibits a linear correlation as low as 0.8505 with the FRM and a nonlinear model correlation as high as 0.9339 when modeled with humidity. The nephelometer shows no relationship with season or temperature but a strong relationship with humidity is observed. A linear correlation as low as 0.3050 and a nonlinear model correlation as high as 0.9508 is observed when modeled with humidity. Nonlinear models have higher correlation than linear models applied to the same dataset. This correlation difference is not always substantial, which may introduce a tradeoff between simplicity of model and degree of statistical association. This project shows that continuous monitor technology produces valid PM(2.5) characterization, with at least partial accounting for variations in concentration from gravimetric reference monitors once appropriate nonlinear adjustments are applied. Although only one regression technically meets new EPA National Ambient Air Quality Standards (NAAQS) Federal Equivalent Method (FEM) correlation coefficient criteria, several others are extremely close, showing optimistic potential for use of this nonlinear adjustment model in garnering EPA NAAQS FEM approval for continuous PM(2.5) sampling methods.

Bias and confounding in longitudinal measures of exhaled monoxides.

The measurement of exhaled nitric oxide and carbon monoxide concentrations is an emerging method of monitoring airway inflammation longitudinally in community-based studies. Inhaled concentrations of these monoxides influence exhaled concentrations. Little is known about the degree to which inhaled concentrations distort temporal trends in, or estimated effects of air pollutants on, exhaled monoxides. We sought to evaluate whether estimated effects of air pollutants on exhaled monoxides are distorted by trends in indoor and outdoor monoxides, and to characterize determinants of exhaled monoxide concentrations among residents of public housing. In a panel study, 42 residents of public housing provided over 1000 exhaled breath samples. Samples from all subjects were analyzed for nitric oxide; samples from 27 of these subjects were also analyzed for carbon monoxide. The effects of indoor and outdoor monoxide concentrations on exhaled concentrations were quantified. Confounding of associations between particulate matter concentrations and exhaled nitric oxide concentrations was explored. Determinants of exhaled monoxide concentrations among public housing residents are similar to those of other populations. Exhaled monoxide concentrations are more strongly associated with indoor than with outdoor monoxide concentrations. Approximately half of the variability in exhaled monoxide concentrations over time can be explained by changes in indoor monoxide concentrations. Indoor monoxide concentrations can markedly distort both temporal trends in exhaled concentrations as well as estimated effects of particulate matter on exhaled monoxides. Prior estimated effects of particulate matter on exhaled nitric oxide concentrations may have been confounded by nitric concentrations indoors at the time of exhaled air collection. To prevent distortions of longitudinal trends in airway inflammation and estimated health effects of air pollutants, inspiratory scrubber use is necessary but not sufficient to remove the confounding effect of indoor monoxides, and analyses should adjust exhaled monoxide concentrations for concentrations indoors.

Demolition of high-rise public housing increases particulate matter air pollution in communities of high-risk asthmatics.

Public housing developments across the United States are being demolished, potentially increasing local concentrations of particulate matter (PM) in communities with high burdens of severe asthma. Little is known about the impact of demolition on local air quality. At three public housing developments in Chicago, IL, PM with an aerodynamic diameter < 10 microm (PM10) and < 2.5 microm were measured before and during high-rise demolition. Additionally, size-selective sampling and real-time monitoring were concurrently performed upwind and downwind of one demolition site. The concentration of particulates attributable to demolition was estimated after accounting for background urban air pollution. Particle microscopy was performed on a small number of samples. Substantial increases of PM10 occurred during demolition, with the magnitude of that increase varying based on sampler distance, wind direction, and averaging time. During structural demolition, local concentrations of PM10 42 m downwind of a demolition site increased 4- to 9-fold above upwind concentrations (6-hr averaging time). After adjusting for background PM10, the presence of dusty conditions was associated with a 74% increase in PM10 100 m downwind of demolition sites (24-hr averaging times). During structural demolition, short-term peaks in real-time PM10 (30-sec averaging time) occasionally exceeded 500 microg/m(3). The median particle size downwind of a demolition site (17.3 microm) was significantly larger than background (3 microm). Specific activities are associated with realtime particulate measures. Microscopy did not identify asbestos or high concentrations of mold spores. In conclusion, individuals living near sites of public housing demolition are at risk for exposure to high particulate concentrations. This increase is characterized by relatively large particles and high short-term peaks in PM concentration.

Application of EPA CMB8.2 model for source apportionment of sediment PAHs in Lake Calumet, Chicago.

A chemical mass balance model developed by the U.S. EPA, CMB8.2, was used to apportion the major sources of PAHs found in the sediments of Lake Calumet and surrounding wetlands in southeast Chicago. The results indicate the feasibility of applying CMB8.2 to pollutants found in aquatic sediments. To establish the fingerprints of PAH sources, 28 source profiles were collected from the literature. Some of the source profiles were modified based on the gas/particle partitioning of individual PAHs. The profiles under the same source category were averaged, and the fingerprints of six sources were established, including coke oven, residential coal burning, coal combustion in power generation, gasoline engine exhaust, diesel engine exhaust, and traffic tunnel air. Nine model operations with a total of 422 runs were made, differing in the choice of fitting species and the sources involved. Modeling results indicate that coke ovens and traffic are the two major sources of PAHs in the area. For traffic sources, either traffic tunnel alone or both diesel and gasoline engine exhausts were entered into the model. These two groups of model operations produced comparable results with regard to the PAH contributions from road traffic. Although the steel industries have shrunk in recent years, closed and still-active coke plants continue to contribute significantly to the PAH loadings. Overall, the average contribution from coke oven emissions calculated by different operations ranges from 21% to 53% of all sources, and that from traffic ranges from 27% to 63%. The pattern of source contributions shows spatial and temporal variations.

Adjusting tapered element oscillating microbalance data for comparison with Federal Reference Method PM2.5 measurements in region 5.

Continuous monitoring of particulate matter (PM) with a diameter less than 2.5 microm (PM2.5) is quickly gaining acceptance as an alternative means of measuring fine PM in the United States. For this project, data were taken from all monitoring sites within Region 5 that used the tapered element oscillating microbalance (TEOM) for PM2.5 and had a collocated Federal Reference Method (FRM) monitor. Scatter plots of TEOM versus FRM show that for a significant fraction of the observations, an independent factor causes the TEOM to underestimate the FRM value. This underestimation appears to increase as temperature decreases. For this analysis, a linear relationship was fit to the TEOM versus FRM data, allowing a break or knot in the relationship, modeled as a change of slope, at a site-specific temperature. To test whether the models are adequate for adjusting future measurements, models were also developed using the first year of data only, and the remaining observations were used to test the durability of the relationships. For all but one monitor in Minnesota, the models developed for each site had consistently high R2s, were predictive of future measurements, and could be used to derive "FRM-like" results from the TEOM measurements. The temperature knots fitted by the model for individual sites ranged from 12.9 to 20.6 degrees C. Data from all six sites in the state of Michigan were also combined to determine if a single model could be developed for the entire state. While the single model for the state of Michigan worked reasonably well, some of the predicted concentrations at individual sites were systematically underestimating the observed concentrations on more polluted days. The same conclusion was drawn for a Region 5-wide model. This approach was also found to work very well for six individual TEOM monitors in New York State.

Effect of ozone and aeroallergens on the respiratory health of asthmatics.

The effect of ambient air pollutants, pollens, and mold spores on respiratory health was studied in an area with low concentrations of chemical pollutants and abundant aeroallergens. A panel of 40 asthmatic subjects living near East Moline, Illinois, recorded peak expiratory flow rates (PEFRs), respiratory symptoms, frequency of asthma attacks, and asthma medication use between April and October 1994. Daily outdoor concentrations of pollutants and aeroallergens were measured, and indoor levels of bioaerosols were measured on several occasions in each participant's home. Ozone was associated with increased morning and evening symptom scores and decreased evening PEFR, and these associations remained significant with adjustment for weather and aeroallergens. The association between ozone and asthma medication use was increased in magnitude and significance with adjustment for weather and aeroallergens; however, the association between ozone and morning PEFR became nonsignificant with weather and aeroallergen adjustment. Significant associations were also found between pollen concentration and decreased evening PEFR, as well as between increased morning and evening symptom scores and asthma medication use. In addition, associations were noted between total spore concentration and increased morning PEFR and decreased morning and evening symptom scores. The inverse associations found with mold spore concentrations were not consistent with the results of other studies; however, the associations between ozone and pollen concentration were consistent with previous studies. When results were stratified by a number of independent risk factors, no differences were noted relative to allergic status or presence of dampness or flooding in the home; however, the associations with outdoor ozone and pollens were seen mainly among participants with low levels of exposure to indoor bioaerosols (< 1,800 spores/m3) or with no environmental tobacco smoke exposure.

Receptor Model Evaluation of the Southeast Michigan Ozone Study Ambient NMOC Measurements.

Large-scale studies like the Southeast Michigan Ozone Study (SEMOS) have focused attention on quantifying and spedating inventories for volatile organic compounds (VOCs). One approach for evaluating the accuracy of a VOC emission inventory is the development of a chemical mass balance (CMB) receptor model for ambient non-methane organic compound (NMOC) measurements. CMB evaluations of ambient hydrocarbon data provide a sample-specific allocation of emissions to individual source categories. This study summarizes the results of an application of the CMB model to the NMOC data from the SEMOS study. Comparison of CMB results with emission inventory values for the Detroit area show that vehicle emissions are well represented by the inventory, as are architectural coatings and coke ovens. Estimated emissions from petroleum refineries and graphic arts industries are much lower in the inventory than determined from the receptor allocation. Under-reporting of fugitive VOC emissions from petroleum refineries is an ongoing problem. Emissions from graphic arts industries are underestimated in the inventory partly because of the broad characterization of the emission factor (i.e., mass emitted/capita), which may be less useful when specific locations and days are under consideration. This study also demonstrates the effectiveness of the CMB approach when used prospectively to track the implementation of emission control strategies. While vehicle emission concentrations were unchanged from 1988 to 1993, measurement-based CMB results suggest a decrease in evaporative emissions during this time period resulting from Reid vapor pressure (RVP) reductions (from 11.0 psi in 1988 to 8.6 psi in 1993) and fleet turnover. Changes in emissions from coke plants and petroleum refineries were also seen in the CMB allocations for these sources.