Epidemiological Study of Beach Water Pollution and Health-Related Bathing Water Standards in Hong Kong

A prospective epidemiological study was undertaken in Hong Kong in 1987, in which 18,741 usable responses were obtained. It showed bathing in the coastal beaches of Hong Kong poses an increased risk of developing gastrointestinal, ear, eye, skin, respiratory and total illness. Swimmers immersed in the more polluted beach waters are exposed to a significantly higher risk of contracting swimming-associated gastrointestinal, skin, respiratory and total illness. E. coli was found to be the best indicator for swimming-associated gastroenteritis and skin symptoms amongst the bathers, and a linear relationship could be established. Staphylococci was a good indicator for ear, respiratory and total illness, and should be used in complementary to E. coli. Beach water quality objectives for both E. coli and staphylococci have been proposed. A 4-tier classification system (rather than a single acceptability criterion) based on swimming-associated health risks has been developed for the beaches of Hong Kong. Information on the bacterial water quality and health risk levels of individual beaches is reported to the public both annually and fortnightly, so that beach-goers can choose where to go for swimming based on health effects data.