Bathing Water Quality and Health ImplicationsC Nelson and A T Williams
School of Applied Sciences
University of Glamorgan
Abstract
Considerable controversy exists with respect to water quality at bathing beaches. In the UK,South Wales beaches appear to be at the forefront regarding these views. An exhaustive studyinvestigating water quality and health was carried out at Barry Island, Wales during thesummer tourist season. The beach is a very popular holiday resort and attracts some 850,000during the summer months. It is composed of fine grained sand backed by a sea wall. Watersamples were taken at two hourly intervals between 1 1:00 and 15:00 hours over a 6 day periodduring a hot August period in 1995. Testing was carried out for faecal colifonns and faecalstreptococci. Simultaneously, a very detailed questionnaire (n=1276) was distributed to beachusers. The questions related to health, food consumed, family history, entry to the water or not,etc. Ten days later a follow up telephone questionnaire was carried out specifically to find ifany person had contacted for example, ear problems, gastrointestinal symptoms etc. Twentyfour percent of swimmers had illnesses compared to 5% for non-swimmers. Levels of faecalcolifonns and faecal streptococci were found to be significantly high (45,000 and 16,000respectively per 100ml). The survey was continued in 1996 at three South Wales beaches.Emphasis was placed on public perception of beaches and attitudes to seaside award schemessuch as the European Blue Flag, investigating the legislative framework through which waterquality is controlled and impact on the beach consumer.
1 Introduction
A case study was carried out on a popular tourist beach in South Wales,investigating quality of the sea water, health implications of bathing andeffectiveness of existing regulation protecting beach users. The crux of thematter centres around EEC Directive 76/160 concerning bathing water [1]which is the fundamental piece of legislation applying to all Member Statesaddressing specifically the issue of water quality at recreational sites,.
The Directive has been the cause for much disputation since its introduction over20 years ago, in 1976. Compliance is based around achieving set values defined
for 19 determinands. Two standards are set for most of the parameters, bothimperative and the stricter guideline values. Two microbiological parameters areconsidered to be the most appropriate determinands, total coliforms andescherichia coliforms (E. coli) set at 10,000 and 2,000 per 100ml respectively. Inaddition to these two indications of sewage contamination, another standard wasset for faecal streptococci stipulating a guideline value of 100 per 100ml.
Design of this Directive was aimed at amenity value as much as setting healthstandards, based on thin epidemiological evidence, one of the main criticismsbeing selection of inappropriate bacterial indicators [2, 3]. Increasing publicawareness over environmental concerns has added to the impetus behind reformsto current legislation over recreational waters. The Directive 76/160 is nowunder review, causing much discontentment, especially in the UK amongst theprivatised water companies. It is likely that the most prominent change will beinclusion of an imperative standard for faecal streptococci, and deletion of thetotal coliform parameter. Although no fixed value is currently set for faecalstreptococci, it is now widely accepted that enterococci is a better indicator ofhealth risk than E.coli [4].
Marine pollution is an emotive issue, high on the environmental agenda in SouthWales with the recent oil disaster early in 1996 when the Sea Empress tankerwas grounded off the Pembrokeshire coastline spilling circa 70 ktons of crudeoil. Two years prior to this environmental catastrophe, saw severe cases ofneurological disabling symptoms supposedly contracted from swimmingoccurring in 2 teenagers, at Oxwich Bay, Gower, Wales, known for itsimpeccable water quality. Although no causal proof was obtained extrapolatingtheir disease back to the water, speculation has increased over the health riskassociated with swimming in coastal waters. The Oxwich cases have been ofparticular interest due to the Bay's consistent compliance with the current EECDirective on water quality. The question to be addressed is, 'does currentlegislation ensure adequate protection of health, on which most of the existingbeach award schemes are based, including the Blue Flag Award (6) and theTidy Britain Group (TBG) Seaside Awards (5)?'
2 Physical background.
2.1 Barry Island Site Description
Whitmore Bay, Barry Island is a popular coastal resort, lying 10 miles West ofCardiff in the Vale of Glamorgan. The beach is predominantly sandy, southfacing on the Bristol Channel with a large surface area of 200,000nf, 800m longand 250m wide to low water; OS reference sheet 171, grid reference 115 663.The resort has a highly developed hinterland both commercial and tourist,including a holiday camp, funfair, amusements, shops, pubs and night-clubs.
Tourism is very important to the area, the beach attracting 850,00 people during1994 [7] and providing 13.4% of the employment sector [8]. The surroundingtown of Barry provides a large catchment with a population of 46 [7], makingup 41% of the Borough. The beach coupled with attractions provide a focalpoint for summer day trips from the surrounding South Wales Valleys andGwent region, also being within 10 miles of the M4 motorway, creating easyaccess for holiday makers.
2.2 Oxwich Bay Site Description
Oxwich Bay, Gower, West Wales is privately owned by the Penrice Estate, alarge proportion of which was declared a National Nature Reserve (NNR) in1962 by the Nature Conservancy Council and includes a Site of SpecialScientific Interest. Although the majority of visitors are attracted to Oxwich Bayfor its coastline, a substantial number visit the Reserve. Oxwich Bay is a pocketbay consisting of a fine sandy beach, backed by a varied and extensive sand dunesystem. Behind the sand dune system is a large freshwater marsh. Wave energyis low. The northern and southern ends of the Bay are flanked by mature broad-leaved woodland. Oxwich point forms the southern boundary of the bay,continuing westwards to Slade Bay following a rocky shoreline with coastalslopes and limestone cliffs. Oxwich is one of the main locations for tourism onGower and attracts a large number of water sport users. However, it suffersseasonal trends similar to other bays along the Gower coastline. This addspressure to managing conservation at Oxwich because of the increasedpopulation during summer months. Holiday facilities exist in the form of a cafe,static caravan sites, hotel and bar. Information [9].
2.3 Langland Bay Site Description
Langland Bay has a fine grained sandy beach which lies in the most intensivelyused stretch of Gower coastline, West Wales. It is protected on both sides byheadlands, the western side siting a golf course, and is backed by beach chalets,tennis courts and a car park, so has low wave energy. The surrounding areaincludes Bishop's Wood and contains a Local Nature Reserve and 2 Sites ofSpecial Scientific Interest. West Glamorgan County Council has designated theBay as an intensive zone aimed at protecting and enhancing the coastline whilstproviding facilities to cater for visitors. The Bay and surround provides a cafeand small gift shop selling food and drinks. It is heavily frequented by cityresidents, tourists which with close proximity to built up areas makes it an idealdestination for day trippers. Langland is also well known for its excellent surfand ideal conditions for water sports. Water based activities which take placeinclude surfing, bathing, canoeing, windsurfing and recreational fishing.Information [9].
The beach Cefh Sidan is situated in Pembrey Country Park, an area of circa2800 ha with a diversity of landscape including saltmarsh, dune system andforeshore. The fine grain sandy beach is large extending 10 km in length fromthe Pier at Burry Port in the south east to the Gwendraeth Estuary in the northwest, backed by a dune system Cefn Sidan is a very popular destination for bothlocals and holiday makers, receiving 450,000 visitors this year [10,11]. Thebeach in 1996 was successfully awarded both an Blue Flag and TBG SeasideAward
3 Methodology
A prospective epidemiological method was employed where participants in thesurvey were self selecting in their activity on the beach. There are advantagesinherent within this type of investigation over a controlled cohort studyrecruiting volunteers. The main benefit allows analysis across age groups. It isunethical in the cohort study to recruit young children for participation.Information was collected on the survey days utilising a semi-structuredquestionnaire to obtain socio-economic data on participants including data onrecent dietary habits, contact with members of their family suffering with illness,contact with animals and visits to the beach detailing their behaviour in terms ofcontact with the sea. This enabled a comparison between the differing levels ofsea immersion and a control group consisting of those interviewed who hadrefrained from entering the water, attempting to eliminate confounding factors.The survey was carried out over a 6 day period in August 1995, during aparticularly hot period, temperatures reaching in excess of 24C, watertemperature being approximately 19C. The questionnaire requested participantsto include their telephone number for use in a follow up telephone questionnaireten days post the interview at the beach. The telephone questionnaire wasconducted to ascertain the number of people who had contracted an illness aftervisiting Barry Island, to compare the ratios of those who had contact with thesea against those who did not enter the water. Ten days is an average time allowpathogenic organisms contained within sewage contaminated seawater toincubate within the human host. The telephone questionnaire requiredrespondents to provide information on high risk foods eaten since the day at thebeach, and again information regarding contact with members of their familysuffering with illness, contact with animals and visits to the beach, detailingcontact with the sea.
In order to relate health risk of swimming to water quality in an attempt toestablish if a dose response relationship existed, samples of sea water were takenon the interview days. The laboratory at the University of Glamorgan wasutilised to analyse the water samples using the membrane filtration technique
[12], following procedures outlined in the EEC Directive concerning the qualityof bathing water. To accommodate proposed amendments to the directiveregarding bacterial determination, emphasis was also placed on measuring thelevel of faecal streptococci as well as the current criteria for E. Coll. In additionthe water was tested for F specific RNA phage using standard procedures atacer Environmental Laboratories and Sciences, Bridgend, Mid Glamorgan. Awindow period between the hours 11:00 and 15:00, was identified in which mostbeach users entered the sea,. Three sets of samples were taken at two pointsalong the beach allowing for spatial variation at the points of highest density ofswimmers. By sampling at 11:00, 13:00 and 15:00 on each day for 6 days bothtemporal and tidal variation were also accounted for. Samples were taken inknee depth of water, 30 cm below the surface using a sampling pole, inaccordance with Environment Procedures [13].
A further survey was completed during 1996 evaluating public perception tobeaches and investigating the awareness, recognition and understanding ofseaside award systems, and also evaluating whether they play an important rolein beach selection. The survey was carried out through August at three differentbeach types. Barry Island with a history of poor water quality, Langland (nrSwansea, West Wales) has a better history of water quality, but not attaining therigid criteria required for the Blue Flag and Cefh Sidan (Pembrey Country Park,West Wales) with water quality meeting guideline standards set by EECDirective on bathing water, 76/160, and successfully obtaining both the BlueFlag and TBG Seaside Award A two phase approach was used in the survey.Firstly participants were asked to fill in a questionnaire asking about theirknowledge of beach award systems and secondly they were shown photographsof the different types of flags and asked if they could accurately identify eachone.
4 Results and Discussion
4.1 Results: Water Quality
The water quality proved to vary widely both temporally and spatially, alsobeing affected by tidal cycles. Barry Island, the survey beach lies on the SevernEstuary, having the second highest rise and fall of the tide in the world (14.7m atAvonmouth), which may account in part for sewage density fluctuations.Samples taken at the beginning of the week tended to be higher than mid-weeksamples, which might be due to high visitor loads on the weekend. Very highcounts of both E. Coli and faecal streptococci were found. E. Coli averaged3400/lOOml exceeding the EEC mandatory value by 1.5 times, and faecalstreptococci 440/100ml exceeding the EEC guideline value by over 4 timesMaximum counts reached a incredible 45,000/lOOml E. Coli and 20,300/100ml.Results for the F specific RNA phage found zero colonies. This could be due to
none being present or due to analytical technique. Research into coliphages isstill taking place. Although the EU are considering implementing a standard forthese indicators, as yet no definitive determinand exists. However research is stillvery active in this field. Table 1 outlines the current microbiological parametersset by Directive 76/160 compared to proposed reforms.The bacteriological results substantiate contention over indicator selection.Current evolution in recreational water legislation is placing greater emphasis ondefining a faecal streptococci parameter for use in water quality determination,which is believed to be an effective indicator of sewage presence [2,14]. AllMember States have to comply to bathing water regulations set by the EC, nowunder review. Reforms to Directive 76/160 were due to come into force byDecember 1995. Continued debate over defining appropriate microbiologicalparameters is prolonging its implementation.
Current standard EEC 76/160Imperative levelGuide levelProposed amendments EC 94/C 112/03Imperative levelGuide level
Kcoli lOOmT'
2000100
2000100
F. streps100ml-*
—100
400100
Table 1. Some standard current and proposed amendments
The Barry Island survey was carried out over 6 days during August, 1995. Theweather was very hot and 1276 questionnaires were obtained. Thequestionnaires included a request for respondent's telephone numbers used inthe post interview survey necessary for health implications analysis. Fivehundred and eighty telephone numbers were submitted of which a total of 535were contacted.
No consistent relationship appeared to exist between illness rates and bacterialevels, questioning a dose response relationship. These results are in oppositionto findings found in previous studies [15,16]. Chi-square analysis was applied tothe data at the 0.05 level showing an increased incidence rate of illness amongstthose that entered the water compared to those that refrained from entering,indicating water quality to have a significant effect on contraction of symptoms.Reported illness incidents for swimmers, waders and non swimmers were 24%,13.8% and 2.3% respectively. There was also a higher incidence rate of illnessbetween waders compared to the non-swimmer group. The symptom rate forswimmers was approximately 24%, which included gastrointestinal problems,skin irritation and sore throats; waders 13.8% and non-swimmers 2.3%.Children under 10 years of age tended to be the most sensitive to contraction ofillness, (38.9% reported ill)) with the 10-20 age group being the most resistant(7%). Figures for the 10-20 age group were 15.8% and for the 30-50 age group,8.7%. Males had a much higher reported illness rate than females. There was noobvious reason for this.
4.3 Results: Beach Classification
A recent survey [16] questioned the applicability of the Directive in ensuringsafety to bathers, on which seaside award schemes are based, namely the BlueFlag and the TBG Seaside Award Flags. These systems are used in promotion ofbeaches, but not only is it likely that they may be centred around standardsbelow acceptable limits, additional work done in this survey questioned publicperception and awareness of these as marketing tools. Results from the surveywork done in 1996 at Barry Island, Langland and Cefh Sidan indicate a greatdeal of confusion about the different awards available and literature such as theMarine Conservation Society Good Beach Guide. In fact only half of the samplegroup (52.5%), had heard of any beach award scheme, less thought theyunderstood them and only about 33% accurately identified the criteria for anBlue Flag. Out of the awards available, the Blue Flag gained the mostrecognition, 64.5%, compared to 41.4% for TBG Seaside Awards. But whenshown a Blue Flag and the TBG Seaside Award Flag as visual stimulus only10.9% and 0.5% respectively accurately recognised them. In fact 7% of theparticipants thought the Blue flag represented danger.
These results indicate the ineffectiveness of the flag systems, giving cause forconcern, for example in the Green Seas Initiative campaign in Wales [18]. TheGreen Seas Initiative is a forum set up between various agencies including WelshWater plc,and Wales Tourist Board. Welsh Water pic. are very pro-active intheir attitude to cleaning up the coast, committing huge expenditures toimproving the sewerage system [19]. Their role in the Green Seas Initiativecampaign is to achieve 50 Blue Flags by the end of the Millenium. So it appearsthat emphasis is being misplaced by putting importance on seaside awardschemes in beach classification.
5 Conclusion
Recent media attention highlighting coastal issues in Wales has brought marinepollution into the limelight, supporting the drive for reform to current legislationon bathing waters, which fall significantly short of standards set by ourcounterparts in North America [20]. Whilst acknowledging the mono-sitelimitation of this study in water quality terms, the results are in line with previousresearch into health implications of bathing in sewage contaminated water [15],indicating swimmers to be at much higher risk of contracting an illness than non-swimmers. Barry Island proved to have high concentrations of faecal bacteriapresent. Even though a dose response relationship was not established it wouldbe presumptuous to assume one does not exist as these findings are at variancewith other findings[15,17]. A suggestion would be to continue further work inthis field examining a range of beaches with varying water quality and focusingon an intensive microbiological sampling programme.
In addition to health standards which already exist, it is imperative that end userperception be considered as part of beach management or any Integrated CoastalZone Management scheme. With reference to the lack in recognition of seasideaward systems a question which should surely be asked is 'has intellectualarrogance failed to appreciate the major issue of consumer perception in beachmanagement?', especially in the UK, as can be seen in Wales through the GreenSeas Initiative in which Welsh Water pic. are engaged. This research indicatesthat most people have little understanding of seaside award flags, if any at all.Reform to the EEC Directive concerning the quality of bathing water shouldattempt establishing an acceptable degree of risk to beach users and base thewater quality determinands on sound scientific evidence. Finally, if agenciesinvolved in utilising seaside award schemes as promotional tools wish tocontinue along this line, a strategy incorporating an intensive educational andmarketing programme should be considered and account of reforms to waterquality legislation should be strictly adhered.
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19. South Wales Echo, September 19* 1995. £5 50m Plan for Beaches.
