Protecting public health from the impact of body-contact recreation.

Population growth and the increasing demand for recreational opportunities have put public and political pressure on water purveyors to make every water body available for multipurpose use. There is increasing evidence that full water-body contact recreation such as swimming, and water/jet skiing may add significantly more microorganisms such as viruses, Giardia, and Cryptosporidium to a water body when compared with non-body contact recreational waters. Body-contact recreation also poses a risk to the consumer inadvertently ingesting contaminated water. Waterborne disease outbreaks caused by recreation are well documented with the endemic rate and the risk level to the public estimated to be very high. Since 1989, 171 outbreaks, associated with recreational water, have been documented in the USA with more than 15,000 individuals infected; these outbreaks occurred in both natural and artificial settings. Discussions on the recently published Long-Term 2 Enhanced Surface Water Treatment Rule (LT2) have focused on varied treatment goals related to microbiological quality and source water protection methods at the heart of this discussion. This paper highlights new studies on risk from recreation, proposed beach standards, modeling to assess the risk of infection, political issues associated with limiting recreation, and what water utilities can do to reduce risk.