Derivation of numerical values for the World Health Organization guidelines for recreational waters

Kay, David; Bartram, Jamie; Prüss, Annette; Ashbolt, Nicholas J.; Wyer, Mark D.; Fleisher, Jay M.; Fewtrell, Lorna; Rogers, Alan; Rees, G. Wyn

doi:10.1016/j.watres.2003.11.032

Cited by 94 publications

(72 citation statements)

References 18 publications

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“…Retail and food manufacturers, plus a variety of other agencies, use microbiological standards based on the presence or absence of indicator organisms, identification of which alerts the agency to a potential health risk from the medium monitored (132,244,245). These standards also incorporate overall counts of nonpathogenic flora, because the organisms of interest are widely spread throughout time and space (129).…”

Section: Microbiological Methodsmentioning

confidence: 99%

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

2014

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SUMMARY There is increasing interest in the role of cleaning for managing hospital-acquired infections (HAI). Pathogens such as vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), multiresistant Gram-negative bacilli, norovirus, and Clostridium difficile persist in the health care environment for days. Both detergent- and disinfectant-based cleaning can help control these pathogens, although difficulties with measuring cleanliness have compromised the quality of published evidence. Traditional cleaning methods are notoriously inefficient for decontamination, and new approaches have been proposed, including disinfectants, steam, automated dispersal systems, and antimicrobial surfaces. These methods are difficult to evaluate for cost-effectiveness because environmental data are not usually modeled against patient outcome. Recent studies have reported the value of physically removing soil using detergent, compared with more expensive (and toxic) disinfectants. Simple cleaning methods should be evaluated against nonmanual disinfection using standardized sampling and surveillance. Given worldwide concern over escalating antimicrobial resistance, it is clear that more studies on health care decontamination are required. Cleaning schedules should be adapted to reflect clinical risk, location, type of site, and hand touch frequency and should be evaluated for cost versus benefit for both routine and outbreak situations. Forthcoming evidence on the role of antimicrobial surfaces could supplement infection prevention strategies for health care environments, including those targeting multidrug-resistant pathogens.

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Section: Microbiological Methodsmentioning

confidence: 99%

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

2014

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“…Owing to the fact that enterococci have been proved to be the most reliable predictors of health risk in recreational waters (Kay et al 1994(Kay et al , 2004Mariñ o et al 1995a;Borrego & Mariñ o 1998), it is necessary to carry out more studies to improve the detection and enumeration of enterococci in natural waters using the defined substrate-based procedure.…”

Section: Discussionmentioning

confidence: 99%

Are the defined substrate-based methods adequate to determine the microbiological quality of natural recreational waters?

Valente

Pedro

Alonso

et al. 2009

Journal of Water and Health

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Monitoring the microbiological quality of water used for recreational activities is very important to human public health. Although the sanitary quality of recreational marine waters could be evaluated by standard methods, they are time-consuming and need confirmation. For these reasons, faster and more sensitive methods, such as the defined substrate-based technology, have been developed. In the present work, we have compared the standard method of membrane filtration using Tergitol-TTC agar for total coliforms and Escherichia coli, and Slanetz and Bartley agar for enterococci, and the IDEXX defined substrate technology for these faecal pollution indicators to determine the microbiological quality of natural recreational waters.

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“…However, it also 99 generates controversy across the scientific, regulatory and policy communities with regular 100 debates being driven by scepticism of whether: (i) E. coli is a suitable faecal indicator 101 organism (FIO) to assess recent faecal pollution (Wu et al, 2011), (ii) the directive is suitably 102 protective of human health (Langford et al, 2000;Kay et al, 2004), and, more recently, (iii) 103 the methods currently used to determine microbial water quality at bathing beaches are fit for 104 purpose . However, it is important to note that microbial water quality testing at designated bathing 131 waters in the EU can serve two separate purposes.…”

Section: The Debate 96mentioning

confidence: 99%

Opportunities and limitations of molecular methods for quantifying microbial compliance parameters in EU bathing waters

Oliver

Niekerk

Kay

et al. 2014

Environment International

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Derivation of numerical values for the World Health Organization guidelines for recreational waters

Cited by 94 publications

References 18 publications

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

Are the defined substrate-based methods adequate to determine the microbiological quality of natural recreational waters?

Opportunities and limitations of molecular methods for quantifying microbial compliance parameters in EU bathing waters

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