Quantitative microbial risk assessment of acute gastrointestinal illness attributable to freshwater recreation in Ontario.

IF 2.9 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2024-12-10 DOI:10.17269/s41997-024-00969-4

Henry Ngo, E Jane Parmley, Nicole Ricker, Charlotte Winder, Heather M Murphy

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引用次数: 0

Abstract

Objectives: The burden of disease associated with acute gastrointestinal illness (AGI) in Canada is estimated to be ~ 20 million cases/year. One known risk factor for developing AGI is recreation in freshwater bodies such as lakes. The proportion of cases attributable to freshwater recreation in Canada, however, is currently unknown. The study objective was to estimate the risk of developing AGI from exposure to Giardia, Cryptosporidium, Campylobacter, Escherichia coli O157:H7, norovirus, and Salmonella during freshwater recreation in Ontario, Canada.

Methods: A quantitative microbial risk assessment (QMRA) was conducted to estimate the number of AGI cases per 1000 recreational events associated with freshwater recreation. QMRA utilizes four steps: hazard identification, exposure assessment, dose-response modelling, and risk characterization. A probabilistic model was developed using the following inputs accounting for uncertainty and variability: published data on pathogen prevalence and concentration in freshwaters in Ontario (hazard identification), recreator water ingestion volumes (exposure), pathogen-specific dose-response models, and ratios between numbers of infections and symptomatic disease cases to estimate illness risks (risk characterization).

Results: The mean estimated AGI risk associated with recreation ranged from 0.8 to 36.7 cases per 1000 swimmers (5th-95th probability interval: 0-226.3 cases/1000) which is in line with previous studies conducted in Lake Ontario, as well as prior QMRAs of freshwater recreation. Upper range predicted values exceeded the Health Canada guideline of less than 20 cases per 1000 recreators.

Conclusion: This study shows that QMRA can be used to estimate disease risk in the absence of large-scale epidemiological studies. The results demonstrate a range of risk that is in line with exposure to pristine (low risk estimates) and more contaminated waters (high risk estimates) and capture the potential risk to vulnerable populations.

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安大略省淡水娱乐引起的急性胃肠道疾病的定量微生物风险评估。

目的：在加拿大，与急性胃肠道疾病（AGI）相关的疾病负担估计约为2000万例/年。发展AGI的一个已知风险因素是在湖泊等淡水水体中休闲。然而，在加拿大，可归因于淡水娱乐的病例比例目前尚不清楚。本研究的目的是评估加拿大安大略省淡水娱乐期间接触贾第鞭毛虫、隐孢子虫、弯曲杆菌、大肠杆菌O157:H7、诺如病毒和沙门氏菌导致AGI发生的风险。方法：进行定量微生物风险评估（QMRA），以估计每1000个与淡水娱乐相关的娱乐事件的AGI病例数。QMRA采用四个步骤：危害识别、暴露评估、剂量反应建模和风险表征。利用下列考虑不确定性和可变性的输入，开发了一个概率模型：安大略省淡水中病原体流行率和浓度的公开数据（危险识别）、再生动物饮水量（暴露）、病原体特异性剂量反应模型，以及用于估计疾病风险的感染人数与有症状疾病病例之间的比率（风险表征）。结果：与娱乐相关的平均AGI风险估计范围为每1000名游泳者0.8至36.7例（第5 -95次概率区间：0-226.3例/1000），这与之前在安大略湖进行的研究以及之前的淡水娱乐QMRAs一致。上限预测值超过了加拿大卫生部的指导方针，即每1000名再造者不到20例。结论：本研究表明，在没有大规模流行病学研究的情况下，QMRA可以用来估计疾病风险。结果显示了一系列风险，这些风险与接触原始水（低风险估计）和受到更严重污染的水（高风险估计）一致，并捕获了脆弱人群面临的潜在风险。

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来源期刊

Canadian Journal of Public Health-Revue Canadienne De Sante Publique PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.10

自引率

4.70%

发文量

128

期刊介绍： The Canadian Journal of Public Health is dedicated to fostering excellence in public health research, scholarship, policy and practice. The aim of the Journal is to advance public health research and practice in Canada and around the world, thus contributing to the improvement of the health of populations and the reduction of health inequalities. CJPH publishes original research and scholarly articles submitted in either English or French that are relevant to population and public health. CJPH is an independent, peer-reviewed journal owned by the Canadian Public Health Association and published by Springer. Énoncé de mission La Revue canadienne de santé publique se consacre à promouvoir l’excellence dans la recherche, les travaux d’érudition, les politiques et les pratiques de santé publique. Son but est de faire progresser la recherche et les pratiques de santé publique au Canada et dans le monde, contribuant ainsi à l’amélioration de la santé des populations et à la réduction des inégalités de santé. La RCSP publie des articles savants et des travaux inédits, soumis en anglais ou en français, qui sont d’intérêt pour la santé publique et des populations. La RCSP est une revue indépendante avec comité de lecture, propriété de l’Association canadienne de santé publique et publiée par Springer.