2019-2020年中国三城市海滨浴场水源性疾病现状及影响因素

Status and influential factors of water-borne diseases in bathing beaches in three cities of China from 2019 to 2020

目的了解中国海滨浴场人群海水浴后的健康现状及其影响因素。方法于2019-2020年5-9月,采用典型抽样的方法,分别对河北秦皇岛、山东青岛、上海3处海滨浴场游客进行问卷调查,收集有效问卷1222份,调查内容包括个人基本信息、最近7天接触海水/海滩情况、海滨浴场活动情况、个人防护措施、自身身体健康状况、海水浴后出现的相关症状或疾病等,并对3个浴场的海水水样和沙滩沙子进行采样、肠球菌和粪大肠菌群检测。结果皮肤感染(26.19%)、鼻塞(12.36%)和眼部感染(8.18%)是海水浴后人群最常出现的症状。多因素Logistic回归分析结果显示,既往身体不适(OR=0.08~140.73,95%CI 0.04~443.64)是影响各症状发病的共同因素(P<0.05),不戴鼻夹(OR=4.65,95%CI 1.53~14.08)、不戴泳镜(OR=541.52,95%CI 121.58~2411.85)和吞咽海水(OR=72.29~79.78,95%CI 19.83~296.78)分别是胃痉挛、眼部感染、鼻塞和喉咙痛的危险因素(P<0.05)。结论个人防护措施和身体条件影响海水浴后人群出现相关症状和疾病,海滨浴场海水和沙子存在微生物污染。

OBJECTIVE To understand the health status and influencing factors of people in bathing beach after bathing. METHODS A questionnaire survey was conducted among the beach tourists in Hebei, Shandong and Shanghai Provinces from May to September, 2019-2020, including personal basic information, seawater/beach exposure in the last 7 days, beach activities, personal protective measures, physical health, related symptoms or diseases after bathing, etc. The seawater samples and sand of the three bathing beaches were sampled and detected. RESULTS A total of 1222 valid questionnaires were collected. Skin infection(26.19%), nasal congestion(12.36%) and eye infection(8.18%) were the most common symptoms of the tourist after seawater bath. Multivariate logistic regression analysis showed that previous physical discomfort(OR=0.08-140.73,95%CI 0.04-443.64) was the common factor of all symptoms(P<0.05), the risk factors of stomach cramps, eye infection, nasal congestion and sore throat were no wear of turbinate(OR=4.65,95% CI 1.53-14.08) and goggles(OR=541.52,95% CI 121.58-2411.85), swallowing seawater(OR=2.29-79.78,95%CI 19.83-296.78) respectively(P<0.05). CONCLUSION Personal protective measures and physical conditions affect people’s symptoms and diseases after bathing. There is microbial pollution in beach water and sand.