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How clean is your surf spot ?
Diseases you can encounter in
Europe due to pollution.
Is it really that Bad?
Dr Guillaume Barucq,
M.D.
EASD Surfing Medicine
Conference 2015
What is Marine Pollution
?
Marine Debris
(visible)
Chemical Pollution
(visible or invisible)
Radioactive Pollution
(invisible)
Microbiological Pollution
 Bacterias, virus, fungus, parasites…
(invisible)
When does marine
pollution occur ?
When there is no
sanitation system
 Video
When the sewage
overflows
 Video
When the rivers flood
 VIDEO
In case of heavy rain
Urban Run-Off (fuel, oil…)
Leaching of soils
(fertilizers, pesticides)
WHAT ARE THE HEALTH
RISKS ASSOCIATED WITH
SEAWATER POLLUTION ?
Context
 Few research available about infectious
diseases among surfers.
 1 Retrospective study (Surfrider Europe)
 Existing publications about bathing or
swimming-related diseases that can hardly
apply to surfing.
Surf Infection Study (G.Barucq 2012-2013)
 Goal : follow the evolution of the number of infections
related to water quality and the type of nautical activity
practised.
 Interesting if several surfers contract the same symptoms
after surfing in the same surf spot, the same day.
 Method : online survey launched in June 2012.
 Quick and easy-to-fill questionnaire.
Results
 166 exploitable answers between June 2012
and October 2013.
 35% of the declarations registered during the
highly polluted month of June 2012.
 95% of the declarations from the south-west of
France (Bask Coast, Landes +++). And also
declarations from Reunion Island, NYC,
Canada…
Nautical Activity Practised
 Surfing / Shortboard (38%)
 Bathing / Swimming (27%)
 Longboarding (23%)
 Bodyboarding (5%)
 Bodysurfing (4%)
 Stand-Up Paddle (2%)
 Kitesurfing /Windsurfing (1%)
Top 10 Symptoms of Surf Infection
 1. Earache
 2. Fever
 3. Abdominal Pain
 4. Diarrhea
 5. Red eye
 6. Nausea /Vomiting
 7. Headache
 8. Skin Rash
 9. Sore throat
 10. Itching
Time of occurrence of the symptoms
after suspected bath / surf session.
 Less than 24 hours (36%)
 Between 1 and 3 days (30%)
 Less than 6 hours (26%)
 Between 3 and 7 days (6%)
Did the Seawater look polluted ?
 Dubious visual appearance (27%)
 Marine litter visualized (19%)
 Recent pollution (18%)
 No obvious sign of pollution (16%)
 Bad smell (12%)
 Bad results of recent seawater analysis (8%)
General Condition before infection
New question added to the questionnaire : are you a
regular surfer or an occasional surfer ?
 In good form : 86%
 Tired / Stressed (14%)
Most diagnosed Infections
 Gastro-enteritis (18%)
 Otitis (18%) : External +++ (=swimmer’s ear)
 Conjunctivitis / ocular infection (16%)
 Skin Infections (10%)*
 Naso-pharyngitis (7%)
 Sinusitis (6%)
*Several staphylococcal infections declared (impetigo, carbuncle,
infected cut, sty…)
How long should you wait after it rains ?
It depends !
Factors which impact Ocean’s
resilience to Pollution
• Volume of water polluted
• Water Temperature
• Salinity
• UV Rays
• Wind
• Rain
• Swell
• Waves
• Currents (horizontal, vertical, upwelling)
• Underwater Waves
• Ocean’s Microbiota
Information on Water
Quality
Seawater Analysis
Analysis Results
(Regional Health Agency)
Analysis Results
(Surfrider Foundation / Nautical Activities Zones)
WATER QUALITY INFORMATION ON THE BEACH
Most of the time, Water
Analysis are informations
from the past.
What we need is real-time
info on water quality.
Rapid Analysis GenSpot
Bacteriological Analysis :
 Sample Preparation < 2h
 RT-PCR (polymerase chain reaction): 1 h
Active Management of the Environment
REAL-TIME MONITORING : Control & Alert
Sample
Preparation
2. Lysis
3. RNA Extraction and purification
RT- PCR
Real-Time
1h
1. Filtration
< 2h
4. RNA Quantification
GenSpot : Decision Support Tool
1
10
100
1000
10000
0 20 40 60 80
temps (heures)
E.coli/100ml
J1 J2 J3
Conventional Method
ANSES Limit
E. Coli
Concentration
(/100ml)1
10
100
1000
10000
0 20 40 60 80
temps (heures)
E.coli/100ml
Baignade
Interdite
GenSpot
Conventional Method
500
Baignade
Autorisée
1000
48h 48h3h
Active Management of Seawater Pollution
Pollution Surf Report :
the next big thing !
VIDEO
BIARRITZ INFOPLAGES
(Smartphone App)
Prevention tips to avoid infection
 Avoid ingesting too much water per session
 Rinse yourself (skin, nasal cavities, ear canal +++)
 Dry yourself (skin, ears, remove
wetsuit/boardshort/bikini after surfing)
 Clean your nose with… seawater (spray)
 Do not surf with an open wound
 Beware with contact lenses (daily contact lens only)
 Wear earplugs
 Don’t surf if too sick or weakened by illness or treatment
 « The Microbe is Nothing.
TheTerrain is Everything.»
Louis Pasteur.
Take-home Messages
• Trust your senses (Watch, Smell and Taste the water)
• Search for the information (recent analysis, beach
classification…)
• Ask for more (local authorities, politician, became a water quality
activist…)
• Avoid surfing when water is polluted
• Surf More when water is clean !
Upcoming Research
• The Beach Bums Study
(Surfers against Sewage)
• Water Quality & Health
(Surfrider Foundation
Europe)
• New Surf Infection study.

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How Clean is your Surf Spot ?

  • 1. How clean is your surf spot ? Diseases you can encounter in Europe due to pollution. Is it really that Bad? Dr Guillaume Barucq, M.D. EASD Surfing Medicine Conference 2015
  • 2. What is Marine Pollution ?
  • 6. Microbiological Pollution  Bacterias, virus, fungus, parasites… (invisible)
  • 8. When there is no sanitation system  Video
  • 10. When the rivers flood  VIDEO
  • 11. In case of heavy rain Urban Run-Off (fuel, oil…) Leaching of soils (fertilizers, pesticides)
  • 12. WHAT ARE THE HEALTH RISKS ASSOCIATED WITH SEAWATER POLLUTION ?
  • 13. Context  Few research available about infectious diseases among surfers.  1 Retrospective study (Surfrider Europe)  Existing publications about bathing or swimming-related diseases that can hardly apply to surfing.
  • 14. Surf Infection Study (G.Barucq 2012-2013)  Goal : follow the evolution of the number of infections related to water quality and the type of nautical activity practised.  Interesting if several surfers contract the same symptoms after surfing in the same surf spot, the same day.  Method : online survey launched in June 2012.  Quick and easy-to-fill questionnaire.
  • 15. Results  166 exploitable answers between June 2012 and October 2013.  35% of the declarations registered during the highly polluted month of June 2012.  95% of the declarations from the south-west of France (Bask Coast, Landes +++). And also declarations from Reunion Island, NYC, Canada…
  • 16. Nautical Activity Practised  Surfing / Shortboard (38%)  Bathing / Swimming (27%)  Longboarding (23%)  Bodyboarding (5%)  Bodysurfing (4%)  Stand-Up Paddle (2%)  Kitesurfing /Windsurfing (1%)
  • 17. Top 10 Symptoms of Surf Infection  1. Earache  2. Fever  3. Abdominal Pain  4. Diarrhea  5. Red eye  6. Nausea /Vomiting  7. Headache  8. Skin Rash  9. Sore throat  10. Itching
  • 18. Time of occurrence of the symptoms after suspected bath / surf session.  Less than 24 hours (36%)  Between 1 and 3 days (30%)  Less than 6 hours (26%)  Between 3 and 7 days (6%)
  • 19. Did the Seawater look polluted ?  Dubious visual appearance (27%)  Marine litter visualized (19%)  Recent pollution (18%)  No obvious sign of pollution (16%)  Bad smell (12%)  Bad results of recent seawater analysis (8%)
  • 20. General Condition before infection New question added to the questionnaire : are you a regular surfer or an occasional surfer ?  In good form : 86%  Tired / Stressed (14%)
  • 21. Most diagnosed Infections  Gastro-enteritis (18%)  Otitis (18%) : External +++ (=swimmer’s ear)  Conjunctivitis / ocular infection (16%)  Skin Infections (10%)*  Naso-pharyngitis (7%)  Sinusitis (6%) *Several staphylococcal infections declared (impetigo, carbuncle, infected cut, sty…)
  • 22. How long should you wait after it rains ? It depends !
  • 23. Factors which impact Ocean’s resilience to Pollution • Volume of water polluted • Water Temperature • Salinity • UV Rays • Wind • Rain • Swell • Waves • Currents (horizontal, vertical, upwelling) • Underwater Waves • Ocean’s Microbiota
  • 27. Analysis Results (Surfrider Foundation / Nautical Activities Zones)
  • 29. Most of the time, Water Analysis are informations from the past. What we need is real-time info on water quality.
  • 30. Rapid Analysis GenSpot Bacteriological Analysis :  Sample Preparation < 2h  RT-PCR (polymerase chain reaction): 1 h Active Management of the Environment REAL-TIME MONITORING : Control & Alert
  • 31. Sample Preparation 2. Lysis 3. RNA Extraction and purification RT- PCR Real-Time 1h 1. Filtration < 2h 4. RNA Quantification GenSpot : Decision Support Tool
  • 32. 1 10 100 1000 10000 0 20 40 60 80 temps (heures) E.coli/100ml J1 J2 J3 Conventional Method ANSES Limit E. Coli Concentration (/100ml)1 10 100 1000 10000 0 20 40 60 80 temps (heures) E.coli/100ml Baignade Interdite GenSpot Conventional Method 500 Baignade Autorisée 1000 48h 48h3h Active Management of Seawater Pollution
  • 33. Pollution Surf Report : the next big thing !
  • 36. Prevention tips to avoid infection  Avoid ingesting too much water per session  Rinse yourself (skin, nasal cavities, ear canal +++)  Dry yourself (skin, ears, remove wetsuit/boardshort/bikini after surfing)  Clean your nose with… seawater (spray)  Do not surf with an open wound  Beware with contact lenses (daily contact lens only)  Wear earplugs  Don’t surf if too sick or weakened by illness or treatment
  • 37.  « The Microbe is Nothing. TheTerrain is Everything.» Louis Pasteur.
  • 38. Take-home Messages • Trust your senses (Watch, Smell and Taste the water) • Search for the information (recent analysis, beach classification…) • Ask for more (local authorities, politician, became a water quality activist…) • Avoid surfing when water is polluted • Surf More when water is clean !
  • 39. Upcoming Research • The Beach Bums Study (Surfers against Sewage) • Water Quality & Health (Surfrider Foundation Europe) • New Surf Infection study.