Rapid urbanisation in the coastal areas of South Africa has led to increasing concern about the potential health effects on bathers resulting from exposure to contaminated seawater. Water quality criteria in South Africa are not epidemiologically derived; consequently a major programme has been launched to develop health-related criteria and policies pertaining to wastewater and stormwater management in the coastal areas of South Africa. In the first phase of the project, an epidemiological-microbiological study was carried out at a moderately polluted beach and a relatively clean beach, in the Western Cape. Individuals present at the beach in family groups were interviewed and follow-up telephone interviews were conducted 3-4 days after the beach outing. Water quality indicators measured on the same day as the beach interviews revealed significantly higher levels of enterococci and faecal coliforms at the moderately polluted beach. Symptom rates for gastrointestinal, respiratory and skin effects were substantially higher among swimmers relative to non-swimmers at the polluted beach, although they did not reach statistical significance.

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