There's swill in those swells
By MARK SHWARTZ
Unfortunately, Charles Moore’s story isn’t terribly unusual. In 2000, Moore and four friends arrived at Southern California’s Seal Beach near the mouth of the San Gabriel River, one of their favorite surfing spots. The water looked clean and inviting; no warning signs were posted. They had a great time riding the waves, but within days he and his buddies came down with strep throat. A bummer, for sure, but worse was in store.
“About a week later, I became delirious and had to be hospitalized,” says Moore, 59, an environmental activist and scientist who monitors global marine pollution. Bacteria had infected a not-quite-healed sore on his elbow and caused a potentially fatal skin infection. Symptoms included severe pain, confusion and damaged skin.
“After a week of suffering in the hospital and having serious fluid ooze from my arm, which was swollen double, I was finally able to go home,” Moore says. “We later found out that a sewage spill had occurred at an inland city upriver.”
Forget sharks and barracudas. The most dangerous creatures you’re likely to encounter at the beach are virulent microbes that issue largely from polluted stormwater runoff and sewage spills or leaks. Heavy rainfall exacerbates the problem, overwhelming sewage systems, which allows human waste to flow past treatment plants and directly out to sea.
“We all have the right to swim or surf without getting sick,” says Mark Gold, EnvD, executive director of Heal the Bay and member of the California state government’s Clean Beach Task Force. It’s a political problem as much as an environmental one. The ultimate solution to improving beach water quality lies on land, the source of most coastal pollutants, but the coastal towns bear the brunt of the costs. “Increased development, spurred on by a rapidly growing population, all but guarantees that coastal contamination will remain a problem for years to come,” Gold says.
Health and economic costs
Many U.S. beachgoers routinely encounter microorganisms capable of causing a wide range of diseases, including encephalitis and dysentery. Globally, about 250 million cases of gastroenteritis and upper respiratory disease, such as sinus infection or sore throat, occur each year from swimming in sewage-contaminated seawater, according to the World Health Organization. The group estimates that billions of dollars are lost annually because of medical costs and employee sick time. Tourist revenue also takes a big hit when popular beaches are closed because of pollution.
In March 2006, the Hawaii Department of Health shut down Honolulu’s Waikiki beach for about a week following a major sewage spill. The microbe-contaminated waters were blamed for several illnesses and implicated in the death of a man who became infected by flesh-eating bacteria. Since Waikiki accounts for nearly half of Hawaii’s tourist visits and expenditures — about $5 billion in 2002 — the economic repercussions of the closure were felt statewide.
But Hawaii isn’t alone. According to the Natural Resources Defense Council, beach closings and health advisories throughout the United States have steadily increased since 1990, the year the group began monitoring beach pollution nationwide. In 2005, NRDC counted more than 20,000 days of closures and advisories in the 29 ocean and Great Lake states — a 5 percent rise over the previous year. NRDC attributes this increase to improved monitoring, burgeoning coastal development and a year of heavy rainfall, which caused extra sewage runoff.
Waterborne diseases are so widespread that epidemiologists have come up with an acronym for them — RWIs, or recreational water illnesses. The Centers for Disease Control warns that children, pregnant women and people with compromised immune systems are most at risk.
In 1986, the Environmental Protection Agency established national standards for fecal bacteria in water. In 1999, California became one of the first states to require weekly water quality tests during the May-to-October tourist season.
"California has the toughest beach water quality standards in the country,” says Heal the Bay’s Mark Gold.
The state’s trendsetting role in coastal protection is driven as much by economics as epidemiology. About 80 percent of state residents live within a 30-mile drive of the shore, and California’s beaches generate about $14 billion in direct revenue and $73 billion to the U.S. economy annually, according to a 1999 San Francisco State University study.
“Each year, between 150 million and 400 million visits are made to California beaches, generating billions of dollars in expenditures by local tourists and swimmers,” says Alexandria Boehm, PhD, the Clare Boothe Luce Assistant Professor of Civil and Environmental Engineering at Stanford, who like Gold is a member of the state Clean Beach Task Force.
In the summer of 1999, while Boehm was completing her doctoral thesis at UC-Irvine, health officials in Orange County shut down several miles of shoreline in the nearby city of Huntington Beach after tests revealed high concentrations of fecal bacteria in the water. The closure lasted more than two months, devastating the city’s economy.
“This is a community whose entire economic welfare depends on the beach,” says Doug Traub, president and CEO of the Huntington Beach Conference and Visitors Bureau. In 1998, the city’s 9 million visitors spent more than $139 million.
Since the 1999 calamity, many municipal and business leaders have become vocal advocates of healthy beaches, Traub says. As examples of community concern, he points to recent sewer upgrades designed to prevent untreated storm water from running directly into the sea, as well as a citywide ban on the pressurized washing of sidewalks.
Despite these efforts, pollution remains a problem, especially in wet weather. Heal the Bay’s 2006 annual water quality report card gave Huntington Beach all A’s in dry weather. But when it rained, several Huntington Beach sites got a C or lower, as did nearly half of the 356 California beaches included in the report.
“Beach pollution is a regional problem that requires a watershed-management approach,” says H. David Nahai, chair of the Los Angeles Regional Water Quality Control Board.
In 2001, the board issued the first regulations requiring Los Angeles County and its 88 municipalities to control the amount of pollution that drains into the sea.
“While coastal communities have been very supportive of our cleanup efforts, a number of municipalities located away from the coast have litigated every initiative we’ve taken, because they don’t see how clean ocean water directly affects them,” Nahai says. So far, the courts have consistently ruled against the inland cities and upheld the board’s authority to protect the county’s watersheds.
Indeed, the socioeconomic effects of beach pollution ripple far beyond the shore, as revealed in a 2006 study by Boehm and collaborators at UCLA. The researchers looked at the economic impact of gastrointestinal infections at 28 Southern California beaches, including two at Huntington Beach. They found that between 627,000 and 1.5 million cases of beach-related gastroenteritis occur annually in Los Angeles and Orange Counties, resulting in a regional loss of $21 million to $414 million a year due to missed work and medical costs.
Given the economic importance of tourism in coastal states, it’s not surprising that government policymakers have begun to address the problem of beach contamination.
In 2000, President Bill Clinton signed a law directing the EPA to improve recreational water quality standards nationwide by 2005, including developing new techniques to rapidly assess water quality.
California and other states use traditional lab tests to monitor fecal bacteria in beach water. But researchers say these tests are flawed.
“Fecal indicator bacteria take time to culture, so there’s usually a 24- to 48-hour delay before the results are known,” says Boehm. “But our research shows that a lot of pollution events last only one day or one hour, so the problem is likely to have passed by the time a warning sign is posted.”
As a result, adds Boehm, officials mistakenly post health advisories at clean beaches while keeping contaminated beaches open, unintentionally exposing swimmers, surfers and snorkelers to waterborne diseases.
Finding quicker tests that are efficient and cost-effective will take more time, according to the EPA, which is one reason the agency extended its deadline for improving water quality standards to 2011.
But the problem is too urgent to allow a six-year extension, argues the NRDC, which sued the EPA in 2006 for “failing to adequately protect the more than 180 million Americans who go to the shore every year from waterborne disease.”
In the meantime, how can people avoid getting sick from the beach? The EPA offers this advice: Don’t swim during and immediately after rainstorms or near discharge pipes, and avoid water contaminated with trash, oil slicks and other visible pollutants. The NRDC further recommends keeping your head above water and staying out completely if you have an open wound or infection.
Says Nancy Stoner, director of NRDC’s Clean Water Project: “A day at the beach should not turn into a night in the bathroom, or worse, in the hospital.”
But don’t count on it.
Comments? Contact Stanford Medicine at