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The relationship of bacterial water quality and health of Lake Okanagan swimmers 1974

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THE RELATIONSHIP OF BACTERIAL WATER QUALITY AND HEALTH OF LAKE OKANAGAN SWIMMERS by BARBARA ELLEN NAEGELE B . S c , T h e U n i v e r s i t y o f B r i t i s h C o l u m b i a , 1 969 A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE i n t h e D e p a r t m e n t o f ZOOLOGY We a c c e p t t h i s t h e s i s a s c o n f o r m i n g t o t h e r e q u i r e d s t a n d a r d THE UNIVERSITY OF BRITISH COLUMBIA 1974 In p r e s e n t i n g t h i s t h e s i s in p a r t i a l f u l f i l m e n t o f the r e q u i r e m e n t s f o r an advanced degree at the U n i v e r s i t y o f B r i t i s h C o l u m b i a , I ag ree tha t the L i b r a r y s h a l l make i t f r e e l y a v a i l a b l e f o r r e f e r e n c e and s t u d y . I f u r t h e r ag ree t h a t p e r m i s s i o n f o r e x t e n s i v e c o p y i n g o f t h i s t h e s i s f o r s c h o l a r l y p u r p o s e s may be g r a n t e d by the Head o f my Department o r by h i s r e p r e s e n t a t i v e s . I t i s u n d e r s t o o d t h a t c o p y i n g o r p u b l i c a t i o n o f t h i s t h e s i s f o r f i n a n c i a l g a i n s h a l l not be a l l o w e d w i t h o u t my w r i t t e n p e r m i s s i o n . Department o f ZOOLOGY The U n i v e r s i t y o f B r i t i s h C o l u m b i a Vancouve r 8, Canada A B S T R A C T T h i s s t u d y was an i n v e s t i g a t i o n i n t o the r e l a t i o n - s h i p o f b a c t e r i a l wa te r q u a l i t y and the i n c i d e n c e o f i l l n e s s amongst l a k e and c h l o r i n a t e d poo l swimmers. Du r i ng the summer o f 1972 t h r e e groups o f swimmers were s u r v e y e d : 1. L a k e O k a n a g a n s w i m m e r s who swam a t t h e K e l o w n a C i t y P a r k b e a c h 2. O g o p o g o A q u a t i c T e a m who swam a t t h e s a m e b e a c h 3 . C h l o r i n a t e d s w i m m e r s who swam a t a n u n h e a t e d c o m m u n i t y p o o l The swimmers ranged i n age from s i x to s i x t e e n and were su r ve yed f o r upper r e s p i r a t o r y i l l n e s s , g a s t r o e n t e r i t i s , o t i t i s e x t e r n a , s h i s t o s o m i a s i s and c o n j u n c t i v i t i s . The l a k e w a t e r , p r o x i m a l c r e e k s , and c h l o r i n a t e d pool were sampled t h r o u g h o u t the swimming season f o r the f e c a l c o n t a m i n a t i o n i n d i c a t o r s ; f e c a l c o l i f o r m s and f e c a l s t r e p t o c o c c i . B a c t e r i a l wa te r q u a l i t y o f the c reek v a r i e d w i t h the e f f l u e n t i n p u t and q u a l i t y o f the l a k e wa te r v a r i e d w i t h i n f l o w from the c r eeks and swimming d e n s i t y . The flake f e c a l i i c o l i f o r m counts g e n e r a l l y remained below 200 o rgan i sms per 100 m i l l i l i t e r s . The l a k e f e c a l s t r e p t o c o c c i coun t s were s l i g h t l y h i g h e r than the f e c a l c o l i f o r m s and more r e s p o n s i v e to swimming d e n s i t y . In the c h l o r i n a t e d pool samples f e c a l c o l i f o r m s were not p r e s e n t w h i l e f e c a l s t r e p t o c o c c i coun ts ranged up to 168 o rgan i sms per 100 m i s . C o n t a m i n a t i o n a t a l l s i t e s was o f both human and an ima l o r i g i n . T o t a l i l l n e s s i n c i d e n c e was h i g h e s t amongst Hake Okanagan swimmers and l o w e s t amongst the Ogopogo A q u a t i c team swimmers. The most d i s t i n c t i v e i l l n e s s d i f f e r e n c e obse r ved between l a k e and c h l o r i n a t e d pool swimmers was the i n c i d e n c e o f o t i t i s e x t e r n a . For Lake Okanagan swimmers the i n c i d e n c e was 17 .82 per 1000 pe r son hours wa te r e x p o s u r e , f o r the Ogopogo A q u a t i c Team the i n c i d e n c e was 16 .48 and f o r c h l o r i n a t e d poo l swimmers i n c i d e n c e was o n l y 0 . 6 7 . I t was s u r m i s e d t h a t the c a u s a t i v e o rgan i sm f o r the a u d i t o r y d e r m a t i t i s was Pseudomonas aeruginosa and i t s p r e sence was v e r i f i e d i n the l a k e wa te r and s t reams and negated i n the c h l o r i n a t e d w a t e r . For l a k e swimmers the c o r r e l a t i o n s between i n c i d e n c e o f i l l n e s s and l a k e f e c a l i n d i c a t o r coun ts were s i g n i f i c a n t l y p o s i t i v e f o r upper r e s p i r a t o r y i n f e c t i o n s , g a s t r o e n t e r i t i s and o t i t i s e x t e r n a . The c o r r e l a t i o n c o e f f i c i e n t e x h i b i t e d i i i between o t i t i s e x t e r n a o f l a k e swimmers and the f e c a l s t r e p t o c o c c i coun t s was . 8 6 6 . Throughout s t a t i s t i c a l a n a l y s i s f e c a l s t r e p t o c o c c i counts d i s p l a y e d s t r o n g e r p o s i t i v e c o r r e l a t i o n s w i t h i l l n e s s i n c i d e n c e than the f e c a l c o l i f o r m d a t a . For c h l o r i n a t e d poo l swimmers the i l l n e s s p a t t e r n s d i d not s i g n i f i c a n t l y c o r r e l a t e w i t h f e c a l s t r e p t o c o c c i c o u n t s . I t was recommended t h a t f e c a l c o l i f o r m s a l one were an i nadequa t e i ndex of r e c r e a t i o n a l wa te r q u a l i t y . I t was a l s o sugges t ed t h a t Ps. aeruginosa w a r r a n t e d f u r t h e r r e s e a r c h as a p o t e n t i a l wa te r a f f i l i a t e d pathogen and wate r q u a l i t y i n d e x . T A B L E O F C O N T E N T S Page ABSTRACT i i LIST OF TABLES v i i i LIST OF FIGURES x ACKNOWLEDGEMENTS x i Chap te r 1 INTRODUCTION 1 O u t l i n e o f I n v e s t i g a t i o n 2 Resea rch O b j e c t i v e s • -5 2 METHODOLOGY . . . 9 l o c a t i o n o f I n v e s t i g a t i o n 9 I l l n e s s Survey 1 B a c t e r i o l o g i c a l Sampl ing 13 L a b o r a t o r y A n a l y s i s 17 3 WATER QUALITY RESULTS 2 2 B a c t e r i a l Water Q u a l i t y 2 2 Morpho logy and I d e n t i f i c a t i o n o f Feca l S t r e p t o c o c c i 31 v Chap te r Page Pseudomonas aeruginosa as a Water Q u a l i t y Index 3 4 A d d i t i o n a l V a r i a b l e s Measured 36 Tempera ture . . . . . . 37 U r i n e and Feca l I n d i c a t o r s 37 Water pH. 37 4 ILLNESS RESULTS 39 Inadequacy o f I n t e r v i e w i n g 39 Genera l I l l n e s s P a t t e r n s 40 I n c i d e n c e o f S p e c i f i c I l l n e s s e s 43 5 INTERPRETATION OF WATER QUALITY DATA. . . . . . . 49 Feca l C o n t a m i n a t i o n o f the Creeks 51 B a c t e r i a l S t a t i s t i c a l A n a l y s i s 52 Source o f Lake Water Feca l C o n t a m i n a t i o n . . 53 C o r r e l a t i o n o f Creek and Lake Water Qual i t y 61 6 INTERPRETATION OF ILLNESS DATA 66 I n c i d e n c e and Exposure 66 O t i t i s E x t e r n a as a Swimming R e l a t e d P r o b l e m . . . . . . 72 7 CORRELATION OF ILLNESS INCIDENCE AND WATER QUALITY 76 S t a t i s t i c a l A n a l y s i s 76 D i s c u s s i o n o f C o r r e l a t i o n A n a l y s i s 78 R u t l a n d C o r r e l a t i o n s . . . . . . . . . . 7 9 v i Chap te r Page Lake Water Q u a l i t y and I l l n e s s C o r r e l a t i o n s ° u Va lue o f I n d i c a t o r O r g a n i s m s . . . . . . . 83 8 CONCLUSION 94 BIBLIOGRAPHY 9 8 APPENDICES: 1 H e a l t h Branch Recommend Water Q u a l i t y S t anda rds 1 0 J 2 L i m n o l o g i c a l I n f o r m a t i o n 105 3 T a b l e s XV I I I . - X X I I 1 0 6 v i i L I S T O F T A B L E S Tab !e Page I F e c a l C o l i f o r m C o u n t s : J u l y , A u g u s t , September 1 972 2 4 I I Feca l S t r e p t o c o c c i C o u n t s : J u l y , A u g u s t , September 1972 2 6 I I I F eca l S t r e p t o c o c c i Morpho logy 32 IV Feca l S t r e p t o c o c c i M o r p h o l o g y : P r e l i m i n a r y I d e n t i f i c a t i o n o f Human and L i v e s t o c k S t r a i n s . . . 33 V Ps. aeruginosa and Feca l C o l i f o r m C o u n t s : J u l y and August 1973 36 VI Feca l I n d i c a t o r Counts i n U r i n e Samples f rom Lake Swimmers 38 VI I Cases o f I l l n e s s Amongst Lake and C h l o r i n a t e d Pool Swimmers, J u l y and Augus t 1 972 4 7 V I I I P e r c en t ages o f I l l n e s s Amongst Lake and C h l o r i n a t e d Pool Swimmers, J u l y and August 1 972 4 a IX R a t i o s o f Feca l I n d i c a t o r Counts 52 Feca l C o l i f o r m : Feca l S t r e p t o c o c c i X S t a t i s t i c a l A n a l y s i s : Compar ison o f Feca l I n d i c a t o r Counts f o r Lake and Creeks 56 v i i i T a b l e Page XI S t a t i s t i c a l A n a l y s i s : C o r r e l a t i o n o f Lake and Creek Feca l I n d i c a t o r Counts 64 X I I I l l n e s s I n c i d e n c e Per Thousand Pe r son Hours Swimming E x p o s u r e : J u l y and August 1972 / 0 X I I I S t a t i s t i c a l A n a l y s i s : Compar i son o f Weekly I l l n e s s I n c i d e n c e f o r C h l o r i n a t e d Pool and Lake Swimmers XIV S t a t i s t i c a l A n a l y s i s : C o r r e l a t i o n o f I l l n e s s Amongst C h l o r i n a t e d Poo l Swimmers and Feca l I n d i c a t o r Counts y b XV S t a t i s t i c a l A n a l y s i s : C o r r e l a t i o n o f I l l n e s s Amongst Lake Swimmers and Feca l I n d i c a t o r Counts 87 XVI O t i t i s E x t e r n a and Feca l I n d i c a t o r C o r r e l a t i o n : Ogopogo Poo l Swimmers 9 3 XVII Lake Oganagan A i r and Water Tempera tures l n 7 1 972 '. . ' I U / XVI I I Water pH of Sampl ing S i t e s 109 XIX Ogopogo Pool Feca l I n d i c a t o r C o u n t s : S u r f a c e v s . Sediment Water Samples ' ' ° XX Feca l I n d i c a t o r C o u n t s : Ogopogo Pool vs . Hot Sands 111 XXI Weekly I l l n e s s I n c i d e n c e Per 1000 Person Hours Swimming Exposure 112 XXI I Ogopogo Feca l I n d i c a t o r Counts Used f o r P r o d u c t Moment C o r r e l a t i o n s 113 i x L I S T O F F I G U R E S F i g u r e Page 1 Map o f Lake Okanagan wa te r s a m p l i n g s i t e s 7 2 Water q u a l i t y s a m p l i n g s i t e s : ' pho tographs 15 3 L a b o r a t o r y a n a l y s i s o f f e c a l c o n t a m i n a t i o n i n d i c a t o r s : pho tographs 20 4 Feca l s t r e p t o c o c c i : s c h e m a t i c o u t l i n e o f p r e l i m i n a r y i n v e s t i g a t i o n . 21 5 Ogopogo poo l f e c a l c o l i f o r m and f e c a l „ R s t r e p t o c o c c i coun t s 6 M i l l Creek f e c a l c o l i f o r m and f e c a l s t r e p t o c o c c i coun ts 7 B r a n d t ' s Creek f e c a l c o l i f o r m and f e c a l s t r e p t o c o c c i coun ts 30 8 Ogopogo pool t h r i c e d a i l y coun ts 59 9 Lake f e c a l s t r e p t o c o c c i v s . a i r and fiQ wate r t e m p e r a t u r e s 10 I l l n e s s i n c i d e n c e per 1000 pe rson hours exposu re 69 11 C o r r e l a t i o n week ly o t i t i s e x t e r n a i n c i d e n c e and f e c a l s t r e p t o c o c c i coun t s 92 A C K N O W L E D G E M E N T S I am i n d e b t e d to the s t a f f o f the Kelowna South Okanagan H e a l t h U n i t who w i l l i n g l y o f f e r e d t h e i r a s s i s t a n c e and made room f o r my i n v e s t i g a t i o n i n t h e i r a l r e a d y cramped q u a r t e r s . I would a l s o l i k e to g i v e s p e c i a l a p p r e c i a t i o n to D r . Dav id C l a r k e (Med i c a l H e a l t h O f f i c e r ) and Mr . Fred A l c o c k ( S e n i o r H e a l t h I n s p e c t o r ) f o r t h e i r c o n s t a n t encouragement . My i n t e r e s t i n e n v i r o n m e n t a l h e a l t h has been i n s p i r e d by t h e i r e n t h u s i a s t i c and e n e r g e t i c approach to p u b l i c h e a l t h p r o b l e m s . x i Chapte r 1 I N T R O D U C T I O N Lake Okanagan, l o c a t e d am ids t s e m i - a r i d mounta ins and p r o d u c t i v e v a l l e y s , i s s i t u a t e d i n an a t t r a c t i v e and r a p i d l y expand ing r e g i o n o f s o u t h e a s t e r n B r i t i s h C o l u m b i a . The l a k e i s one i n a c h a i n o f s e v e r a l l a k e s wh ich t o g e t h e r w i t h t h e i r t r i b u t a r i e s form 3,000 square m i l e s o f the Okanagan B a s i n ( F i g u r e l()i. The a t t r i b u t e s o f the Okanagan B a s i n i n c l u d e f e r t i l e l a n d , government i n d u s t r i a l i n c e n t i v e s , M e d i t e r r a n e a n summers, s k i h i i l l s , s p o r t f i s h i n g and p l e a s a n t beaches . The r e g i o n i s u n d e r s t a n d a b l y d e v e l o p i n g r e l a t i v e l y q u i i e k l y . For y e a r s i t was assumed t h a t Lake Okanagan and the s u r r o u n d i n g B a s i n would rema in an unchang ing a e s t h e t i c a t t r i b u t e c a p a b l e o f p r o v i d i n g f o r i n d u s t r i a l , a g r i c H t u r a l , r e c r e a t i o n a l , and t o u r i s t needs o f the r e g i o n . I f managed w i t h f o r e s i g h t and d i s c r e t i o n the l a k e has renewab le p o t e n t i a l but p r e s e n t l y p l a n n i n g i s i n a s t a t e o f f l u x w i t h one " i n t e r e s t " group b a t t l i n g the p r i o r i t i e s o f a n o t h e r . 1 2 The o b s e r v a t i o n s r e g a r d i n g i n c r e a s e d p o l y c h l o r i n a t e d b i p h e n y l s i n f i s h , weed growth a l ong s h o r e l i n e s , Anabaena a l g a e b l o o m s , d e c r e a s e d wa te r t r a n s p a r e n c y and n u t r i e n t en r i chmen t f rom sewage o u t f a l l s a re not i n ba l ance w i t h needs f o r i n c r e a s e d i r r i g a t i o n , hous ing and h ighways . To con tend w i t h the prob lems o f f u t u r e p l a n n i n g i n the Okanagan B a s i n , a two m i l l i o n d o l l a r , f o u r y e a r , f e d e r a l and p r o v i n c i a l s t u d y was commenced i n 1969 . The o b j e c t o f t h i s "Canada B r i t i s h Co lumbia - Okanagan B a s i n Agreement S t u d y " was to p r epa r e a f ramework f o r the management o f wa te r r e s o u r c e s . Trh e t s t ii dy n e n d e a v o ured „ t o c p n oduc e a a d p ill a n - w h i c h •< i n c 1 u d e d; c o n - s i d e r a t i o n f o r s o c i a l , economic and e n v i r o n m e n t a l a s p e c t s . The c o n t r o v e r s i e s r e s u l t i n g f rom even the p r e l i m i n a r y f i n d i n g s a re numerous and the arguments w i l l l i k e l y abound as to wh i ch i s the p r e f e r a b l e c o u r s e to f o l l o w . OUTLINE OF INVESTIGATION Out o f t h i s mixed p o l i t i c a l e n v i r o n m e n t a l s i t u a t i o n regarding Lake Okanagan, I e x t r a c t e d one a rea o f r e s e a r c h . I t i s an a rea whiich r e c e i v e d a t t e n t i o n i n the e a r l y 1 9 5 0 ' s ( S t e v e n s o n , 1 9 5 3 ) , has a g a i n been r e q u e s t i o n e d ( K r i s h n a s w a m i , 1971) but as y e t has not been s u f f i c i e n t l y documented . The q u e s t i o n I examined was whether o r not the b a c t e r i o l o g i c a l wa te r q u a l i t y o f Lake Okanagan c o r r e l a t e d w i t h 3 the i l l n e s s i n c i d e n c e obse r ved i n l o c a l swimmers. I unde r took r e s e a r c h on one Lake Okanagan beach to s u b s t a n t i a t e the h y p o t h e s i s t h a t i l l n e s s p a t t e r n s o f swi.mmers c o r r e s p o n d e d w i t h f l u c t u a t i o n s i n wate r q u a l i t y . I t was my a s sumpt i on t h a t the l a k e env i ronment undermined the h e a l t h o f swimmers and I c o l l e c t e d da ta d u r i n g the summers o f 1972 and 1973 to t e s t t h i s h y p o t h e s i s . The p r o j e c t was l o c a t e d i n Kelowna ( p o p u l a t i o n 47 ,000 1973) wh ich i s the l a r g e s t of the s e v e r a l c i t i e s near Lake Okanagan. The p a r t i c i p a n t s were c h i l d r e n who swam e i t h e r a t the main c i t y park beach or a t the c h l o r i n a t e d community p o o l . Thought was g i v e n to trie 1!Qding non-swimmers, however a c c o r d i n g to S tevenson (1953) and Ames (1969) swimmers demons t r a t e a g r e a t e r i l l n e s s r a t e than non-swimmers i r r e s p e c - t i v e o f l o c a t i o n and water c o n t a m i n a t i o n . The e x p l a n a t i o n g i v e n f o r t h i s d i f f e r e n c e i s t h a t water i s an abnormal h a b i t a t f o r man and hence a f f e c t s h e a l t h r e g a r d l e s s o f i t s b a c t e r i a l q u a l i t y . Between the two r e s e a r c h groups I expec t ed i l l n e s s i n c i d e n c e among l a k e swimmers to be g r e a t e r than the i n c i d e n c e o f s i m i l a r i l l n e s s e s among c h l o r i n a t e d poo l swimmers. The swimming s e a s o n , because o f t e m p e r a t u r e c h a n g e s , l a s t e d a ' s h o r t p e r i o d b e g i n n i n g w i t h the J u l y 1 s t weekend and end ing w i t h Labour Day, September 3 r d . Even by mid-August t empe ra tu r e s dropped s u f f i c i e n t l y to l e s s e n p a r t i c i p a t i o n . 4 The days were o f t e n warm but the c o l d n i g h t s q u i c k l y a f f e c t e d t e m p e r a t u r e s i n the c h l o r i n a t e d p o o l , wh ich was u n h e a t e d , and the l a k e . My i n v e s t i g a t i o n s d i d not dea l w i t h s e r i o u s wate r bourne i l l n e s s e s such as Salmonella typhi o r i n f e c t i o u s h e p a t i t i s , but w i t h the i n c o n v e n i e n t n u i s a n c e i l l n e s s e s such as c o l d s and g a s t r o e n t e r i t i s . For d e t e r m i n a t i o n o f wa te r q u a l i t y I a p p l i e d the c o n t a m i n a t i o n i n d i c a t o r s f e c a l c o l i f o r m and f e c a l s t r e p t o c o c c i . The concep t o f c o l i f o r m s as an i n d i c a t o r o f human sewage and hence p o t e n t i a l pathogens has been used f o r a lmos t s e v e n t y - f i v e y e a r s w i t h o c c a s i o n a l r e a p p r a i s a l as to i t s r e l i a b i l i t y . R e c e n t l y f e c a l c o l i f o r m r a t h e r than the t o t a l c o l i f o r m count has g a i n e d f a v o u r . T o t a l c o l i f o r m s i n c l u d e d s t r a i n s u b i q u i t o u s to the e n v i r o n - ment but not n e c e s s a r i l y common i n f e c a l m a t e r i a l ( G e l d r e i c h , 1 9 6 5 ) . Two c r i t i c i s m s a g a i n s t u s i n g s o l e l y the c o l i f o r m i n d i c a t o r a re f i r s t l y i t i s r e p r e s e n t a t i v e o f o n l y e n t e r i c pathogens and s e c o n d l y i n some cases e n t e r i c i n f e c t i o n s , such as s a l m o n e l 1 o s i s , Have been caused by i n g e s t i n g wate r w i t h no or few c o l i f o r m s ( D u t k a , 1 9 7 3 ) . As a supplement to the f e c a l c o l i f o r m a n a l y s i s I i n c l u d e d f e c a l s t r e p t o c o c c i c o u n t s . Feca l s t r e p t o c o c c i a n a l y s i s has been recommended as be ing "more p r a c t i c a l , e f f i c i e n t and a c c u r a t e than c o l i f o r m t e s t s f o r e v a l u a t i n g the s a n i t a r y 5 q u a l i t y o f a l m o s t a l l t ypes o f w a t e r . " Feca l s t r e p t o c o c c i s t a n d a r d s are mandatory i n p a r t s of the U n i t e d S t a t e s , e s p e c i a l l y f o r c h l o r i n a t e d p o o l s but a re not i n c l u d e d i n the B r i t i s h Co lumb ia r e c r e a t i o n a l wa te r q u a l i t y s t a n d a r d s (Appendi x 1 ) . RESEARCH OBJECTIVES T h i s p r o j e c t was the f i r s t s tudy on an Okanagan beach comb in ing i n t e n s i v e b a c t e r i o l o g i c a l t e s t i n g and the s u r v e y i n g o f i l l n e s s e s amongst swimmers. The Okanagan B a s i n S tudy d i d not i n c l u d e i n q u i r i e s i n t o h e a l t h o f the swimming p o p u l a t i o n . Some wate r s a m p l i n g was done i n wh i ch beaches were sampled t w i c e a month ( L y n c h , 1 9 7 2 ) , but the a c t u a l b a t h i n g p o p u l a t i o n was i g n o r e d and the c o n c l u s i o n a r r i v e d a t by the Okanagan B a s i n S tudy r e g a r d i n g d r e c r e a t i o n water qual i i ' tyuwas t y i tisufif i 'c i en tadata t .a . . " My o b j e c t i v e was to d e l v e f u r t h e r i n t o t h i s c o n c e r n , q u e s t i o n i n g the i n f l u e n c e o f r e c r e a t i o n a l wa te r q u a l i t y on the h e a l t h of swimmers. The p r o j e c t was a l s o prompted by i n f o r m a t i o n and r e c o r d s f rom D r . D. C l a r k e , M e d i c a l H e a l t h O f f i c e r , South Okanagan H e a l t h U n i t . Du r i ng the pas t f i f t e e n y e a r s he had C? B a r t l e y , L. S l a n e t z , "Types and S i g n i f i c a n c e o f Feca l S t r e p , " A . J . P . H . , V o l . 5 0 , 1960 , p. 1552 . 6 sensed an i n c r e a s e i n r a t e o f upper r e s p i r a t o r y a i l m e n t s but was l a c k i n g d a t a . T.he t o t a l c o l i f o r m coun ts wh i ch have been t aken d u r i n g these y e a r s were w i t h i n the p u b l i c h e a l t h s t a n d a r d s but the samples were too i n t e r m i t t e n t to be used as a b a s e l i n e f o r e p i d e m i o l o g i c a l j u d g e m e n t s . I t was hoped t h a t my s tudy would he lp c l a r i f y the p remise t h a t Lake Okanagan wa te r q u a l i t y has a d e t r i m e n t a l e f f e c t on the h e a l t h o f swimmers. My i n v e s t i g a t i o n i n v o l v e d t h r e e q u e s t i o n s : 1) d o l a k e s w i m m e r s e x h i b i t a h i g h e r i n c i d e n c e o f i l l n e s s t h a n c h l o r i n a t e d p o o I sw i m m e r s ? 2) i s t h e r e a c o r r e l a t i o n b e t w e e n o b s e r v e d i l l n e s s a n d b a c t e r i a l w a t e r q u a l i t y ? 3 ) how a n d why d o e s t h e b a c t e r i a l w a t e r q u a I i t y v a r y ? Recent assessments were done by the Okanagan B a s i n S tudy on p h y s i c a l and c h e m i c a l f e a t u r e s o f Lake Okanagan. I n v e s t i g a t i o n s were made i n t o s ea sona l f l u c t u a t i o n s o f c h l o r i d e s , p h o s p h a t e s , n i t r o g e n and a l g a e g r o w t h . The i n t e n t i o n o f a b a c t e r i a l and i l l n e s s su r vey was to add to the i n f o r m a t i o n a v a i l a b l e on Lake Okanagan. Q u e s t i o n n a i r e s t u d i e s (Okanagan Bas ,% 9 S£udy ? tBu l#e t i n #5) r e p o r t e d t h a t 91% o f t o u r i s t s c o n s i d e r e d swimming i m p o r t a n t , 73% o f r e s i d e n t s swam a n n u a l l y and 80% o f t hese d i d so on more than twenty o c c a s i o n s . The l a k e i s o b v i o u s l y an i m p o r t a n t r e c r e a t i o n a l r e s o u r c e w i t h swimming a pr ime a c t i v i t y f o r t o u r i s t s and r e s i d e n t s . F i g u r e 1A. L o c a t i o n of Lake Okanagan . S A M P L I N G S I T E S w Brandt's Creek L A K E O K A N A G A N K E L O W N A Hot Sands Beach Ogopogo Pool SCALE . 4 5 m i l e s F i g u r e I B . Water Samp l ing S i t e s Chap te r 2 METHODOLOGY LOCATION OF INVESTIGATION There a re s e v e r a l p u b l i c beaches s c a t t e r e d a l o n g the s h o r e l i n e o f Kelowna and the most c e n t r a l and p o p u l a r one i s the c i t y park beach commonly c a l l e d "Hot S a n d s . " The Hot Sands beach i n c l u d e s a s e m i - e n c l o s e d boardwa lk a rea c a l l e d Ogopogo Pool ( F i g u r e 1 ) . Ogopogo i s r e f e r r e d to as a poo l but i n essence i t i s p a r t o f the beach demarcated w i t h a f l o a t i n g wa lkway . Form t h i s l o c a t i o n I chose two t ypes o f swimmers a l l between the ages o f s i x and s i x t e e n . One group was the Ogopogo A q u a t i c Swim Team wh ich swam f o r a minimum o f one hour d a i l y d u r i n g the week i n the area d e s i g n a t e d Ogopogo P o o l . P a r t i c i p a n t s i n t h i s group rema ined c o n s t a n t t h r o u g h o u t the summer. The o t h e r l a k e group were swimmers f rom the Hot Sands swimming c l a s s e s and these c h i l d r e n swam one hour t h r e e t imes week l y f o r a t o t a l o f two weeks . P a r t i c i p a n t s i n t h i s group thus changed eve ry two weeks . 9: 10 The compar i son group f o r the s tudy swam a t the R u t l a n d community poo l wh i ch a t t h a t t ime was the o n l y c h l o r i n a t e d poo l open to the p u b l i c . As w i t h " the "Hot Sands " swimmers c l a s s e s were h e l d t h r i c e week ly f o r two weeks . The pool was f i v e m i l e s e a s t o f the l a k e . I d i d not i n d i v i d u a l l y s e l e c t the p a r t i c i p a n t s . A l l the c h i l d r e n r e g i s t e r e d f o r swimming c l a s s e s i n the t h r e e l o c a t i o n s were i n c l u d e d i n the i l l n e s s s u r v e y . As a r e s u l t , group s i z e , age , and sex d i s t r i b u t i o n v a r i e d w i t h swimming l o c a t i o n . The r a t i o o f male and f ema le p a r t i c i p a t i o n i n the i l l n e s s su r vey was as f o l l o w s : L o c a t i o n T o t a l P a r t i c i p a n t s Mai e Female R a t i o Ogopogo Swim Team Hot Sands Swimmers R u t l a n d Swimmers 52 148 248 26 64 115 26 84 133 1:1 1 :1 .32 1 :1 .16 Nor d i d I d i s t i n g u i s h p a r t i c i p a n t s a c c o r d i n g to t h e i r s o c i o - economic b a c k g r o u n d s . J u d g i n g from the d i s t r i b u t i o n o f t e l e p h o n e numbers o f p a r t i c i p a n t s i t i s my e s t i m a t i o n t h a t the Hot Sands arid R u t l a n d swimmers r e p r e s e n t e d s i m i l a r r e s i d e n t i a l c r o s s s e c t i o n s o f Kelowna w h i l e the Ogopogo Swim Team was c o m p r i s e d o f c h i l d r e n from the more a f f l u e n t r e s i d e n t i a l d i s t r i c t s . 11 ILLNESS SURVEY I c o l l e c t e d i n f o r m a t i o n on the c h i l d r e n ' s h e a l t h by i n t e r v i e w i n g both the c h i l d r e n and the p a r e n t s . A l s o I gave forms to the swimming i n s t r u c t o r s ^ and r e q u e s t e d them to keep r e c o r d s o f s p e c i f i e d h e a l t h p r o b l e m s . I l l n e s s e s and i n f e c t i o n su rveyed were c a t e g o r i z e d i n t o : r e s p i r a t o r y i n f e c t i o n s , c o l d s , o t i t i s e x t e r n a , g a s t r o e n t e r i t i s , c o n j u n c t i v i t i s , s h i s t o s o m i a s i s and m i s c e l l a n e a . For purposes o f i n t e r v i e w i n g they were r e f e r r e d to as s o r e t h r o a t s , c o l d s , ear a c h e s , stomach f l u , eye i n f e c t i o n s , and s k i n i r r i t a t i o n s . These categQif i 'es were based on r e s e a r c h by S tevenson (1 953) and p r e v i o u s o b s e r v a t i o n s f rom Lake Okanagan ( C l a r k e , 1 9 5 9 ) , i n wh ich e y e , e a r , n o s e , and t h r o a t i n f e c t i o n s and g a s t r o e n t e r i t i s were the i n f e c t i o n s a s s o c i a t e d w i t h swimmers. I l l n e s s e s were c a t e g o r i z e d w i t h r e s p e c t to s i m i l a r i t y o f symptoms r a t h e r than s i m i l a r i t y o f c a u s e . Upper r e s p i r a t o r y a i l m e n t s f o r example may be caused by s e v e r a l d i f f e r e n t v i r u s e s and some of these same v i r u s e s such as the a d e n o v i r u s e s may a l s o cause g a s t r o i n t e s t i n a l symptoms ( S a r t w e l l , 1 9 6 5 ) . C o l d s , wh i ch a re caused by r h i n o v i r u s e s , were i n a s e p a r a t e c l a s s i f i - c a t i o n f o r purposes o f i n t e r v i e w i n g and then were amalgamated w i t h upper r e s p i r a t o r y i n f e c t i o n s to s i m p l i f y a n a l y s i s . Two o f the swimming i n s t r u c t o r s were r e l a t e d to the l o c a l med i c a l h e a l t h o f f i c e r and may have been s l i g h t l y b i a s e d to ove r e s t i m a t e . 12 O t i t i s e x t e r n a o r d e r m a t i t i s o f the e x t e r n a l a u d i t o r y c ana l was s p e c i f i c a l l y i n c l u d e d because o f i t s a s s o c i a t i o n w i t h s swimming ( S e n t u r i a , 1956 ; W r i g h t , 1 9 7 2 ) . S h i s t o s o m i a s i s o r swimmer 's i t c h i s a known haza rd o f l a k e swimming and caused by shistosome cercariae (MacKenthum, 1964) w h i c h , as a p a r t o f t h e i r l i f e c y c l e , a re r e l e a s e d from s n a i l s two o r t h r e e weeks a f t e r the o n s e t o f warm w e a t h e r . Beaches i n Kelowna are t r e a t e d eve ry f o u r y e a r s w i t h copper s u l f a t e to e l i m i n a t e the hos t s n a i l s . C o n j u n c t i v i t i s was i n c l u d e d i n a n t i c i p a t i o n o f an i n f e c t i o n sometimes e x p e r i e n c e d by c h l o r i n a t e d pool swimmers. No d i s t i n c t i o n was made between v i r a l , b a c t e r i a l o r chem i ca l c o n j u n c t i v i t i s . I was o f t e n p r e s e n t a t the swimming c l a s s e s to check a i l m e n t s w i t h the c h i l d r e n . At the c o m p l e t i o n o f each two week swimming s e s s i o n l l i r i i n t e r v i e w e d p a r e n t s by t e l e p h o n e . The p a r e n t s o f the Ogopogo p a r t i c i p a n t s were i n t e r v i e w e d a t the end o f J u l y and A u g u s t . I n c i d e n c e raifcher than p r e v a l e n c e was su r ve yed and so a c o n d i t i o n was t a b u l a t e d o n l y once even when a s i m i l a r i n f e c t i o n r e - o c c u r r e d . I f , f o r examp le , the same p a r t i c i p a n t s u f f e r e d a s u c c e s s i o n o f ear i n f l a m m a t i o n s the p rob lem was l i s t e d as one case not s e v e r a l s e p a r a t e ones . I i n t e r v i e w e d by t e l e p h o n e r a t h e r than w r i t t e n q u e s t i o n n a i r e i n o r d e r to have an u n b i a s e d r e t u r n r a t e . I opened the c o n v e r s a t i o n by s a y i n g the s u r v e y was a South Okanagan H e a l t h U n i t p r o j e c t on the h e a l t h o f c h i l d r e n . 13 Ra the r than ask a s e t o r d e r o f q u e s t i o n s I t h r e a d e d the q u e s t i o n s i n t o c o n v e r s a t i o n and as the comprehens ion o f p a r e n t s v a r i e d , so d i d my manner . Wi th each i n t e r v i e w the f o l l o w i n g b a s i c i n f o r m a t i o n was c o l l e c t e d : a g e a n d s e x o f c h i l d t y p e s o f i I I n e s s e s o r i n f e c t i o n s d a t e o f f i r s t s y m p t o m s p r e v i o u s i n c i d e n c e o f s i m i l a r p r o b l e m s e r v c c e s o f p h y s i c i a n u t i l i z e d s w i m m i n g l o c a t i o n s s w i m m i n g f r e q u e n c y Data was a c c e p t e d f rom swimmers who swam e i t h e r o n l y a t the R u t l a n d c h l o r i n a t e d poo l or i n Lake Oganagan. P a r t i c i p a n t s who swam i n wa te r s o t h e r than the d e s i g n a t e d pool o r l a k e were e x c l u d e d from the f i n a l d a t a . BACTERIOLOGICAL SAMPLING Water samples were t aken f rom R u t l a n d P o o l , Ogopogo Poo l and the two c r e e k s and were a n a l y z e d f o r f e c a l c o l i f o r m s and f e c a l s t r e p t o c o c c i . S i n c e Ogopogo poo l and the Hot Sands a re i n j u x t a p o s i t i o n , Ogopogo wa te r samples were a c c e p t e d as r e p r e s e n t i n g wa te r q u a l i t y fow b o t h . To a s c e r t a i n t h i s I ran a p r e l i m i n a r y c o m p a r a t i v e t e s t s e r i e s f o r the two swimming a reas (Append ix 3 ) . The c r e e k s , M i l l and B r a n d t ' s 14 ( F i g u r e 2 ) , a re l o c a t e d on e i t h e r s i d e o f the Hot Sands and they were each sampled a t the mouth f o r t h e i r p o t e n t i a l c o n t r i b u t i o n to the beach wa te r q u a l i t y . M i l l Creek i s 0 .53 m i l e s f rom Ogopogo Poo l and i s f ed by ground wa te r seepage f rom s u r r o u n d i n g r e s i d e n t i a l and c a t t l e f e e d l o t s and f rom mounta in r u n o f f . I t s peak f l o w i s d u r i n g the summer months and 1972 was a p a r t i c u l a r l y heavy r u n o f f y e a r . B r a n d t ' s C r e e k , 0 .84 m i l e s f rom Ogopogo P o o l , d r a i n s t he i n d u s t r i a l s e c t i o n o f Kelowna and c o l l e c t s e f f l u e n t f rom " C a l o n a Wines " and the "Sun Rype L t d . " f r u i t p r o c e s s i n g p l a n t . B r a n d t ' s Creek has a l owe r mean d i s c h a r g e and a l e s s e r n i t r a t e c o n - c e n t r a t i o n than M i l l but a h i g h e r B i o l o g i c a l Oxygen Demand and t o t a l c o l i f o r m a growth (Append ix 2 ) . D u r i n g J u l y and August o f 1972 the wate r s a m p l i n g s c h e d u l e f o r each s i t e was as f o l l o w s : L o c a t i o n F requency T i me R u t l a n d Pool Ogopogo Pool M i l l Creek B r a n d t ' s Creek D a i l y Twice o r t h r i c e t imes da i l y T h r i c e week ly T h r i c e week l y 9 a .m. 8 a .m. and/or 12 p . m . , 4 p.m. 8:00 a .m. 8 :30 a .m. 15 F i g u r e 2. Water q u a l i t y s amp l i ng s i t e s . 16 Water s a m p l i n g o f the l a k e and c r e e k s c o n t i n u e d th rough September a l t h o u g h i n t e r v i e w i n g o f swimmers was comp le ted by the end o f A u g u s t . In the summer o f 1973 a d d i t i o n a l s a m p l i n g was done to i n v e s t i g a t e f o r the p r e s e n c e , o f Pseudomonas aeruginosa. Each l o c a t i o n was sampled t h r e e t imes a week i n the morn ing and wa te r was a n a l y z e d f o r f e c a l c o l i f o r m s and Pseudomonas aeruginosa. Samples were c o l l e c t e d i n 6 o z . s t e r i l i z e d b o t t l e s f rom the wa te r s u r f a c e by f a c i n g the b o t t l e ' mouth a g a i n s t the f l o w d i r e c t i o n . For the c h l o r i n a t e d poo l sodium t h i o s u l f a t e t r e a t e d b o t t l e s were u s e d . S u r f a c e s a m p l i n g i s the a c c e p t e d mode i n b a t h i n g wate r q u a l i t y s t u d i e s ( C a r p e n t e r , 1 9 7 2 ) . B a c t e r i a s e t t l e both i n the sed iment and a t the s u r f a c e but i t i s the top l a y e r wh ich c o n t a c t s the n o s e , mouth , eyes and ea rs o f swimmers. Re suspens i on o f s i l t may i n t e r f e r e w i t h B a c t e r i a l c o n c e n t r a t i o n s but g e n e r a l l y i t has been a c c e p t e d t h a t s u r f a c e s a m p l i n g i s s u f f i c i e n t ( Tennan t , 1 9 7 1 ) . I c u l t u r e d a s e r i e s o f sed iment samples (Append ix 3) f o r a compar i son w i t h s u r f a c e s a m p l e s . H i g h e s t d a i l y a i r t e m p e r a t u r e s were r e c o r d e d and the l a k e and R u t l a n d poo l s u r f a c e wa te r t e m p e r a t u r e s were measured two to t h r e e t imes a week (Append ix 3 ) . The pH o f each sample s i t e was d e t e r m i n e d week l y w i t h bromthymol b l u e . In August 1972 u r i n e samples f rom s i x l a k e swimmers were a n a l y z e d f o r f e c a l c o l i f o r m s , f e c a l s t r e p t o c o c c i , and 17 Ps. aeruginosa. The t e s t s were done to s u b s t a n t i a t e the s u s p i c i o n t h a t u r i n e was a p o t e n t i a l c o n t r i b u t i n g s o u r c e o f t h e s e o r g a n i s m s . LABORATORY ANALYSIS I comp le ted a l l b a c t e r i o l o g i c a l a n a l y s i s w i t h M i l l i p o r e membrane f i l t e r appa r a tus f o l l o w i n g the t e c h n i q u e s and c u l t u r e medias o u t l i n e d i n " S t a n d a r d Methods 13th E d i t i o n , " and the " B . B . L . M a n u a l , " and " B i o l o g i c a l A n a l y s i s o f Water and W a s t e w a t e r . " The p l a s t i c " d i s p o s a b l e " p e t r i p l a t e s were s t e r i l i z e d i n e t h a n o l f o l l o w e d by a 24 hour immers ion i n 1% b l e a c h and r i n s i n g w i t h d i s t i l l e d w a t e r . Mayonna ise j a r s s u f f i c i e d i n l i e u o f e r l ynmeye r f l a s k s f o r a u t o c l a v i n g the m e d i a . The media was made ve ry f o u r or f i v e days and s t o r e d i n a 10°C f r i d g e between u s e . G r i d s and f i l t e r paper were t r a n s f e r r e d to p l a t e s w i t h f l a t t i p p e d s t e r i l i z e d t w e e z e r s . B r o t h media were d i s p e n s e d w i t h 2 ml s y r i n g e s . A l l p l a t e s were taped p r i o r to i n c u b a t i o n . Feca l c o l i f o r m s were i s o l a t e d u s i n g M-FC b r o t h i n the ampoule form and were i n c u b a t e d i n a wate r bath a t 44.5°C f o r 24 h o u r s . At t h i s e l e v a t e d t e m p e r a t u r e o n l y f e c a l c o l i f o r m s grow ( K a b l e r , 1961) and c o l o n i e s are s h i n y i n k b l u e . KF b r o t h was used f o r f e c a l s t r e p t o c o c c i i s o l a t i o n s i n c e i t i s the 18 media most f r e q u e n t l y recommended f o r a c c u r a t e r e s u l t s ( Kenne r , 1 9 6 1 ) . To g i v e c o l o u r d i f f e r e n t i a t i o n to the s t r e p t o c o c c i c o l o n i e s one ml o f 1% t e t r a z o l i u m s o l u t i o n was added to the media ( F i g u r e 3 ) . F e ca l s t r e p t o c o c c i c o l o n i e s were i n c u b a t e d a t 37°C i n a d r y hea t i n c u b a t o r and c o l o n i e s ranged i n c o l o u r f rom p a l e p ink to deep r e d . To f u r t h e r i d e n t i f y f e c a l s t r e p t o c o c c i c o l o n i e s I t r a n s f e r r e d w i t h a p l a t i n u m l o o p a s e l e c t i o n o f c o l o n i e s t o - b r a i n - h e a r t i n f u s i o n a g a r . P l a t e s were i n c u b a t e d a t 44.5°C two d a y s and 10°C f o r f i v e d a y s . Growth a t t hese t e m p e r a t u r e s d i s t i n g u i s h e d s t r a i n s a c c o r d i n g to the s c h e m a t i c o u t l i n e i n F i g u r e 4 ( G e l d r e i c h , 1 9 6 9 ) ; Ps. aeruginosa was i s o l a t e d on pseudose l agar and i n c u b a t e d a t 37° and checked a f t e r 18-24 hours and 48 h o u r s . C o l o n i e s wh i ch d i f f u s e d g reen p i g m e n t a t i o n o r f 1 u o r e s c e d t u n d e r UV were q u a n t i f i e d as Ps. aeruginosa (D r . W e i n s t e i n , p e r s . comm.) . R e s u l t s were c o m p i l e d as the number o f o rgan i sms per 100 m i l l i l i t e r s . For each i n d i c a t o r o rgan i sm t e s t e d two sample p l a t e s and one c o n t r o l p l a t e were i n c u b a t e d . The two sample coun t s were averaged and r a i s e d to the n e a r e s t i n t e g e r . For samples wh ich were based on l e s s than 100 mis o f wa te r the coun t s were m u l t i p l i e d by the r e q u i r e d m u l t i p l e to a g a i n y i e l d o rgan i sms per 100 m i s . Samples wh ich produced crowded growth were r e j e c t e d . 19 The p r o x i m i t y o f s amp l i ng s i t e s a l l o w e d b a c t e r i a l p l a t i n g to be comple ted w i t h i n an hour o f s amp l i ng and hence d i e - o f f r a t e was m in ima l and a c c u r a c y o f i s o l a t i o n max ima l .^ The p e r s i s t e n c e o f f e c a l c o l i f o r m s and f e c a l s t r e p t o c o c c i v a r i e s w i t h the s p e c i e s . Most s p e c i e s d i m i n i s h 50% to 80% a f t e r a one to two day l a g w h i l e o t h e r s such as s. f a e c a l i s s u r v i v e up to two weeks ( G e l d r e i c h , 1 9 6 9 ) . Due to t hese d i f f e r i n g s u r v i v a l r a t e s I f e l t i t was i m p o r t a n t to c u l t u r e samples i m m e d i a t e l y . ' P u b l i c H e a l t h samples are o r d i n a r i l y sen t to the P r o v i n c i a l L a b o r a t o r y i n Vancouver wh i ch means a one to t h r e e day l a g and i t i s c o n c e i v a b l e t h a t t h i s t ime l a g r e s u l t s i n a s i g n i f i c a n t l o s s o f a c c u r a c y . I t i s contended by the S . O . H . U . t h a t p r o v i n c i a l l a b r e s u l t s a re i n v a r i a b l y l ower than l o c a l a n a l y s i s . Feca l S t r e p t o c o c c i KF B ro th Feca l C o l i f o r m s M-FC B ro th Ps. aeruginosa Pseudose l Agar F i g u r e 3 . L a b o r a t o r y a n a l y s i s o f f e c a l c o n t a m i n a t i o n i ndi c a t o r s . 21 GROWTH KF Agar B r a i n Hea r t GROWTH a t 45°C and 10°C E n t e r o c o c c i - gu t warm b looded a n i m a l s S. faeoal-is var. liquefaoiens-ubiqui, tous S. f a e e a l i s - ( a t y p i c a l ) v e g e t a t i o n s o u r c e Red-Pink C o l o n i e s I n f u s i o n Agar GROWTH a t 45°C o n l y S. bovis - l i v e s t o c k and p o u l t r y sou r ce s S. equinus - l i v e s t o c k and p o u l t r y sou r ce s F i g u r e 4 . Feca l s t r e p t o c o c c i : s c h e m a t i c o u t l i n e o f p r e l i m i n a r y i d e n t i f i c a t i o n . Chapte r 3 WATER QUALITY RESULTS BACTERIAL WATER QUALITY The d e t a i l s o f the f e c a l i n d i c a t o r coun ts f rom each wa te r sample a r e p r e s e n t e d i n T a b l e s I t o V and d e p i c t e d i n F i g u r e s 5 to 8. At the c h l o r i n a t e d poo l f e c a l c o l i f o r m s were unde - t e c t e d w h i l e f e c a l s t r e p t o c o c c i were f r e q u e n t l y i s o l a t e d and ranged as h igh as 168 o rgan i sms/100 m i s . S t r e p t o c o c c i a r e s l i g h t l y more c h l o r i n e r e s i s t a n t than c o l i f o r m s and i t i s not uncommon f o r f e c a l s t r e p t o c o c c i to be p r e s e n t i n c h l o r i n a t e d p o o l s (Mai lman , 1 9 6 2 ) . The coun t s y i e l d e d i n the c h l o r i n a t e d poo l samples were dependent on the d e n s i t y o f swimmers a t the t ime o f s a m p l i n g ( M a i l m a n , 1962).. The s u r f a c e wa te rs have pocke t s o f c o n t a m i n a t i o n wh ich va ry w i t h the d i s t r i b u t i o n o f swimmers and t h e s e p o c k e t s a re d e s t r o y e d by d i s s e m i n a t i o n and c h l o r i n e . A d d i t i o n a l s a m p l i n g o f the pool would have p r o v i d e d a more d e s c r i p t i v e r e p r e s e n t a t i o n o f the chang ing f e c a l s t r e p t o c o c c i 2 2 23 l e v e l s . I c o l l e c t e d a l l the R u t l a n d samples f i v e to t en m inu tes a f t e r c h i l d r e n e n t e r e d the wa te r and i t would have been i n t e r e s t i n g to t e s t l e v e l s l a t e r i n the day when c rowd ing was h e a v i e r . The l a k e wa te r samples u s u a l l y p roduced f e c a l c o l i f o r m s and f e c a l s t r e p t o c o c c i coun ts wh i ch f l u c t u a t e d i n u n i s o n ( F i g u r e 5 ) . However t h e r e were d i s t i n c t d i f f e r e n c e s between the d a i l y v i c i s s i t u d e s o f the two i n d i c a t o r s . F e c a l c o l i f o r m s were more s t a b l e over t ime and sometimes remained ze ro f o r s e v e r a l d a y s . The f e c a l s t r e p t o c o c c i coun t s tended to be h i g h e r and i n c r e a s e d t h r o u g h o u t the day . The 8 a .m. samples were t aken b e f o r e even the a v i d t o u r i s t s were swimming but by noon , when the beaches were c rowded , f e c a l s t r e p t o c o c c i coun t s had i n c r e a s e d ( Tab l e I I ) . Feca l c o l i f o r m s d i d not d i s p l a y t h i s d a i l y t r e n d nor d i d they r e a c h s t h e h igh l e v e l s o f the s t r e p t o c o c c i . There weire s i x o c c a s i o n s when f e c a l s t r e p t o c o c c i were over 200/100 mis but o n l y once was f e c a l c o l i f o r m s t h i s d e n s e . In M i l l Creek the f e c a l s t r e p t o c o c c i o rgan i sms u s u a l l y p redomina ted over f e c a l c o l i f o r m s ( F i g u r e 6) w h i l e i n B r a n d t ' s Creek the f e c a l c o l i f o r m s c o u n t s were f a r h i g h e r than f e c a l s t r e p t o c o c c i ( F i g u r e 7 ) . In B r a n d t ' s Creek t h e r e was one a t y p i c a l week i n wh ich both f e c a l i n d e x o rgan i sms were d e s t r o y e d by the c h e m i c a l s r e l e a s e d d u r i n g "Sun Rype" p r o c e s s i n g . Du r i ng J u l y , the f e c a l s t r e p t o c o c c i coun ts i n Table I Fecal Coliform Counts, July, August, September 1972 Date Rutland Pool (Chlorinated) Ogopogo Pool 8 a.m. Ogopogo Pool 12 p.m. Ogopogo Pool 4 p.m. Brandt's Creek Mil l Creek July - 11 0 8 0 38 584 . 1 2 0 • 4 4 . 2,000 720 13 0 20 40 14 68 75 _ 5,000 1 ,820 17 o 0 4 330 18 0 0 10 0 19 0 0 25,000 440 . 20 0 0 0 8 0 21 2 9 20,000 330 24 0 2 - 8 340 560 25 0 2 0 - 14,000 270 26 0 72 36 10 18,000 710 27 0 16 8 46 28,000 560 , 28 0 i 4 5 251 7,800 480 31 0 2 0 0 2,000 370 Aug. ' 1 0 2 2 40 80,000 316 2 10 8 - 3 0 22 4 4 140,000 452 4 0 80 60 80 7 0 20 4 • 6 27,500 380 8 0 0 4 4 9 0 8 2 10 17,500 604 10 0 6 12 11 0 14 40 136 80,000 268 14 0 4 0 6 6,600 580 15 0 12 76 0 CONTINUED Table I (Continued) Date Rutland Pool (Chlorinated) Ogopogo Pool 8 a.m. Ogopog Pool 12 p.m. Ogopogo Pool 4 p.m. Brandt's Creek Mil l Creek Aug. 16 0 0 22 6 * 0 664 17 0 6 0 18 0 0 2 0 0 280 21 0 2 16 0 196 22 0 0 6 0 23 0 100 0 0 2,000 84 24 0 0 0 4;800 25 0 2 108 1,700 676 28 0 18 18 0 240 30 10 2 700 31 0 0 0 1 ,400 500 Sept. 5 36 0 5,200 228 8 0 . 0 2,980 240 12 2 0 6,300 60 15 2 0 3,200 400 19 2 0 1,000 0 22 0 6 1 ,314 50 24 26 4 4 390 50 29 0 0 46,000 218 Zero readings due to NaoH from f ru i t processing. Table II Fecal Streptococci Counts, July, August, September 1972 Date Rutland Pool (Chlorinated) Ogopogo Pool 8 a.m. Ogopogo Pool 12 p.m. Ogopogo Pool 4 p.m. Brandt's Creek Mi l l Creek July •11 12 13 14 17 18 19 20 21 24 25 26 27 28 31 Au|. 2 3 4 7 8 9 10 11 14 15 0 0 3 3 1 14 16 0 4 82 15 8 2 0 3 1 168 1 2 22 10 39 7 2 4 1 2 32 28 18 9 75 6 0 52 15 38 15 10 2 1 113 88 75 80 113 . 28 96 350 775 134 • 226 226 0 . 63 26 27 22 110 9 92 6 113 '103 21 290 198 8 48 22 102 89 330 18 •1 8 7 85 12 27 87 206 34 32 9 7 0 10 340 40 44 4 92 2 312 560 2,500 2,600 3,000 950 290 2,500 4,500 4,500 2,000 4,000 232 144 1 ,000 48 102 474 68 700 1 ,600 3,000 3,200 2,800 1 ,500 466 492 228 604 204 224 PO ov CONTINUED Table II (Continued) Date Rutland Pool (Chlorinated) Ogopogo Pool 8 a . m . Ogopogo Pool 12p.m. Ogopogo Pool 4. a.m. Brandt's Creek Mi l l Creek Aug. 16 0 6 49 2 8 0 17 0 0 1 18 30 35 22 0 8 0 21 12 0 41 88 900 22 10 12 1 7 24 1 1 56 25 41 37 84 3,000 8 28 2 8 58 1,750 41 30 0 0 57 12,000 400 31 0 1 0 14,000 390 Sept. 5 17 0 880 626 8 31 1 1 ,460 1,400 12 .- 1 1 15 0 0 1 ,200 60 19 0 6 1,000 0 22 0 0 8,000 38 24 26 o 0 - 0 29 4 o 60,000 0 ro OGOPOGO POOL, FECAL COLIFORM VS. FECAL STREPTOCOCCI < 720h % 640 o 560 2 4 8 0 h ~ 4 0 0 g 320 _ i | 240 I60h HIGHEST DAILY COUNTS FECAL COLI o - o F E C A L STREP 20 JULY 30 9 19 AUGUST FIGURE 5 29 8 18 SEPTEMBER MILL CREEK, FECAL COL!FORM VS. FECAL STREPTOCOCCI k—A FECAL COLI 0--0 FECAL STREP 20 JULY o IK I \ IN3 9 19 AUGUST FIGURE 6 8 18 SEPTEMBER FECAL INDICATOR COUNTs/lOO mis LOGARITHMIC SCALE PO CD CO o O p o o o o O b o. o o o o o o o c o o o o o o o oe 31 M i l l Creek were s l i g h t l y h i g h e r than coun ts i n B r a n d t ' s whereas d u r i n g A u g u s t , the f e c a l s t r e p t o c o c c i coun ts i n B r a n d t ' s were n o t i c e a b l y h i g h e r than coun ts i n M i l l C r e e k . A f t e r September 15th 1972 coun ts dropped f o r both i n d i c a t o r s a t a l l l o c a t i o n s e x c e p t B r a n d t ' s C r e e k . B r a n d t ' s dropped t e m p o r a r i l y and then peaked a g a i n towards the end of September . Morpho logy and I d e n t i f i c a t i o n o f Feca l S t r e p t o c o c c i Feca l s t r e p t o c o c c i c o l o n i e s were e a s i l y d i s t i n g u i s h e d by c o l o u r and I have summari ze.ddi n the next t a b l e t y p i c a l c o l o u r s and c o l o n y s i z e s o b s e r v e d . I d i d not q u a n t i f y c o l o n i e s i n r e f e r e n c e to c o l o u r s i n c e t h e r e i s not y e t s u f f i c i e n t i n - f o r m a t i o n to match morpho logy on KF b r o t h w i t h s t r e p t o c o c c a l s p e c i e s . Each l o c a t i o n had i t s own a n o m a l i e s . In M i l l Creek a l a r g e p u r p l e c o l o n y appeared s e v e r a l t imes d u r i n g the summer and a t R u t l a n d the s t r e p t o c o c c i c o l o n i e s s u s p i c i o u s l y r e semb led the c o l o n i e s l a t e r i s o l a t e d f rom u r i n e . A l t h o u g h t h i s c o l o u r d i f f e r e n t i a t i o n i s not o f immedia te v a l u e f o r t h i s s t u d y , i t may, i n f u t u r e , become a g u i d e l i n e f o r d e t e r m i n i n g s o u r c e o f contami n a t i o n . The r e s u l t s f rom the p r e l i m i n a r y f e c a l s t r e p t o c o c c i d i f f e r e n t i a t i o n on b r a i n h e a r t i n f u s i o n agar a re l i s t e d i n T a b l e IV. A g a i n t h i s was a q u a l i t a t i v e s a m p l i n g o f c o l o n i e s 32 T a b l e I I I F e ca l S t r e p t o c o c c i Morpho logy COLONY MORPHOLOGY ON KF AGAR Range i n s i z e o f c o l o n i e s : 0.1 mm - 1.0 mm C o l o u r e d c o l o n i e s examined under m i c r o s c o p e : w e r e g r a m + v e s o m e d i p l o i d o n l y m o s t i n c h a i n s most c o l o n i e s were s h i n y and m o i s t COLOURS OBSERVED: R u t l a n d P o o l : Smal l b r i g h t p i nk c o l o n i e s . Ogopogo P o o l : Wide v a r i e t y o f c o l o u r s . B r a n d t ' s C r eek : V a r i e t y o f p i n k c o l o u r s . M i l l C r e e k : Samples were o f t e n p redomina ted by medium p a l e p i n k c o l o n i e s . The o n l y sample s i t e c o n t a i n i n g p u r p l e c o l o n i e s . Any c o l o n i e s a p p e a r i n g as opaque w h i t e were counted as o v e r g r o w t h . and not a measurement o f the a c t u a l r a t i o s o f l i v e s t o c k and human c o n t a m i n a t i o n . S t r a i n s o f human o r i g i n were i s o l a t e d f rom each sample s i t e . T h i s was s u b s t a n t i a t e d by growth a t both 10°C and 45°C. A c c o r d i n g to the r e s u l t s a t 10°C each s i t e was a l s o shown to ha rbour the l i v e s t o c k s t r a i n s S. bovis and s. equinus. The l i v e s t o c k s t r a i n s a re p a r t i c u l a r l y s h o r t Table IV Fecal Streptococci: Preliminary Identif icat ion of Human and Livestock Strains a. Growth of Fecal Streptococci on Brain Infusion Agar - 10° and 45° These c o l o n i e s were e i t h e r E n t e r o c o c c l , a t y p i c a l S. faeaalie o r S. faeaalie vav liquefaoiene. Colony Source Size Colour on KF Broth Rutland Pool smal 1 pale pink Ogopogo Pool 1 arge dark red large orange ii medium pink " medium orange medi urn purple 1 arge pale pink medium dark red " 1 arge pink 1 arge orange medi urn pal e " 1 arge pale yel1ow-orange smal 1 red Brandt's Creek medium dark red Mill Creek medium dark red I I medium dark pink I I 1 arge pale pink I I 1 arge pink b. Growth of Fecal Streptococci on Brain Infusion Agar - 10°C These c o l o n i e s were e i t h e r S. bovis o r S. equinue o f l i v e s t o c k o r i g i n . Rutland Pool medi urn pale yel1ow-orange II medi urn pink Ogopogo Pool large pink I I smal 1 orange M smal 1 bright orange •1 large pink I I medium pink it large pale pink. n medium orange ii j medium pale yellow-orange n smal 1 red it medium dark red I I 1 arge orange Brandt's Creek 1 arge pale pink I I smal 1 dark pink •I medium yel1ow-orange Mil l Creek medi urn pink .1 mm small .5 mm medium 1.0 mm larae 34 s h o r t - l i v e d and t h e r e f o re J - i n o r d e r to have been i s o l a t e d the c o n t a m i n a t i o n must have been f a i r l y r e c e n t . The l a k e wa te r samples d i s p l a y e d the most v a r i e d c o l o u r r e p r e s e n t i v e s o f bo th human and l i v e s t o c k s t r a i n s . PSEUDOMONAS AERUGINOSA AS A WATER QUALITY INDEX 2 D u r i n g my e x p l o r a t i o n o f h e a l t h and swimmers I i n t e r - v iewed two d o c t o r s f o r t h e i r t hough t s and o b s e r v a t i o n s . The e a r , nose and t h r o a t s p e c i a l i s t (D r . P. Found , p e r s . comm.) ment ioned t h a t he had i n p r e v i o u s y e a r s sen t i n swabs f rom p a t i e n t s c o m p l a i n i n g o f o t i t i s e x t e r n a but s i n c e P s . aeruginosa was a lways i d e n t i f i e d he now no l o n g e r b o t h e r e d to v e r i f y the c a u s e . He s a i d he was not c e r t a i n i f the Pseudomonas was a s s o c i a t e d w i t h the l a k e wate r and so I d e c i d e d to pursue t h i s a s p e c t . Samples m a i l e d to the P r o v i n c i a l L a b o r a t o r y d u r i n g August 1972 c o n f i r m e d the p resence o f the p o t e n t i a l pathogen a t B r a n d t ' s M i l l , Ogopogo and Hot S ands , but not i n the R u t l a n d pool . In the summer o f 1973 I o b t a i n e d the q u a n t i a t i v e r e s u l t s l i s t e d i n T a b l e V. M i l l Creek was p o s i t i v e f o r Ps. aeruginosa on 63% o f the days s a m p l e d , B r a n d t ' s and Ogopogo on 30% o f the d a y s . In an e n v i r o n m e n t a l s tudy o f the G a t i n e a u Lakes ( Tannan t , 1 9 7 1 ) , where f e c a l c o l i f o r m s and f e c a l s t r e p t o c o c c i coun t s were c o m p a r a t i v e to t hose measured i n 35 Lake Okanagan, Ps. aeruginosa was c o n f i r m e d i n o n l y 8% to 10% o f samples f rom l a k e s and t r i b u t a r i e s . In compa r i son t h e r e f o r e I f e e l t h a t the Kelowna beach w a r r a n t s f u r t h e r i n v e s t i g a t i o n i n t o the q u a n t i t a t i v e ^ p re sence o f Ps. aeruginosa and i t s p o t e n t i a l r o l e as pathogen and i n d i c a t o r o r g a n i s m . The pseudomonas da t a ddid not r e l a t e to the f e c a l c o l i f o r m s f l u c t u a t i o n s obse r ved d u r i n g the same summer. Ps. aeruginosa i s p r e s e n t i n 10% o f h e a l t h y human f e c a s ( R e i t l e r , 1957 ; S u t t e r , 1961) and I had expec t ed the o rgan i sm to c o r r e s p o n d w i t h c o l i f o r m c o u n t s . Ps. aeruginosa i s c a p a b l e o f m e t a b o l i z i n g ove r 100 o r g a n i c compounds and hence would be a b l e to s u r v i v e w e l l i n the c r e e k s but a g a i n i t s p r e sence was not v e r i f i e d as c o n s i s t e n t l y as I had e x p e c t e d . Not a l l s t r a i n s o f Ps. aeruginosa a re p a t h o g e n i c and even a p p a r e n t l y i d e n t i c a l s t r a i n s may or may not be p a t h o g e n i c (D r . J . C a m p b e l l , p e r s . comm.) . I t i s e s t a b l i s h e d as a p a t h o g e n i c o rgan i sm i n s k i n n e c r o s i s , mixed i n t e s t i n a l i n f e c - t i o n s and o t i t i s e x t e r n a . W i thou t f u r t h e r s tudy I cannot i n t e r r e l a t e Ps. aeruginosa w i t h any o t h e r v a r i a b l e s . The r e s u l t s c o n f i r m and e s t a b l i s h the p resence o f t h i s o rgan i sm i n M i l l C r e e k , B r a n d t ' s Creek and Ogopogo p o o l . ''The q u a n t i a t i v e a c c u r a c y o f p seudose l media i n c o m b i n a t i o n w i t h membrane f i l t e r t e c h n i q u e i s u n s e t t l e d (D r . S. W e i n s t e i n , p e r s . comm.) . I found t h a t when pseudomonas d i d grow i t was o b v i o u s ( F i g u r e 3) s i n c e each c o l o n y was enve loped i n a d i f f u s i o n o f g reen p i g m e n t . Table V Ps. aeruginosa and Fecal Coliform Counts, July and August 1973 a. Pseudomonas aeruginosa counts Date Mil l Creek Ogopogo Pool Brandt's Creek June 11 0 0 o 20 0 0 0 22 0 0 0 27 0 0 0 July 3 0 0 0 4 0 46 0 6 T.M.T.C. 0 0 9 0 0 0 11 13 0 0 13 1 2 0 17 6 0 0 18 6 2 0 20 0 3 0 23 0 0 . 0 -25 6 0 0 27 1 3 0 30 16 7. 0 Aug. 1 6 2 0 3 1 0 0 6 10 0 4 8 17 0 12 10 4 1 6 13 1 0 4 15 9 39 1 12 17 4 2 2 20 1 0 16 22 3 1 0 24 T.M.T.C. 0 Fecal coliform counts Date Mil l Creek Ogopogo Pool Brandt's Creek June 11 56 0 448 20 144 0 520 22 >172 0 50- 27 436 0 100 July 3 320 138 280 4 400 0 320 6 650 96 T.M.T.C. 9 50 2 73,000 11 200 154 56,000 13 270 - 240,000 17 300 0 >100,000 18 230 0 129,000 20 - 6 600,000 23 210 5 130,000 25 490 0 150,000 27 1 00 0 2,600,000 30 130 32 - Aug. 1 152 12 580,000 3 332 98 22,500,000 6 160 2 80,000 8 1 ,100 100 >35,000 10 640 34 21 ,000 13 560 12 . >1,000 15 650 12 >1 ,000 17 475 66 >3,200 20 210 4 400 22 410 8 >1 ,300 24 1,250 4 14,600 37 ADDITIONAL VARIABLES MEASURED Tempera tu re Water t e m p e r a t u r e f l u c t u a t i o n s c l e a r l y responded to a i r t empe ra tu r e changes ( Tab l e X V I I ) . The R u t l a n d poo l t e m p e r a t u r e s were s i m i l a r to t hose o f Ogopogo poo l and dependent on a i r t e m p e r a t u r e s . I d i d not measure swimming d e n s i t y but i t was v i s i b l y obv i ous t h a t h o t t e r weather i nduced more c h i l d r e n to swim more f r e q u e n t l y . U r i n e and Feca l I n d i c a t o r s T o i l e t f a c i l i t i e s were f a r enough f rom the beach to make u r i n a t i n g i n the wa te r e a s i e r . U r i n e i n the b l a d d e r i s s t e r i l e but on p a s s i n g t h rough the u r i n a r y t r a c t i t c o n t a c t s w i t h f e c a l c o l i f o r m and f e c a l s t r e p t o c o c c i . Normal body f l o r a i s p r edomina ted by Gram p o s i t i v e s t a p h y l o c o c c i and s t r e p t o c o c c i ( C a r p e n t e r , 1972) and t h e r e f o r e i n u r i n e f e c a l s t r e p t o c o c c i t end to outnumber f e c a l c o l i f o r m s . I coaxed a few u n w i l l i n g c h i l d r e n to donate u r i n e samples and the r e s u l t s o b t a i n e d a re l i s t e d below'. The f ema le u r i n e i n t h e s e samples p roduced the h i g h e r c o u n t s . Water pH Chemica l e f f l u e n t s , t e m p e r a t u r e c h a n g e s , swimming l o a d and season B i o l o g i c a l Oxygen Demand i n c r e a s e s were a few 38 T a b l e VI F eca l I n d i c a t o r Counts i n U r i n e Samples f rom Lake Swimmers Sex Feca l C o l i f o r m s Fe ca l S t r e p t o c o c c i Ps. aeruginosa M 0 TMTC*(> 200 ,000 ) 0 M 40 TMTC 0 M 4 ,000 45 ,000 0 F 80 TMTC 0 F 6 ,000 TMTC 0 F TMTC (> 200 ,000 ) TMTC 0 * TMTC = Too Many to Count o f the v a r i a b l e s wh ich i n f l u e n c e d pH changes (Append ix 3 ) . The pH v a l u e s f l u c t u a t e d f rom 6.8 to 9 a t B r a n d t ' s C r e e k , 7.5 to 8.6 f o r M i l l and 7.2 to 8.4 f o r Ogopogo. At R u t l a n d the pH r e a d i n g s were on o c c a s i o n below the r e q u i r e d s t a n d a r d s , o f B r i t i s h C o l u m b i a . S i n c e c o l o u r i m e t r y r a t h e r than a pH meter was used I q u e s t i o n the a c c u r a c y o f these r e s u l t s . Du r i ng the summer, a l k a l i n i t y i n c r e a s e s i n the l a k e a re r e l a t e d to i n c r e a s e d p r i m a r y p r o d u c t i v i t y , and C 0 2 and b i c a r b o n a t e d e p l e t i o n . Du r i ng t h i s p e r i o d the average l a k e pH r i s e s f rom 8.0 to 8 . 2 . T h i s s u b t l e change was not measu rab l e a t the Ogopogo poo l because s h a l l o w wa te r combined w i t h swimming d e n s i t y i n t e r f e r e d w i t h t y p i c a l pH r e a d i n g s o f the l a k e w a t e r . Chap te r 4 ILLNESS RESULTS INADEQUACIES OF INTERVIEWING To uncover i l l n e s s p a t t e r n s , wh ich were o f t e n a s s o - c i a t e d w i t h s u b j e c t i v e symptoms, was , a t t i m e s , a c o n f u s i n g t a s k . C h i l d r e n comp l a i ned about i m a g i n a r y p r o b l e m s , hop ing f o r a t t e n t i o n , mothers c o u l d not r e c a l l wh ich c h i l d had been s i c k and what one p a r e n t c o n s i d e r e d s e r i o u s ano the r one o v e r - l o o k e d . There were o c c a s i o n s when p a r e n t s s u p p r e s s e d i n f o r - ma t ion a l r e a d y g i v e n by t h e i r c h i l d r e n . In one case a young boy r e p o r t e d an o b v i o u s s h i s t o s o m i a s i s r a sh but when the mother was c o n t a c t e d s e v e r a l days l a t e r she i n s i s t e d her son was f i n e and d e n i e d the p o s s i b i l i t y o f a s k i n i r r i t a t i o n . When be i ng i n t e r v i e w e d c e r t a i n p a r e n t s i m m e d i a t e l y sensed the i s s u e o f a " p o l l u t i o n s t u d y " and v o l u n t e e r e d t h e i r own i n t e r p r e t a t i o n s . Some p a r e n t s s t a t e d t h a t they r e f u s e d to a l l o w t h e i r c h i l d r e n to swim i n the l a k e because o f " p o l l u t i o n " o r p r e v i o u s summers o f ear i n f e c t i o n s . One p a r e n t announced t h a t the l a k e must be i m p r o v i n g because " t he c h i l d r e n w e r e n ' t 39 40 as s i c k t h i s summer." Mothers o f the h i g h e r income Ogopogo swimmer 's were more s e n s i t i v e to the q u e s t i o n s I a s k e d , more d i s t r a u g h t over unwe l l c h i l d r e n but l e s s o p i n i o n a t e d than r e s i d e n t s f rom o t h e r a r e a s . The p s y c h o l o g i c a l awareness o f an i l l n e s s was s u b - j e c t i v e as was my i n t e r p r e t a t i o n o f what was s a i d so the i n c i d e n c e s r e c o r d e d were u n d e n i a b l y b i a s e d . V. attempted to be c o n s i s t e n t when i n t e r p r e t i n g d a t a . For i n s t a n c e , i f t h e r e were c o n f l i c t i n g remarks between a pa r en t and c h i l d I then b e l i e v e d wh i cheve r pe rson c l a i m e d an i l l n e s s had o c c u r r e d . The major advantage o f the c o n v e r s a t i o n approach was t h a t e v e n t u a l l y 100% o f c h i l d r e n and p a r e n t s were c o n t a c t e d . GENERAL ILLNESS PROBLEMS H e a l t h prob lems enumerated d u r i n g the swimming season were c o m p i l e d w i t h r e f e r e n c e to i l l n e s s e s obse r ved per group ( T a b l e e V I I ) and then f o r ease o f v i s u a l and s t a t i s t i c a l com- p a r i s o n s c o n v e r t e d i n t o p e r c e n t a g e s (Tab le V I I I ) . U n f o r t u n a t e l y , sample s i z e v a r i e d bo th between and w i t h i n the t h r e e groups s u r v e y e d . S t a t i s t i c a l t r a n s f o r m a t i o n s , however , were not deemed n e c e s s a r y f o r a g e n e r a l i z e d compar i son o f i l l n e s s p a t t e r n s . I have c o l l a t e d i l l n e s s e s a c c o r d i n g to the weeks su r ve yed r a t h e r than i n d i v i d u a l d a y s . Water samples were not 41 t aken d u r i n g weekends and so I c o u l d not s t a t i s t i c a l l y match i l l n e s s e s w i t h two of eve ry seven d a y s . A l s o when t a l k i n g w i t h c h i l d r e n o r p a r e n t s they were o f t e n vague as to whether the onse t o f an i l l n e s s was one day o r the n e x t . I a t t empted to redue-e the degrees o f f reedom and l o s t s t a t i s t i c a l power . I o m i t t e d the v a r i a b l e s age and sex from i l l u s t r a - t i o n s s i n c e I d i d not c o n s i d e r t hese v a r i a b l e s m e a n i n g f u l f o r the e l e m e n t a r y a n a l y s i s d e s i r e d . I a l s o amalgamated the two c a t e g o r i e s "uppe r r e s p i r a t o r y a i l m e n t s " and " c o l d s " i n t o one . A l t h o u g h the r e s p i r a t o r y i l l n e s s e s r e p r e s e n t e d s e v e r a l e t i o l o g i c a l agents and was more ambiguous than the " c o l d " c a t e g o r y , comb in ing the two c a t e g o r i e s was c o n v e n i e n t and d i d not a f f e c t s t a t i s t i c a l r e l e v a n c e . With r e g a r d to t o t a l i l l n e s s e s e x p e r i e n c e d d u r i n g the summer o f 1972 , the h i g h e s t pe r c en t age was f rom the Ogopogo a q u a t i c team (88.5%) f o l l o w e d by Hot Sands swimmers ( 5 1 . 4 % ) . The t o t a l i l l n e s s r a t e s o f the l a k e swimmers i n c l u d e d s h i s t o s o m i a s i s and o t i t i s e x t e r n a , n e i t h e r o f wh i ch was p r e v a l e n t amongst c h l o r i n a t e d pool p a r t i c i p a n t s . T h i s d i f f e r e n c e accounted i n p a r t f o r the l ower t o t a l i l l n e s s e s obse r ved w i t h c h l o r i n a t e d pool swimmers. For c o m p a r a t i v e i n t e r e s t a 1959 Okanagan Lake i l l n e s s su r ve y based on i d e n t i c a l c a t e g o r i e s and s i m i l a r t ypes o f swimmers r e p o r t e d r e l a t i v e l y l ower t o t a l i l l n e s s p e r c e n t a g e s ( C l a r k e , 1 9 5 9 ) : 42 1956-59 Pe r cen t age o f I l l n e s s Amongst Lake Okanagan Swimmers S i t e 1956 1957 1958 1959 Ogopogo A q u a t i c 31% 40% 7 2 . 4 % 5 0 . 9 % Pool Hot Sands Beach 13% 21% 25% 20% At a l l t h r e e swimming s i t e s upper r e s p i r a t o r y i n f e c - t i o n s r e p r e s e n t e d a s i g n i f i c a n t p rob lem and f o r R u t l a n d and Hot Sands swimmers c o l d s were a main c o m p l a i n t . The one o b v i o u s sex r e l a t e d d i f f e r e n c e I obse r ved i n the raw da ta was w i t h c o l d s . The i n c i d e n c e o f c o l d s was more f r e q u e n t among g i r l s . S i n c e the sex r a t i o a t R u t l a n d and the Hot Sands was i n the f a v o u r o f f ema les t h i s may e x p l a i n the h i g h p e r c e n t a g e s quoted f o r upper r e s p i r a t o r y p r o b l e m s . S t u d i e s f rom o t h e r f r e s h wa te r r e g i o n s have measured " e y e , e a r , nose and t h r o a t " a i l m e n t s as r e p r e s e n t i n g 60% to 70% o f t o t a l i l l n e s s e s ( S t e v e n s o n , 1 9 5 3 ; D u t k a , 1 9 7 3 ) . I l l n e s s r e s u l t s f rom the p r e s e n t s tudy y i e l d an ever g r e a t e r p r o p o r t i o n o f such a i l m e n t s : 43 " E y e , E a r , Nose and T h r o a t " I n f e c t i o n s o f Swimmers . ' e c a t l o r , Eye , E a r , Nose and 0, 0/ ^ T 1 .. l o c a t i o n T h r o a t I n f e c t i o n s /o % o f T o t i l I n f e c t i o n s R u t l a n d Pool 43 8 7 . 8 % Hot Sands Beach 55 72 .4% Ogopogo Pool 43 9 3 . 6 % T h i s does not c a t e g o r i c a l l y imp l y t h a t the Okanagan has a s i g - n i f i c a n t l y h i g h e r e y e , e a r , nose and t h r o a t i n f e c t i o n r a t e because i t may a l s o i n d i c a t e a l e s s e r prob lem w i t h o t h e r i l l - nesses such as g a s t r o e n t e r i t i s . INCIDENCE OF SPECIFIC ILLNESSES Swimmer's i t c h or s h i s t o s o m i a s i s was obse r ved on the l e g s o f younger l a k e swimmers and o c c a s i o n a l l y on i n s t r u c t o r s who t a u g h t s t a n d i n g i n the w a t e r . Two cases were r e p o r t e d by Ogopogo swimmers but they may have a c q u i r e d the r a s h wading th rough the s h a l l o w e r wa te r s to r each the p o o l . Some i n d i v i - d u a l s , owing perhaps to s k i n pH, a re more s e n s i t i v e than o t h e r s to the c e r c a r i a e embedding . One mother i n t e r v i e w e d had f o u r c h i l d r e n who swam t o g e t h e r but o n l y one a c q u i r e d the 44 r a s h . The h i g h e s t i n c i d e n c e was r e p o r t e d d u r i n g the second week i n J u l y , two weeks a f t e r the b e g i n n i n g o f warm w e a t h e r . Four cases o f c o n j u n c t i v i t i s were r e p o r t e d by poo l swimmers but not u n t i l A u g u s t . Red and s o r e or i t c h y eyes have i n p a s t been a c o n d i t i o n obse r ved i n l a k e swimmers a l t h o u g h t h e r e were no i n s t a n c e s o f i r r i t a t e d eyes d u r i n g 1972 . I t has been sugges t ed (Dr . D. C l a r k e , p e r s . comm.) t h a t e i t h e r a l g a e or chem i ca l e f f l u e n t s were r e s p o n s i b l e f o r p r e v i o u s l a k e a s s o c i a t e d eye r e d n e s s . G a s t r o e n t e r i t i s was r e p o r t e d by each group o f swimmers but a g a i n not u n t i l August f o r R u t l a n d swimmers. The l a s t week i n J u l y f o u r R u t l a n d swimmers had g a s t r o e n t e r i t i s but because they had been swimming e l s ewhe re the da t a was e x c l u d e d . From Ogopogo swimmers t h r e e cases o f g a s t r o e n t e r i t i s were r e p o r t e d , a l l d u r i n g the f o u r t h week i n J u l y , w h i l e f rom Hot Sands swimmers g a s t r o e n t e r i t i s was r e p o r t e d i n J u l y and A u g u s t . I n to the m i s c e l l a n e o u s c a t e g o r y , I put e v e r y t h i n g f rom pneumonia to low grade f e v e r s . In e a r l y August s e v e r a l l a k e swimmers ment ioned they had stomach aches combined w i t h d i f f i c u l t y b r e a t h i n g . I t seemed too n o n - s p e c i f i c to i n c l u d e w i t h m i s c e l l a n e a but i n f u t u r e perhaps more a t t e n t i o n s h o u l d be t aken w i t h t h i s c a t e g o r y . The o u t s t a n d i n g d i f f e r e n c e between l a k e and c h l o r i - na ted poo l swimmers was the i n c i d e n c e o f e x t e r n a l ear i n f e c t i o n s . 45 From 200 l a k e swimmers a t o t a l o f 47 o t i t i s e x t e r n a cases were noted w h i l e a t the c h l o r i n a t e d poo l o n l y one i n s t a n c e was r e p o r t e d out o f 248 swimmers. Amongst the Ogopogo swimmers, o t i t i s e x t e r n a was p r e v a l e n t d u r i n g the e n t i r e swimming season but i n c i d e n c e peaked to 30 .8% i n J u l y and then dropped to ze ro a f t e r the f i r s t weekuj nsAugustt .h WithsHqJu Sands p a r t i c i p a n t s the i n c i d e n c e o f e x t e r n a l ear i n f e c t i o n s was more e v e n l y d i s t r i b u t e d t h r o u g h o u t the summer, w i t h a peak o f 12 .8% (Tab le V I I ) . The h i g h e s t i n c i d e n c e f o r both groups o f l a k e swimmers was the f i n a l week i n J u l y . E x t e r n a l ear i n f e c t i o n s have been a swimming a s s o c i a t e d annoyance f o r many y e a r s and i t i s my i m p r e s s i o n t h a t the prob lem has i n c r e a s e d w i t h i n the pas t de cade . The f i g u r e s f rom a su r vey o f the Ogopogo a q u a t i c team i n the l a t e f i f t i e s ( A l c o c k , 1960) were lower than the 1972 r e s u l t s . In t h i s e a r l i e r s t u d y i n f o r m a t i o n was not g i v e n as to the age range o f the g r o u p , swimming f r e q u e n c y o r o t h e r v a r i a b l e s and the compar i son w i t h p r e s e n t r a t e s may be u n j u s t i f i e d . Cases o f O t i t i s E x t e r n a : Ogopogo A q u a t i c Swim Team 1957 1958 1959 1960j 1972 Number (in group 40 58 55 74 52 % ea>ann fec t i : ohsons20 .0% 39 .7% 18 .2% 31 .0% 5 7 . 7 % 46 There were a l s o s e v e r a l o t h e r b r i e f s u r v e y s done on Lake Skaha i n 1970-1971 i n wh i ch the i n c i d e n c e o f o t i t i s e x t e r n a d i d not f a l l below 15% f o r any g i v e n group (South Okanagan H e a l t h U n i t , 1 9 7 1 ) . The ear i n f e c t i o n s v a r i e d i n s e v e r i t y and a f t e r the i n i t i a l one most c h i l d r e n s u f f e r e d a s e r i e s o f ear a c h e s . Each pe r son i n t e r v i e w e d s t a t e d t h a t he d i d not e x p e r i e n c e prob lems d u r i n g o t h e r seasons a l t h o u g h s e v e r a l s a i d they had s u f f e r e d ear i n f e c t i o n s i n p r e v i o u s summers. Some c h i l d r e n used i s o p r o p a n o l drops on o c c a s i o n and t h r e e Ogopogo swimmers wore ear p l u g s . Such p r o p h y l a c t i c measures were l i k e l y s u c c e s s f u l and may have l e s s e n e d the i n c i d e n c e p o t e n t i a l . Wi th Hot Sands swimmers t h e r e was an age d i f f e r e n t i a l a s s o c i a t e d w i t h o t i t i s e x t e r n a . The younger c h i l d r e n were not as f r e q u e n t l y a f f l i c t e d and t h i s was p r o b a b l y a t t r i b u t a b l e to swimming a b i l i t y and hence exposure o f ears to w a t e r . Amongst 6 to 8 y e a r o l d s the i n c i d e n c e was 14 .8% and amongst 12-14 i t was 4 3 % . A l t h o u g h the p a r t i c i p a t i o n age d i s t r i b u t i o n f o r Ogopogo swimmers was s i m i l a r t hese c h i l d r e n d i d not e x h i b i t the same o t i t i s e x t e r n a age d i s t i n c t i o n . Even the y o u n g e s t wese a c c o m p l i s h e d swimmers and i n c o m p e t i t i v e swimming undoub ted l y were w e l l exposed to wa te r r e g a r d l e s s o f a g e . Table VII Cases of Il lness Amongst Chlorinated Pool and Lake Swimmers, 1972 Location Date Group Si ze Upper Respiratory Infection Colds Ot i t i s Externa Gastroenteri t i s Shistosomlasls (Swimmer's Itch) Conjunctivi t is Misc. Tota1s Rutland Pool July 1st Wk 2nd 3rd 4th 58 58 60 60 1 2 2 2 8 1 2 - - - 3 10' 3 2 Aug. 1st Wk 2nd 3rd 4th 80 80 50 50 1 4 3 1 7 3 1 1 3 1 1 1 1 1 ' 2 4 11 13 7 4 TOTAL 248 13 25 6 - 4 4 53 Hot, Sands July 1st Wk 2nd 3rd 4th 62 62 63 63 . 1 2 2 2 1 5 7 13 2 4 8 3 1 6 1 - 3 18 14 27 Aug. 1st Wk 2nd 3rd 4th 23 23 16 6 - 2 3 1 2 2 2 2 - 5 9 TOTAL 148 7 31 17 11 10 - 76 Ogopogo Aquatic Pool July 1st Wk , 2nd' 3rd 4th 52 52 52 52 1 1 2 3 1 1 . 4 , 8 16 3 2 - 2 2 1 5 12 22 Aug. 1st Wk 2nd 3rd 52 52 52 3 2 - 1 - . - - 4 2 TOTAL 52 9 4 30 3 2 - 4 46 Table V.I 11 Percentages of I l lness Amongst Chlorinated Pool and Lake Swimmers, 1972 V Location Date Group Si ze Upper Respiratory (inc. colds) Ot i t i s Externa Gastroenteritis Shistosomiasis Swimmer's Itch Conjunctlvi t is Misc. Total Per Cent 111ness Rutland Pool July 1st Wk 2nd 3rd 4th 58 58 60 60 5.17% 17.30 5.0 3.33 - 5.16% 17.3 5.0 3.33 Aug. 1st Wk 2nd 3rd 4th 80 80 50 50 2.5 13.75 12.0 2.0 1 .25% 3.75% 1125 2.0 2.0 1.25% 1.25 4.0 ' 5.0% 13.8 16.3 14.0 8.0 TOTAL 248 15. 32% jl .25% 2.42% 1.61% 5.0% 21 .37% Hot Sands July 1st Wk 2nd 3rd 4th 62 62 63 63 3.23 11.29 14.29 23.80 v 3.22% 6.35 12.7 4.85% 6.35 1 .63% 9.7 1 .59 4.85% 29.09 22.3 42.8 Aug. 1st Wk 2nd 3rd 4th ; 23 23 16 6 8.69 13.04 4.35 8.70 8.7 8.7 8.7 21 .7 39.2 TOTAL 148 25.67% 11.50% 7.43% 6.75% 51.35% Ogopogo Aquatic Pool July 1st Wk 2nd 3rd 4th 52 52 52 52 1.92 7.69 5.77 1 .93% 7.7 15.4 30.8 5.77% 3.85 3.85 3.85 1.92% 9.6 23.1 42.3 Aug. 1st Wk 2nd 3rd 52 52 52 5.77 3.85 1 .9 3 7.7 3.85 TOTAL 52 25.00% 57.70% 5.77% 3.85% 7.69s; 88.46% Chap te r 5 INTERPRETATION OF WATER QUALITY DATA Feca l s t r e p t o c o c c i i s b e g i n n i n g to become more p o p u l a r i n Nor th Amer i c a as an i n d i c a t o r o rgan i sm to be measured i n c o n j u n c t i o n w i t h f e c a l c o l i f o r m s f o r the d e t e r m i n a t i o n o f r e c r e a t i o n a l wa te r q u a l i t y . I p u r p o s e f u l l y used the word p o p u l a r s i n c e the f u n c t i o n a l r o l e o f i n d i c a t o r o rgan i sms and the somewhat a r b i t a r y h e a l t h s t a n d a r d s f o r r e c r e a t i o n a l wa te r r e c e i v e s c o n s t a n t c r i t i c i s m (Ames, 1969 ; D u t k a , 1 9 7 3 ; K e v i n , 1968 ; K r i s h n a s w a m i , 1 9 7 1 ) . In my s c a n n i n g o f the l i t e r a t u r e I a b s t r a c t e d one a u t h o r who p r e s e n t e d e p i d e m i o l o g i c a l e v i dence c o r r e l a t i n g i l l n e s s r a t e s o f swimmers w i t h b a c t e r i a l wa te r q u a l i t y and the l e v e l n o t e d i n h i s r e s e a r c h ( S t e v e n s o n , 1953) was 2,300 t o t a l c o l i f o r m s . Whether i t i s s a l t , f r e s h or c h l o r i n a t e d wate r the arguments abound as to what i s a " p o t e n t i a l h e a l t h h a z a r d . " I t i s c l a i m e d t h a t 200 f e c a l c o l i f o r m and TOOsfeca l s t r e p t o c o c c i ( Tennan t , 1971) a re the d e m a r c a t i o n p o i n t s but t h e s e c o n c l u s i o n s a re not founded on 49 50 s u f f i c i e n t e m p i r i c a l e v i d e n c e . A comment by Mai lman (1962) sums the c r i t i c i s m s f o r c h l o r i n a t e d poo l s t a n d a r d s . Swimming pool b a c t e r i o l o g i c a l standards are r e a l l y standards of a t t a i n a b i l i t y and are not based onaepidemiological v evidence. 1 Recent Canad ian s t u d i e s on r e c r e a t i o n a l wa te r q u a l i t y , wh ich i n c l u d e p a r t s o f the Okanagan B a s i n S tudy and the Env i ronment Canada r e p o r t on the G a t i n e a u L a k e s , a c c e p t e d as t h e i r i n i t i a l p remise the h e a l t h s t a n d a r d s summarized i n Append ix 1. By t e s t i n g a s s o r t e d p u b l i c beaches and f i n d i n g them w i t h i n t o t a l and f e c a l c o l i f o r m l i m i t s both s t u d i e s i n t e r p r e t e d these r e s u l t s as c o n c l u s i v e e v i dence o f a c c e p t a b l e wa te r q u a l i t y . I t was not q u e s t i o n e d f u r t h e r as to whether wa te r q u a l i t y c o u l d s t i l l have a n e g a t i v e impac t on h e a l t h . B a c t e r i a l r e s u l t s f rom the Kelowna beachtwere w i t h i n the B r i t i s h Co lumbia wate r s t a n d a r d s but I w i sh to go beyond t h i s p r e s e t l i m i t and i n t e r p r e t the " p o t e n t i a l h e a l t h h a z a r d " to swimmers f rom a s s o c i a t i o n w i t h i t h i s one p a r t i c u l a r beach . A l t h o u g h the f e c a l i n d i c a t o r coun ts were w i t h i n the h e a l t h s t a n d a r d s t h i s does not deny the p o s s i b i l i t y t h a t the obse r ved wa te r q u a l i t y had a d e l e t e r i o u s e f f e c t on h e a l t h . My d a t a l a c k s the depth and v a r i a b i l i t y upon wh ich to e s t i m a t e M a i l m a n , " C o c c i T e s t f o r D e t e r m i n i n g Mouth and Nose P o l l u t i o n o f Swimming Pool W a t e r , " " A J P H , V o l . 4 7 , p. 2001 . 51 p r e c i s e p o i n t s or "mag ic number" a t wh i ch wate r q u a l i t y does o r does not a f f e c t h e a l t h . I t does however have enough s u b - s t a n c e to d e s c r i b e c e r t a i n r e l a t i o n s h i p s which e x i s t between the s t r e a m s , the l a k e and the swimmers. FECAL CONTAMINATION OF THE CREEKS Feca l c o l i f o r m and f e c a l s t r e p t o c o c c i a re both i n c u b a t e d i n the f e c e s o f warm b looded a n i m a l s , however , the r e l a t i v e r a t i o s o f the o rgan i sms va r yy w i t h the t ypes o f a n i m a l . Human f e c e s c o n t a i n s r o u g h l y f o u r t imes more f e c a l c o l i f o r m than s t r e p t o c o c c i w h i l e domes t i c and w i l d an ima l f e c e s grow g r e a t e r numbers o f f e c a l s t r e p t o c o c c i ( G e l d r e i c h , 1 9 6 9 ) . T h i s i s a u s e f u l d i s t i n c t i o n f o r t r a c i n g sou r ces o f r e c e n t c o n t a m i n a t i o n . The b a s i c r e l a t i v e r a t i o s r u l e to be used w i t h d i s c r e t i o n is:-: - i f t h e f e c a l c o l i f o r m t o f e c a l s t r e p t o c o c c i r a t i o i s g r e a t e r t h a n 4 . 0 c o n t a m i n a t i o n i s o f h u m a n o r i g i n - i f t h e r a t i o i s l e s s t h a n 0 . 7 c o n t a m i n a - t i o n i s f r o m a n i m a l o r i g i n ( G e l d r e i c h , 1 9 6 9 ) . Due to d i s c r e p a n c i e s o f d i e o f f r a t e s t h i s r u l e a p p l i e s o n l y to f r e s h f e c a l c o n t a m i n a t i o n . From the c reek wate r q u a l i t y da t a i t was appa ren t t h a t f e c a l s t r e p t o c o c c i p redomina ted i n M i l l Creek and f e c a l 52 c o l i f o r m i n B r a n d t ' s . The r a t i o s a t M i l l were commonly l e s s than 0 .7 and i n B r a n d t ' s u s u a l l y g r e a t e r than 4 . 0 (Tab le I X ) . S i n c e M i l l Creek r e c e i v e d more a g r i c u l t u r a l d r a i n a g e and B r a n d t ' s the i n d u s t r i a l e f f l u e n t s , the r a t i o s comply w i t h e x p e c t a t i o n s . Ogopogo wa te r q u a l i t y f rom the morn ing samples was a m i x t u r e o f r a t i o s and w i l l be d i s c u s s e d s e p a r a t e l y . T a b l e IX R a t i o s o f Feca l I n d i c a t o r Counts Feca l C o l i f o r m : Feca l S t r e p t o c o c c i n ? •:- a Date Ogopogo Pool 8 a .m. Samples B r a n d t ' s Creek M i l l Creek J u l y 26 4 .0 6.92 0 .355 27 1 .78 9 .45 0 .176 28 0 .053 2.20 0 .178 31 0 .33 6 .90 0.247 August 2 2.0 32 .0 0 .676 3 0.2 31 .2 0.92 4 1 3 . 3 — — BACTERIAL STATISTICAL ANALYSIS D id b a c t e r i a l counts i n M i l l Creek f l u c t u a t e c o n c o m i t a n t l y w i t h t hose i n Ogopogo Poo l ? Were f e c a l s t r e p t o c o c c i coun t s i n Ogopogo s i g n i f i c a n t l y h i g h e r than f e c a l 53 c o l i f o r m and d i d the c r e e k s c o n t r i b u t e to t h e s e coun t s ? To f u r t h e r i n t e r p r e t such q u e s t i o n I made use o f p a i r e d " t " t e s t s and p r o d u c t moment c o r r e l a t i o n c o e f f i c i e n t s . The " t " t e s t s were used to check whether the t ime and l o c a t i o n d i f f e r e n c e s were s i g n i f i c a n t . The c o r r e l a t i o n c o e f f i c i e n t s were used to de t e rm ine how c l o s e l y a l i g n e d the i ndex o rgan i sms of the l a k e were w i t h those o f the c reek and to r e l a t e t empe ra - t u r e and f e c a l i n d i c a t o r s . S i n c e sample s i z e s v a r i e d , the s i g n i f i c a n c e o f the c o r r e l a t i o n c o e f f i c i e n t s was f u r t h e r t e s t e d w i t h the " t " t e s t . The s t a t i s t i c a l a n a l y s i s f o r b a c t e r i a l water q u a l i t y i s summarized i n Tab l e X. FECAL CONTAMINATION OF THE KELOWNA BEACH P r i o r to i n t e r p r e t i n g the wate r q u a l i t y o f the l a k e swimming a rea I w i sh to emphas ize two samp l i ng compar i sons wh ich were done . The f i r s t was the compar i son of Ogopogo Pool w i t h the Hot Sands Beach and the second was the compar i son o f the s u r f a c e w i t h sed iment samples (Tab le X ) . The " t " t e s t a c c e p t e d the n u l l h y p o t h e s i s f o r the f i r s t compar i son and t h e r e f o r e a l l b a c t e r i a l measurements t aken can be r e l a t e d to Ogopogo Pool and Hot Sands swimmers. In the second com- p a r i s o n the n u l l h y p o t h e s i s was a c c e p t e d f o r f e c a l s t r e p t o c o c c i 54 but r e j e c t e d f o r f e c a l c o l i f o r m s . T h i s r e s u l t s i m p l i e s t h a t s t i r r i n g o f the sed iments by wind or swimmers may have a f f e c t e d s u r f a c e f e c a l c o l i f o r m c o u n t s . Depth r e l a t e d v a r i a t i o n s have a l s o been obse r ved i n o t h e r s t u d i e s but they were c o n - s i d e r e d o f l i 'minor" impo r t ance (Tennan t , 1 9 7 1 ) . When the Ogopogo 8 a .m. f e c a l c o l i f o r m coun ts were compared s t a t i s t i c a l l y w i t h the noon and 4 p.m. f e c a l c o l i f o r m r e s u l t s the d i f f e r e n c e was i n s i g n i f i c a n t ( Tab l e X ) . When the d a i l y f e c a l c o l i f o r m coun ts were compared w i t h the d a i l y f e c a l s t r e p t o c o c c i l e v e l s the d i f f e r e n c e s were s i g n i f i c a n t a t 8 a . m . , 12 p.m. and 4 p.m. As was i n i t i a l l y appa ren t i n the r e s u l t s , f e c a l s t r e p t o c o c c i coun t s were f r a c t i o n a l l y h i g h e r than f e c a l c o l i f o r m . An a d d i t i o n a l s i g n i f i c a n t d i f f e r e n c e was d e t e c t e d between 8 a .m. f e c a l s t r e p t o c o c c i coun ts and the 12 p.m. and 4 p.m. f e c a l s t r e p t o c o c c i c o u n t s . The morn ing f e c a l s t r e p t o c o c c i coun ts were s t a t i s t i c a l l y l ower than the noon o r a f t e r n o o n c o u n t s . There was n o t , however , a s i g n i f i c a n t d i f f e r e n c e between the 12 p.m. and 4 p.m. c o u n t s . The count d i f f e r e n c e s o b s e r v e d , both between the two i n d e x o rgan i sms and d u r i n g the d a i l y f e c a l s t r e p t o c o c c i i n c r e a s e s , l i k e l y r e l a t e s to the p resence and d e n s i t y o f swimmers. N a t u r a l s k i n f l o r a and u r i n e , as ment ioned p r e - v i o u s l y , a re p redomina ted by Gram p o s i t i v e s t r e p t o c o c c i ( C a r p e n t e r , 1 9 7 2 ) . When d a i l y swimming d e s n t i y i n c r e a s e d 55 so d i d the amount o f d i r e c t c o n t a c t between wate r and s k i n . F e c a l s t r e p t o c o c c i coun ts c o r r e s p o n d i n g l y i n c r e a s e d w i t h the d e s n t i y o f b a t h e r s and then dropped a g a i n each n i g h t as the wa te r d i s p e r s e d . As one o f the mothers I spoke w i t h a p t l y d e s c r i b e d , " T h e r e ' s n o t h i n g wrong w i t h the l a k e s . Peop le who swim i n them are d i r t i e r t hann they a r e . " I f hot weather i n s p i r e s swimmers, who adds to the f e c a l s t r e p t o c o c c i l e v e l s i t i s l o g i c a l t h a t t empe ra tu re s h o u l d p o s i t i v e l y c o r r e l a t e w i t h the i n d i c a t o r . The c o e f f i c i e n t c a l c u l a t e d ( Tab l e X) was .504 w h i c h , g i v e n 32 degrees o f f r e e d o m , was s i g n i f i c a n t . The c o r r e l a t i o n i s a l s o appa ren t i n F i g u r e 9 i n wh ich the minimum a i r t empe ra tu r e s o f J u l y 20thi i s A u g u s t 17th and August 30th c o i n c i d e w i t h the l o w e s t i n f l e x i o n p o i n t s o f the f e c a l s t r e p t o c o c c i c o u n t s . S i n c e the c o l i f o r m s were not e q u a l l y s u s c e p t i b l e to d e n s i t y changes the c o r r e l a t i o n w i t h t empe ra tu r e was l e s s w i t h a c o e f f i c i e n t o f . 2 1 6 . The pH changes may a l s o have been d e n s i t y dependent but I d i d not t ake s u f f i c i e n t samples d u r i n g swimming c l a s s e s to a s c e r t a i n any t r e n d s . A t the R u t l a n d poo l n e i t h e r pH nor t e m p e r a t u r e c o r r e l a t e d w i t h the u n p r e d i c t a b l e f e c a l s t r e p t o c o c c i c o u n t s . Table X Stat is t ica l Analysis: Comparison of Fecal Contamination Indicator Counts Paired "t " Tests H „ : d = 0 H,: d > 0 < d a: TWO TAIL *a - .05 for a l l one and two ta i led tests d.f. = degrees of freedom Data from Table XX , 1. Ogopogo Pool vs. Hot Sands Beach a. June Fecal Col 1. b. August Fecal C o l l . c. August Fecal Strep. n = 15 d . f . = 14 " t " a = 1.776 1 calc - J : > u . *. ACCEPT Ho C o u n t s f r o m Ogopogo P o o l were a c c e p t e d as e q u a l and hence a s u b s t i t u t e f o r c o u n t s f r o m the Hot Sands n = 18 d . f . = 17 "t " =2.110 a * calc - J 0 U .-. ACCEPT Ho n = 17 d . f . = 16 " t " = 2.120 a " f ' c a l c " - 9 8 0 9 . ' . ACCEPT Ho 2. Ogopogo Pool: Surface vs. Sediment Samples Data from Table XIX H 9 : ..d" = 0 Hi: H" < 0 > d~ a: TWO TAIL a. Fecal C o l i . b. Fecal Strep. n = 10 d. f . =9 "t" • = 2.262 - f c a U = 2.416 ! . ' . REJECT H o There was a s igni f icant difference between surface and sediment fecal c o l i . n = 12 d.f . = 10 " t " =2.201 a M t " c a l c = " 6 3 7 . ' . ACCEPT Ho CONTINUED Table X (Continued) 3. Ogopogo: 8 a.m., 12 p.m., 4 p.m. Data from Tables I and II H 0 : d" < 0 H,: d > 0 a: ONE TAIL a. Fecal C o l l . , 8 a.m. vs. 12 p.m. b. Fecal C o l i . , 8 a.m. vs. 4 p.m. c. Fecal Strep., 8 a.m. vs. 12 p.m. n = 30 d.f . = 29 »t'^ = 1.699 " t ' c l c " - 3 8 6 . " . ACCEPT H 0 n = 25 d.f. = 24 " t " = 1 .711 a " t " i =1.489 calc . * . ACCEPT Ho n = 30 d.f . = 29 "t" = 1 .699 a - t - c a l c = 1.832 .'. REJECT H 0 d. Fecal Strep., 8 a.m. vs. 4 p.m. e. Fecal Strep., 12 p.m. vs. 4 p.m. n = 23 d.f . =22 "t " =1.717 • t - c a l c - 2.459 .-. REJECT H 0 The f e c a l s t r e p , c o u n t s a t 12 p.m. were s i g n i f1 c a n t l y h i g h e r t h a n 8 a.m. c o u n t s . n = 18 , d.f . = 17 " t " a = 1 .740 " ' " ca l c = T ' 6 8 1 . * . ACCEPT H 0 4. Ogopogo Pool: Fecal Co l i . vs. Fecal Strep. Counts ' z Data from Tables I and II H 0: d < 0 H i : d~ > 0 a: ONE TAIL a. 8 a.m. Samples b. 12 p.m. Samples c. 4p .m. Samples n = 35 d.f . = 34 " t " a = 1.690 "t " , = 1.908 calc .*. REJECT H 0 n = 27 d.f . =28 "t " = 1.701 a " * " c . l c " 2 - 8 7 1 .'. REJECT H 0 n = 23 d.f . = 22 "t" = 1.717 • f c a l c = 2.623 . - . REJECT H 0 There was a s i g n i f i c a n t d i f f e r e n c e between each s e t o f f e c a l c o l i . and f e c a l s t r e p , c o u n t s Table X (Continued) Temperature Correlation with Fecal Indicators 'Data from Tables I, II and XVII < n Hj H 0 : r < 0 poi i t i ve correlat ion not s igni f icant r < 0 signif icant positive correlation a = ONE TAIL a. Temperature and Ogopogo Fecal Co l l , n = 37 d.f. 35 1.69 "*"calc = K 3 1 ° ACCEPT Ho r = .216 b. Temperature and Ogopogo Fecal Strep. 35 d.f . = 33 "t " = 1 .693 a M t " c a l c = 3 - 3 5 2 .'. REJECT H0 r = .504 S i g n i f i c a n t c o r r e l a t i o n between f e c a l s t r e p , c o u n t s and a i r t e m p e r a t u r e s c. Temperature and Rutland Fecal Strep, 33 d.f, 31 "t" = 1 .896 a " f d c - - 6 9 8 .-. ACCEPT Ho r = .1.24 Pseudomonas aeruginosa (1973) Data from Table V H 0 : r < 0 posit ive correlation not s igni f icant Hi : r > 0 a: ONE TAIL - s ignif icant positive correlation a. PB. aeruginosa and Temperature b. Pe. aeruginosa and Ogopogo Fecal C o l i . n = 24 d.f. =22 "t" = 1.717 i , t M c a l c = " - 4 9 6 . •. ACCEPT Ho I r = -.042 n = 22 d.f . = 20 "t " = 2.086 a - t - c a l c -.857 ACCEPT Ho r = -.180 <J1 CO OGOPOGO, THRICE DAILY COUNTS OF FECAL STREPTOCOCCI O O < O 400 c/) ^ 300 Z> o o Q_ Ld £ 200 r— 00 00 0 1 I I 27 31 JULY • 8:00 A.M. 112:00 P.M. 4:00P.M 1 1 In i _ Q 1 P I I 4 7 AUGUST i I I I FIGURE 8 HIGHEST DAILY FECAL STREP COUNTS/lOOmis LOGARITHMIC SCALE — _ ro oj •£» (T> co T E M P E R A T U R E U F 61 CORRELATION OF THE CREEK AND LAKE WATER QUALITY Crowding was not the s o l e s o u r c e o f the c o l o n i e s wh i ch grew f rom the l a k e w a t e r s . I n to Lake Okanagan th rough numerous v i l l a g e s and c i t i e s l e a d 2,340 square m i l e s o f t r i b u t a r i e s . With r e g a r d to f e c a l i n d i c a t o r s , wh ich s u r v i v e a t most s e v e r a l weeks , the nearby o u t f a l l s p r o v i d e d a n o t h e r s o u r c e o f f e c a l o r g a n i s m s . For Ogopogo poo l and the Hot Sands b e a c h , M i l l and B r a n d t ' s Creek were c l o s e s t w i t h wind d i r e c - t i o n f a v o u r i n g M i l l C r e e k . Ano the r f i v e m i l e s to the sou th o f the Hot Sands beach was the o u t l e t f rom the Kelowna p r i m a r y waste t r e a t m e n t p l a n t and of a l l i n p u t s i n t o the l a k e , the sewage p l a n t r e l e a s e s the h i g h e s t b a c t e r i a and n u t r i e n t l o a d i n g ( H e a l t h B r a n c h , 1 9 7 3 ) . I d i d not i n v e s t i g a t e the p o s s i b l e impac t o f t h i s e f f l u e n t on the Hot Sands beach because I assumed t h a t the o u t f a l l was too d i s t a n t to cause a s u b s t a n t i a l e f f e c t . To de t e rm ine the i n f l u e n c e o f M i l l and B r a n d t ' s C reeks on the wa te r q u a l i t y o f Ogopogo poo l o r the Hot Sands beach I c o r r e l a t e d the b a c t e r i a l da ta f rom the s e p a r a t e l o c a t i o n s u s i n g f i r s t a f o u r hour l a g and then a 24 hour l a g ( Tab l e X I ) . Computa t i ons f rom ano the r s e r i e s w i t h an e i g h t hour l a g were not l i s t e d s i n c e r e s u l t s were ana logous to the f i r s t s e t . For the f o u r hour l a g the morn ing c r e e k coun t s were compared w i t h the noon l a k e coun ts and f o r the one day l a g the morn ing c r eek coun ts were p a i r e d w i t h the 62 8.a .mi : 1 ake-counts? .o f the next day . As the mouths o f both c r e e k s were w i t h i n one m i l e o f the Ogopogo p o o l , i t seemed r e a s o n a b l e t h a t p o t e n t i a l b a c t e r i a l c o r r e l a t i o n s would o c c u r w i t h i n a one day t ime s p a n . The da t a were a n a l y z e d s e p a r a t e l y f o r J u l y and August because the f e c a l i n d i c a t o r s i n B r a n d t ' s Creek were more i r r a t i c i n the l a t t e r month . From M i l l Creek both f e c a l c o l i f o r m and f e c a l s t r e p t o c o c c i coun ts c o r r e l a t e d p o s i t i v e l y , d u r i n g J u l y , w i t h Ogopogo f e c a l i n d i c a t o r s . The c o e f f i c i e n t s i m p l y t h a t M i l l Creek c o n t r i b u t e d b a c t e r i a l l o a d i n g to the Hot Sands Beach . A l t h o u g h the f e c a l s t r e p t o c o c c i counts i n M i l l Creek were h i g h e r than the f e c a l c o l i f o r m coun ts i t was the f e c a l c o l i f o r m count c o r r e l a t i o n wh ich produced the s t r o n g e r c o e f f i c i e n t ( r = . 8 8 7 ) . T h i s i r r e g u l a r i t y was due p r o b a b l y to the s e n s i t i v i t y o f f e c a l s t r e p t o c o c c i to the i n f l u e n c e o f a l t e r n a t e v a r i a b l e s such as swimming d e n s i t y . B r a n d t ' s Creek and Ogopogo Poo l p r o v i d e d one , s i g - n i f i c a n t but l i k e l y a c c i d e n t i a ! , c o r r e l a t i o n d u r i n g J u l y when the c o e f f i c i e n t f o r f e c a l s t r e p t o c o c c i was r = . 5 7 8 . The c o e f f i c i e n t s d u r i n g Augus t f o r both f e c a l c o l i f o r m s and f e c a l s t r e p t o c o c c i were i n s i g n i f i c a n t . As a v e r i f i c a t i o n o f the c r e e k s and l a k e c o e f f i c i e n t s I then c r o s s r e l a t e d the coun ts f rom the two c r e e k s . The J u l y f e c a l s t r e p t o c o c c i were c o i n c i d e n t a l l y i n phase ( r = . 8 1 2 ) . I t was t h i s c o r r e l a t i o n wh i ch p r o b a b l y a c coun ted f o r the 63 chance f e c a l s t r e p t o c o c c i c o r r e s p o n d e n c e between B r a n d t ' s Creek and Ogopogo Pool . Not one o f the c r eek and l a k e c o r r e l a t i o n c o e f f i c i e n t s d u r i n g August was s i g n i f i c a n t . Does t h i s i n d i c a t e t h a t a f t e r J u l y n e i t h e r o f the c r e e k s c o n t i n u e d to i n f l u e n c e beach wate r q u a l i t y ? I t may, but i t may a l s o i n d i c a t e t h a t wind and wate r c u r r e n t changes c r e a t e d too much i n t e r f e r e n c e f o r a s i g n i f i c a n t c o r r e l a t i o n w i t h o u t more e l a b o r a t e a n a l y s i s . S i n c e t h e r e appears to be a p o t e n t i a l f e c a l c o n t a m i n a t i o n c o r r e l a t i o n between the c r eeks and the l a k e , s p r i n g would be a p r e f e r a b l e season t o q q u e s t i o n , w i t h o u t swimming l o a d i n t e r - f e r e n c e , the a s s o c i a t i o n o f l a k e and c reek wa te r q u a l i t y . Table XI Stat ist ica l Analysis:Correlatlon of Fecal Indicator Counts H »: r < 0 H,: r > 0 Positive Correlation Not Significant Signif icant Positive Correlation 1 ct : .05, ONE TAIL Data from Tables I and II 1n Product Moment Correlat ions. 1. Mi l l Creek vs. Ogopogo Pool Samples a. July fecal c o l i . : 4 hour lag (8 a.m. and 12p.m.) b. August fecal co l l . : 4 hour lag c. July fecal strep.: 4 hour lag n = 13 d.f . = 11 "t" = 1.796 a " ' " c a l c " 6 - 3 6 5 .*. REJECT H0 r = .887 July fecal co l l levels In Ogopogo correlated strongly with Mill C reek fecal co1 I n = 10 d.f . = 8 "t" = 1.860 a '^ 'ca lc ° - 2 0 7 . ' . ACCEPT Ho r - .073 n = 12 d.f . » 10 "t" = 1.812 a " f c a l c = 2.265 . ' . REJECT H o r =• .582 July fecal strep also correlated with Ogopogo counts d. August fecal s t rep. : 4 hour lag e. July and August fecal col l . : 1 day lag (8 a.m. & 8 a.m.) f. July and August fecal strep.: 1 day lag n = 9 d.f . = 7 " t " a = 1.895 M t " c a l c - - - 4 5 0 .•. ACCEPT Ho r • -.450 n = 19 d.f. = 17 "t" = 1.729 a " t M c a l c " - 8 5 2 6 ACCEPT Ho r = .203 n = 18 d.f. = 16 " t " a = 1.746 " f c a l e - 1.712 . ' . ACCEPT Ho r - .393 2. Brandt's Creek vs. Ogopogo ' a. July fecal c o l i . : 4 hour lag b. August fecal co l l . : 4 hour lag c. July fecal strep.: 4 hour lag n = 12 c . f . = 10 " t " a = 1.812 - t - c - l c - .102 . * . ACCEPT H0 r = .032 n = 10 d.f. = 8 . " t " a = 1 .860 " * " c« l c = - 2 3 1 ACCEPT H0 r = .231 ' n = 14 d. f . = 12 " t " a = 1.782 - t " e a l c - 2.455 .'. REJECT H o r = . 578 _ • CONTINUED t : Table XI (Continued) 2. Brandt's Creek vs. Ogopogo (Continued) d. August fecal s trep: : 4 hour lag e. July and August fecal c o l i ; : 1 day lag f. July and August fecal s trep; : 1 day lag n = 8 d.f . = 6 " t " 0 = 1.943 " f ' c a l c = ^ . * . ACCEPT H 0 r = .408 n = 22 d.f. - 20 " t " 0 = 1.725 n t " c a l c = - 6 4 2 .•. ACCEPT H 0 r = .142 n = 17 d.f . =15 " t " a = 1.753 " t " c a l c :- 1.165 . *. ACCEPT H 0 r = .288 3. Mi l l Creek vs. Brandt's Creek a. July fecal c o l i . b. August fecal col 1. c. July fecal strep. n = 13 d.f . = 11 " t " a 1.796 "*"calc = " - 0 7 1 ACCEPT Ho r = -.022 n = 9 d.f . = 7 " t " a = 1.895 « t " c a l c = -1.145 . ' . ACCEPT Ho r = -.397 n = 12 d.f. = 10 "t" = 1.812 " t ' e . l e " 4 - 3 9 7 . - . REJECT H 0 r = .812 F e c a l s t r e p , l e v e l s c o r r e - l a t e d i n B r a n d t ' s and M i l l C reeks d u r i n g J u l y . d. August fecal strep. en n = 12 d.f . =10 " t " a = 1.812 M t " c a l c = - 2 1 5 ! . ' . ACCEPT H 0 r = .068 Chap te r 6 INTERPRETATION OF ILLNESS DATA INCIDENCE AND EXPOSURE Throughout the s t u d y I d e l e t e d the v a r i a b l e s wh i ch I d i d not c o n s i d e r n e c e s s a r y f o r e x p o s i n g the i n i t i a l l y h y p o t h e s i z e d i n t e r a c t i o n s . I e x t r a c t e d o n l y t hose f a c e t s wh i ch were r e q u i r e d f o r a l i n e a r d e s c r i p t i o n o f the r e l a t i o n - s h i p between water q u a l i t y and the h e a l t h o f swimmers. One of the n e g l e c t e d v a r i a b l e s was economic s t a t u s . I assumed a min ima l s o c i a l and economic d i f f e r e n c e between R u t l a n d and Hot Sands swimmers but t h e r e were l i k e l y c e r t a i n d i s t i n g u i s h - i n g r easons as to why some p a r e n t s and c h i l d r e n p r e f e r r e d one l o c a t i o n to a n o t h e r . Whatever the r e a s o n , I have c o n - t i n u e d to assume t h a t such d i f f e r e n c e s d i d not a f f e c t i l l n e s s p a t t e r n s d e s c r i b e d e a r l i e r . Ano the r i m p o r t a n t v a r i a b l e wh i ch I o n l y p a r t i a l l y a c coun ted f o r was swimming e x p o s u r e . I d i d not a t t empt to a s s e s s t o t a l swimming t ime f o r p a r t i c i p a n t s e i t h e r d u r i n g the weeks they were be ing s u r v e i l l e d o r p r i o r to t h e i r p a r - t i c i p a t i o n . I t r e a t e d each two-week swimming s e s s i o n as a 66 67 s e p a r a t e group even though some o f the R u t l a n d and Hot Sands swimmers e i t h e r had been e n r o l l e d i n an e a r l i e r s e s s i o n o r c o n t i n u e d i n t o the n e x t . T o t a l swimming exposu re was r e l e v a n t to the o p p o r t u n i t y f o r c o n t a c t w i t h o t h e r swimmers and wa te r q u a l i t y and hence was r e l e v a n t to the p r o b a b i l i t y o f c o n - t r a c t i n g an i l l n e s s . A l t h o u g h the maximum was not measured the number o f minimum swimming hours was known and f o r the R u t l a n d and Hot Sands swimmers i t was e q u i v a l e n t . T h e r e f o r e a l l i l l n e s s i n c i d e n c e s l i s t e d i n Tab l e XI I were based on i d e n t i c a l minimum wa te r e x p o s u r e . Ogopogo swimmers however swam not o n l y r e g u l a r l y f o r the e n t i r e summer but an a d d i t i o n a l two hours per week more than o t h e r p a r t i c i p a n t s . To c l a r i f y the i l l n e s s compar i sons between Ogopogo poo l and o t h e r s i t e s the i n c i - dences per 1000 pe r son hours exposure were c a l c u l a t e d as shown i n T a b l e s XI I and XX I . S i n c e c h i l d r e n tend to romp i n and ou t o f the wa t e r a l l day the f i g u r e s quoted may be s e v e r e l y u n d e r e s t i m a t e d f o r the R u t l a n d and Hot Sands swimmers. The Ogopogo swimmers, e s p e c i a l l y the o l d e r o n e s , were c o n - ce rned w i t h c o m p e t i t i o n and not f r o l i c i n g and so i n t h e i r case the d i s c r e p a n c y between maximum and minimum exposure depended on the f r e q u e n c y o f swim mee t s . One o f the i n t r o d u c t o r y hypotheses was t h a t i n c i d e n c e o f i l l n e s s was h i g h e r amongst l a k e swimmers. The most c o n c i s e 68 r e s u l t s u p p o r t i n g the h y p o t h e s i s was the i n c i d e n c e o f o t i t i s e x t e r n a and a l t h o u g h p e r c e n t a g e s f rom T a b l e V I I I i n d i c a t e the i n c i d e n c e a t Ogopogo to be f a r g r e a t e r than a t Hot Sands the c a l c u l a t i o n i n T a b l e XI I d e s c r i b e d the two l o c a t i o n as hav ing a s u r p r i s i n g l y c l o s e i n c i d e n c e i n terms of wa te r e x p o s u r e . I had assumed t h a t the two l a k e groups would e x h i b i t c o n c u r r i n g i l l n e s s p a t t e r n s f o r each c a t e g o r y ' s not j u s t o t i t i s e x t e r n a . Aga in from Tab l e XI I t h i s was e v i d e n t l y not the case f o r upper r e s p i r a t o r y i n f e c t i o n s or g a s t r o e n t e r i t i s . The Ogopogo i n c i d e n c e s per 1000 pe rson hours exposu re were even lower than i n c i d e n c e s f o r the same a i l m e n t s a t R u t l a n d . T h i s c o n t r a d i c t i o n o f e x p e c t a t i o n s may be e x p l a i n e d by two p o s s i b i l i t i e s . The c h l o r i n a t e d poo l w a t e r , wh ich i s r e c y c l e d f o r s e v e r a l days b e f o r e r e n e w a l , may ha rbour v i r u s e s not p r e v a l e n t i n the c o n t i n u a l l y moving l a k e w a t e r . A l s o the Ogopogo swimmers may deve l op an immuni ty to some o f the i n - f e c t i o u s s t r a i n s o f g a s t r o e n t e r i t i s and upper r e s p i r a t o r y v i r u s e s . An i n c r e a s e d r e s i s t a n c e would e x p l a i n the lower i n c i d e n c e . o f O f those Ogopogo swimmers who d i d s u f f e r i n f e c - t i o n s , a t t a c k was not c o n f i n e d to one age b r a c k e t o r new members. There were s i x new members i n 1972 but even the y o u n g e s t had l e a r n e d to swim i n the l a k e i n y e a r s p r e v i o u s and perhaps they too had deve loped i m m u n i t y . When compared w i t h the Hot Sands swimmers , R u t l a n d swimmers e x h i b i t e d l ower i n c i d e n c e s per 1000 pe rson hours UJ cr 40.0 ID 00 o Q_ X LU GO rr 30.0 Z> O X o CO fr LU 20.0 Q_ O O o \ LU O 10.0 z: LU Q O z: ILLNESS INCIDENCE PER 1000 PERSON HOURS EXPOSURE JULY and AUGUST 1972 • RUTLAND M HOT SANDS §1OGOPOGO J Z 1 Upper Respiratory Otitis Externa Infections ILLNESS CATEGORY FIGURE 10 Gastroenteritis Shistosomiasis Conjunctivitis en T a b l e XI I I l l n e s s I n c i d e n c e per Thousand Pe r son Hours Swimming Exposure _. Ju.-ly and lu'g'u.si§_1 9 7 2 _ L o c a t i o n Upper R e s p i r a t o r y O t i t i s E x t e r n a G a s t r o e n t e r i t i s Sh i s tos.omias.is. C o n j u n c t i v t i s R u t l a n d Poo l 25 .538 .672 4 .032 2.688 Hot Sands Beach 39 .832 17 .820 11 .530 10 .482 -- Ogopogo A q u a t i c Poo l 7.142 16 .484 1 .648 1 .099 -- J Observed I l l n e s s x 1000 I ( # i n G roup ) (M in Swim Hrs Per Week)(Weeks Exposed) o Ta-ble XIII S ta t i s t i ca l Analysis: Comparison of Weekly I l lness Incidence for Chlorinated Pool and Lake Swimmers Paired "t" tests ' ! I l lness Comparison of Chlorinated Pool and Lake Swimmers Data from Tables VIII and XXI H 0 : d < 0 Hi: d > 0 •• a: ONE TAIL 1. Rut!and Il lnesses vs. Hot Sands a. Upper respiratory infections b. Gastroenterit is c. Ot i t i s Externa n = 8 d.f. = 7 "t" = 1 .895 a " t n c a l c " - 4 1 6 .•. ACCEPT H0 n = 8 d .f . = 7 "t" = 1.895 a " t M c a l c = 1 ' 7 9 8 . * . ACCEPT H0 2. Rutland Il lnesses vs. Ogopogo n = 7 d . f . = 6 n = 7 d . f . = 6 "t " = 1.943 a "t" = 1.943 a " ' " c a l c = 2 - 4 2 5 M t " c a l c = - 5 9 9 2 .'. REJECT H o . * . ACCEPT Ho S i g n i f i c a n t d i f f e r e n c e i n i n c i d e n c e o f u p p e r r e s p i r a - t o r y i n f e c t i o n s b e t w e e n R u t l a n d a n d O g o p o g o sw i mme r s . 3. Hot Sands Il lnesses vs. Ogopogo n = 7 d . f . =6 n = 7 d . f . = 6 n = 7 d . f . = 6 "t" = 1 .943 a "t" = 1.943 a " t " = 1.943 a M t " c a l c = 3 - 3 5 5 "*"calc " 2 - 4 1 3 M t " c a l c = - 0 5 5 . • . ACCEPT Ho . • . ACCEPT H0 . - . ACCEPT Ho S i g n i f i c a n t d i f f e r e n c e b e - t w e e n l a k e s w i m m e r s S i g n i f i c a n t d i f f e r e n c e b e - t w e e n l a k e s w i m m e r s 72 exposure i n a l l c a t e g o r i e s e x c e p t c o n j u n c t i v i t i s . However when the upper r e s p i r a t o r y and g a s t r o e n t e r i t i s i n c i d e n c e s o f the two s i t e s were compared on a week l y b a s i s u s i n g p a i r e d one t a i l e d " t " t e s t s the d i f f e r e n c e s measured were not s i g - n i f i c a n t ( Tab l e X I I I ) . In o t h e r w o r d s , f o r upper r e s p i r a t o r y a i l m e n t s and g a s t r o e n t e r i t i s the week ly p e r c e n t a g e d i f f e r e n c e s were s m a l l enough to be a c c e p t e d by a " t " t e s t but the t o t a l d i f f e r e n c e s f o r the summer were s i g n i f i c a n t i n terms o f pe rson hours e x p o s u r e . G e n e r a l l y the r e s u l t s i n d i c a t e t h a t Hot Sands swimmers s u f f e r e d the h i g h e s t i n c i d e n c e per 1000 pe rson hours exposure f o r each c a t e g o r y excep t c o n j u n c t i v i t i s w h i l e Ogopogo swimmers e x p e r i e n c e d the l o w e s t i n c i d e n c e o f the g a s t r o e n t e r i c and upper r e s p i r a t o r y i l l n e s s e s . OTISIS EXTERNA AS A SWIMMING RELATED PROBLEM Ps. aeruginosa i s the c a u s a t i v e o rgan i sms most o f t e n a s s o c i a t e d w i t h o t i t i s e x t e r n a (Ha rdy , 1954 ; W r i g h t , 1974) and as was r e c o r d e d e a r l i e r t h i s p o t e n t i a l pathogen was p r e s e n t i n the l a k e and c r e e k s but not i n the c h l o r i n a t e d p o o l . I do not have enough e v i d e n c e to v e r i f y a c o r r e l a t i o n between the q u a n t i t a t i v e p r e sence o f pseudomonas and the i n c i d e n c e of o t i t i s e x t e r n a but the l i t e r a t u r e l e n d s s u p p o r t to the p r o b a b i l i t y t h a t Ps. aeruginosa i s , a t l e a s t , a s e conda r y 73 e t i o l o g i c a l ! agent o f the ear prob lems wh ich f o r y e a r s have a f f l i c t e d Okanagan swimmers. I f one were to be sudden l y immersed i n wa te r d e n s e l y c o n t a m i n a t e d w i t h P s . aeruginosa an ear i n f e c t i o n would not d e v e l o p . A s e r i e s o f changes must o c c u r to the ear c ana l p r i o r to i n f e c t i o n and these changes are r e l a t e d to the f r e - quency o f wa te r e x p o s u r e . The r e s i d e n t b a c t e r i a l f l o r a o f a h e a l t h y ear c ana l isSGram p o s i t i v e ( W r i g h t , 1974) and does not v a r y w i t h g e o g r a p h i c l o c a t i o n , sex o r season ( L i n d s a y , 1 9 5 8 ) . The cana l has an o i l y a c i d i c c o a t i n g r e l e a s e d f rom sebaceous g l a n d s and t h i s c o a t i n g a c t s as a mechan i c a l b a r r i e r and b a c t e r i o c i d a l agent a g a i n s t p e n e t r a t i o n by m i c r o - o r g a n i s m s ( C a r r , 1 9 6 1 ) . When the cana l i s exposed f r e q u e n t l y to wate r the e p i t h e l i a l l i n i n g i s d i s r u p t e d , d u c t s become p l u g g e d , l i p i d s a re removed ( S e n t u r i a , 1954) and the pH becomes a l k a l i n e . T h i s p r o c e s s i s has tened by warm t e m p e r a t u r e s and h igh h u m i d i t y and i t would a l s o , I p resume, be has tened by a l k a l i n e w a t e r . At t h i s s t a g e the ear i s p r e d i s p o s e d to o t i t i s e x t e r n a and i f P s . aeruginosa i s i n t r o d u c e d i n t o the ear the i n f l a m m a t r y d e r m a t i t i s o f o t i t i s e x t e r n a i s p r o d u c e d . T h i s p r o c e s s has been obse r ved to o c c u r n a t u r a l l y i n ^swimmers ( W r i g h t , 1 974) and d i v e r s ( C o b e t , 1970) and has been a r t i f i c i a l l y i nduced i n c a t s ( S e n t u r i a , 1954) and g u inea p i g s ( W r i g h t , 1 9 7 2 ) . R e c e n t l y Wr igh t (1974) h y p o t h e s i z e d t h a t the c r u c i a l p e r i o d 74 i s when the f l o r a i n the ear c ana l changes f rom Gram p o s i t i v e o rgan i sms to Gram n e g a t i v e . Gram n e g a t i v e o rgan i sms o t h e r than pseudomonas such as E. c o l i have a l s o been c o n f i r m e d as c a u s a t i v e agents but not as f r e q u e n t l y . Swimmers i n Lake Okanagan were i n c o n t a c t w i t h f e c a l c o l i f o r m and Ps. aeruginosa, bo th Gram n e g a t i v e o r g a n i s m s . A c c o r d i n g to the l i t e r a t u r e , i t i s the wate r wh ich damages the meata l s u r f a c e p r e s e t t i n g c o n d i t i o n s f o r i n f e c t i o n and a c c o r d i n g to my da ta i t i s the l a k e wate r wh i ch ha rbours the Gram n e g a t i v e pathogens r e s p o n s i b l e f o r o t i t i s e x t e r n a . The wa te r p l a y s the s e q u e n t i a l r o l e o f l e a c h i n g the l i p i d c o a t i n g and then i n t r o d u c i n g the p a t h o g e n s . I t would have been i n t e r e s t i n g to a s c e r t a i n how the i n c i d e n c e o f o t i t i s e x t e r n a c o r r e s p o n d e d w i t h the p r e sence o f Ps. aeruginosa. In T a b l e XI (page 64) pseudomonas d i d not p o s i t i v e l y c o r r e l a t e w i t h e i t h e r a i r t empe ra tu r e or the 1973 f e c a l c o l i f o r m coun ts and samples were too i n f r e q u e n t to t e s t f o r a l a g c o r r e l a t i o n . P resumab ly i f Ps. aeruginosa d i d not c o r r e l a t e w i t h f e c a l c o l i f o r m s i t would a l s o not c o r r e l a t e w i t h f e c a l s t r e p t o c o c c i . I h e s i t a t e to draw i n f e r - ences from the i n t e r m i t t e n t da ta §f> one summer. One o f the p h y s i c i a n s i n t e r v i e w e d remarked t h a t the swimmer 's ear problems o c c u r r e d g e n e r a l l y two weeks a f t e r the b e g i n n i n g of summer w e a t h e r . T h i s concu rs w i t h the da ta c o l l e c t e d i n wh ich the h i g h e s t i n c i d e n c e o f i n f l a m m a t i o n was 75 the l a t t e r h a l f o f J u l y . O t i t i s e x t e r n a does not sp read to o t h e r a reas o f the ear and so i s u s u a l l y t r e a t e d w i t h p a i n r e l i e v e r s and a u r a l g e n or g l y c e r o l . Swimmers i n the c h l o r i n a t e d p o o l , e x c e p t f o r one c a s e , d i d not d e v e l o p o t i t i s e x t e r n a . 1 Had P s . aeruginosa been p r e s e n t i n the c h l o r i n a t e d wa te r then c o n d i t i o n s would a l s o have f a v o u r e d the deve lopment o f e x t e r n a l ear d e r m a t i t i s amongst R u t l a n d swimmers. In a su r vey o f 205 C o l o r a d o c h l o r i n a t e d p o o l s , 32 were deemed " u n s a f e " because o f the q u a l i t a t i v e p r e sence o f P s . aeruginosa and of the p o o l s r e g i s t e r e d " u n s a f e " o n l y 54 .3% were p o s i t i v e f o r t o t a l c o l i f o r m s ( P a l m q u i s t , 1 9 7 3 ) . The c o n c l u s i o n f rom t h i s su r ve y was t h a t P s . aeruginosa* because o f i t s " a b i l i t y to cause o t i t i s e x t e r n a i n f e c t i o n s i n sw immers , " s h o u l d be i n c l u d e d as a b a c t e r i a l i n d i c a t o r i n the e x a m i n a t i o n o f c h l o r i n a t e d p o o l s . I agree w i t h t h i s s u g g e s t i o n and t h i n k i t s h o u l d be ex tended to i n c l u d e f r e s h wa te r b a t h i n g a r eas i f and when u s e f u l q u a n t i t a t i v e P s . aeruginosa l e v e l s can be agreed upon . I t i s the r e s p o n s i b i l i t y o f p u b l i c h e a l t h depar tments to s e t t l e on s u i t a b l e and u s e f u l p r e v e n t a t i v e s t a n d a r d s . Du r i ng 1973 the c h l o r i n a t e d wa te r o f a Kelowna mote l was checked because o f c o m p l a i n t s o f e x t e r n a l ear i n f e c t i o n s . Counts average 14/100 mis P s . aeruginosa. 76 Chap te r 7 CORRELATION OF ILLNESS INCIDENCE AND WATER QUALITY STATISTICAL ANALYSIS Product-moment c o r r e l a t i o n a n a l y s i s was used to d e s c r i b e the c o n c o m i t a n t f l u c t u a t i o n s between i l l n e s s i n c i d e n c e and wa te r q u a l i t y ( Tab l es XIV and XV ) . In the f i r s t s e r i e s i l l n e s s e s were p a i r e d w i t h b a c t e r i a l coun ts f rom the same week. Two s e t s o f b a c t e r i a l coun ts were used to c o u n t e r - b a l a n c e the f a c t t h a t w i t h i n each, swimming group d i f f e r e n t c h i l d r e n swam a t s e p a r a t e t imes t h r o u g h o u t the morn ing and a f t e r n o o n , and so were exposed to d i f f e r i n g l e v e l s o f c o n - t a m i n a t i o n . In one s e t week ly i l l n e s s i n c i d e n c e was p a i r e d w i t h the h i g h e s t f e c a l i nd ex coun ts f rom the same week. In the a l t e r n a t e s e t * i l l n e s s i n c i d e n c e was matched w i t h the c o r r e s p o n d i n g week l y mean c o u n t . Then , because o f d i f f e r e n c e s i n i l l n e s s i n c u b a t i o n p e r i o d s , two a d d i t i o n a l c o r r e l a t i o n s e r i e s were c a l c u l a t e d . I n to one s e r i e s a two day l a g was i n t r o d u c e d wh ich was i n t e n d e d p a r t i c u l a r l y f o r the g a s t r o e n t e r i t i s i n c u b a t i o n p e r i o d and 77 i n t o the o t h e r a seven day l a g was i n t r o d u c e d to a c coun t f o r upper r e s p i r a t o r y p r o b l e m s . S i n c e c o r r e l a t i o n s were on a week l y r a t h e r than a day to day b a s i s the i m p l i c a t i o n s o f i n t r o d u c i n g a l a g would depend on when d u r i n g the week i l l n e s s events o c c u r r e d r e l a t i v e to maximum f e c a l c o n t a m i n a t i o n l e v e l s . For i n s t a n c e i f i l l n e s s e s were maximum toward the end of a g i v e n week and b a c t e r i a l coun ts towards the b e g i n n i n g then the r e s u l t a n t c o r r e l a t i o n c o e f f i c i e n t s would be s i m i l a r both w i t h or w i t h o u t a two day l a g . The c o r r e l a t i o n c o e f f i c i e n t s were t r a n s f o r m e d i n t o " t " v a l u e s to t e s t whether the c o r r e l a t i o n s were p o s i t i v e l y s i g n i f i c a n t . The l e n g t h o f swimming season v a r i e d f o r l o c a t i o n s and so c o e f f i c i e n t s were based on d i f f e r e n t degrees o f f r e edom. There were two i n h e r e n t weaknesses i n the c o r r e l a - t i o n a n a l y s i s . One as ment ioned e a r l i e r was l o s s o f degrees o f f reedom due to amalgamat ion o f i l l n e s s da t a and the o t h e r weakness conce rned the r e l e v a n c e o f f e c a l c o n t a m i n a t i o n d a t a . S i n c e wate r q u a l i t y , e s p e c i a l l y f e c a l s t r e p t o c o c c i counts change s i g n i f i c a n t l y w i t h i n hours o r even w i t h i n minutes i t must be assumed t h a t the measured wate r samples were t y p i c a l o f the b a c t e r i a l d e n s i t y to wh ich i n d i v i d u a l swimmers were e x p o s e d . In a c t u a l i t y the b a c t e r i a l l e v e l encoun te r ed by a swimmer was dependent on swimming d e n s i t y , t ime of day and l o c a t i o n w i t h the poo l o r beach and even w i t h i n one sub-group 78 o f swimmers the range o f wa te r q u a l i t y v a r i e d f a r more than the t a b u l a t e d f i g u r e s i n d i c a t e . DISCUSSION OF CORRELATION ANALYSIS Does the measured d i s p a r i t y i n i l l n e s s i n c i d e n c e v a r y d e p e n d e n t l y or i n d e p e n d e n t l y w i t h the measured f l u c t u a t i o n s i n wate r q u a l i t y ? Are the p e r i o d s o f h i g h i l l n e s s i n c i d e n c e p a r a l l e l e d by h i g h e r l e v e l s o f feca l c o n t a m i n a t i o n ? The main o b j e c t i v e o f the s tudy was to answer t h i s q u e s t i o n o f c o r r e l a - t i o n between r e c r e a t i o n a l wa te r q u a l i t y and the h e a l t h o f swimmers. I f s i g n i f i c a n t p o s i t i v e c o r r e l a t i o n s were d e f i n e d i t s i g n i f i e d s u p p o r t o f the b a s i c h y p o t h e s i s . C o n v e r s e l y i f p o s i t i v e c o r r e l a t i o n s were not s t a t i s t i c a l l y r e v e a l e d then e i t h e r the h y p o t h e s i s was unsuppor t ed o r the wrong i n d i c a t o r o rgan i sms were u s e d . P o s i t i v e s t a t i s t i c a l c o r r e l a t i o n s g i v e c r e d i b i l i t y to the h y p o t h e s i s but the l a c k o f c o r r e l a t i o n s does not n e c e s s a r i l y i n v a l i d a t e the h y p o t h e s i s . I s t r e s s e d the l o g i c o f c o r r e l a t i o n s because the i n t e n d e d f u n c t i o n o f wa te r q u a l i t y i n d i c a t o r s i s o f t e n o v e r l o o k e d and wate r i s j udged to be c l e a n o r degraded on p r e - s e t u n q u e s t i o n e d s t a n d a r d s . The c o e f f i c i e n t s c a l c u l a t e d i n Tab l e XV o f f e r c o n - v i n c i n g s u p p o r t to the h y p o t h e s i s o f wa te r i n f l u e n c e d i l l n e s s e s . Feca l s t r e p t o c o c c i and i l l n e s s da ta c o n s i s t e n t l y p r o v i d e d 79 s t r o n g e r and more f r e q u e n t l y s i g n i f i c a n t c o r r e l a t i o n s than f e c a l c o l i f o r m s . There were e i g h t i n s t a n c e s i n wh ich i l l n e s s c o r r e l a t i o n s w i t h f e c a l s t r e p t o c o c c i were s i g n i f i c a n t w h i l e the c o r r e s p o n d i n g c o r r e l a t i o n s w i t h f e c a l c o l i f o r m were not s i g n i f i c a n t . R u t l a n d C o r r e l a t i o n s As the c o n t r o l g r o u p , R u t l a n d i l l n e s s i n c i d e n c e i d e a l l y would not have r e q u i r e d c o r r e l a t i o n a n a l y s i s . How- e v e r , not o n l y were f e c a l s t r e p t o c o c c i p r e s e n t but on o c c a s i o n c h l o r i n a t e d pool coun ts were h i g h e r than morn ing l a k e c o u n t s . I t was t h e r e f o r e n e c e s s a r y to de t e rm ine the c o e f f i c i e n t i n T a b l e X IV . Not one o f the c o e f f i c i e n t s was s i g n i f i c a n t but the g a s t r o e n t e n t i s c o e f f i c i e n t ( r = .599) was more s u g g e s t i v e than the o t h e r i l l n e s s e s of a p o s i t i v e c o r r e s p o n d e n c e and was c e r t a i n l y s t r o n g e r than the ze ro v a l u e e x p e c t e d . The .599 c o r r e l a t i o n was i n f a c t i d e n t i c a l to the f e c a l s t r e p t o c o c c i c o e f f i c i e n t f o r g a s t r o e n t e n t i s amongst Hot Sands swimmers. F eca l i n d i c a t o r s do not c o n f i r m the p resence o f pathogens and so the c o r r e l a t i o n o f g a s t r o e n t e n t i s and f e c a l s t r e p t o c o c c i does not i m p l i c a t e the wa te r as a d i s e a s e t r a n s m i t t e r but me re l y r e i n f o r c e s the u s e f u l n e s s o f f e c a l s t r e p t o c o c c i as an i n d i c a t o r measurement f o r c h l o r i n a t e d w a t e r . 80 R u t l a n d i l l n e s s e s were a l s o c o r r e l a t e d w i t h Ogopogo f e c a l s t r e p t o c o c c i ( Tab l e X I V ) . C o e f f i c i e n t s were r e a s s u r - i n g l y and i n s i g n i f i c a n t l y n e g a t i v e . Lake Water Q u a l i t y and I l l n e s s C o r r e l a t i o n s G e n e r a l l y the c o r r e l a t i o n s w i t h o u t l a g s y i e l d e d the s t r o n g e s t c o e f f i c i e n t s . Even when two day l a g s were s i g n i f i - c a n t , c o e f f i c i e n t s were s t i l l weaker than r e s u l t s w i t h o u t l a g s . For Ogopogo swimmers the use o f f e c a l s t r e p t o c o c c i h i g h e s t coun t s r a t h e r than o f mean coun t s y i e l d e d the s t r o n g e r c o r r e - l a t i o n w h i l e w i t h Hot Sands swimmers the r e v e r s e o c c u r r e d and use o f f e c a l s t r e p t o c o c c i mean coun ts r e j e c t e d t h r e e h y p o t h e s i s where h i g h e s t count c o r r e l a t i o n s had r e j e c t e d two . S i n c e Hot Sands swimmers were d i s p e r s e d ove r a more e x p a n s i v e a rea than the Ogopogo swimmers, mean coun ts r a t h e r than h i g h e s t were l i k e l y a more r e a l i s t i c r e p r e s e n t a t i o n o f wa te r q u a l i t y . The use o f f e c a l c o l i f o r m mean o r f e c a l c o l i f o r m h i g h e s t coun ts d i d not a f f e c t the s i g n i f i c a n c e of any t e s t s due p r o b a b l y to the f a c t t h a t d a i l y f e c a l c o l i f o r m counts were f a r more s t a b l e than f e c a l s t r e p t o c o c c i l e v e l s . With Ogopogo upper r e s p i r a t o r y i n f e c t i o n s n e i t h e r f e c a l c o l i f o r m nor f e c a l s t r e p t o c o c c i p r o v i d e d a s i g n i f i c a n t p o s i t i v e c o r r e l a t i o n whereas w i t h Hot Sands i n c i d e n c e f e c a l s t r e p t o c o c c i coun ts y i e l d e d a c o e f f i c i e n t o f .836 w i t h o u t a 81 l a g and .639 w i t h the two day l o g . The weak Ogopogo c o r r e l a - t i o n was c o m p a t i b l e w i t h the low i n c i d e n c e per 1000 pe rson hours exposure ( Tab l e XXI ) and the r e j e c t e d " t " t e s t ( T a b l e X I I I ) and a g a i n a p o s s i b l e r e f l e c t i o n o f the r e s i s t a n c e f a c t o r ment ioned p r e v i o u s l y . The s u b s t a n t i a l f e c a l s t r e p t o c o c c i c o r r e l a t i o n w i t h Hot Sands r e s p i r a t o r y d a t a was a d e c i s i v e i n d i c a t i o n t h a t the 39 .83 i n c i d e n c e per 1000 pe r son hours was d i r e c t l y a s s o c i a t e d w i t h swimming wate r q u a l i t y . In R u t l a n d the i n c i d e n c e f o r equa l exposure was 25 .53 w i t h a c o r r e l a t i o n c o e f f i c i e n t o f - . 3 1 7 , a d i s t i n c t c o n t r a s t to the beach c o r r e l a t i o n . In r e sponse to upper r e s p i r a t o r y c o r r e l a t i o n s f o r a l l l o c a t i o n s the f e c a l c o l i f o r m were p e r - c e p t i b l y l e s s s e n s i t i v e . For Ogopogo swimmers g a s t r o e n t e r i t i s was s i g n i f i - c a n t l y p o s i t i v e w i t h both f e c a l s t r e p t o c o c c i and f e c a l c o l i f o r m . The t h r e e r e c o r d e d cases o c c u r r e d not o n l y d u r i n g the same week but on the same day wh ich happened to be J u l y 2 6 , 1972 , the day o f the h i g h e s t f e c a l s t r e p t o c o c c i coun ts i s o l a t e d t h r o u g h o u t the summer (775/100 m i s ) . Two days e a r l i e r the count had been 350/100 mis wh ich was the second h i g h e s t sample r e c o r d e d . I t i s appa ren t why the Ogopogo g a s t r o e n t e r i t i s c o r r e l a t e d w i t h wa te r q u a l i t y i n s p i t e o f i t s low i n c i d e n c e per swimming hours e x p o s u r e . Wi th r e s p e c t to o t i t i s e x t e r n a a l l f e c a l c o l i f o r m c o r r e l a t i o n s were i n s i g n r i i f i c a n t . For Hot Sands swimmers the 82 f e c a l s t r e p t o c o c c i and o t i t i s e x t e r n a c o r r e l a t i o n were s i g - n i f i c a n t w i t h o u t a l a g ( r = .866) and w i t h a two day l a g ( r = .802) w h i l e f o r Ogopogo p a r t i c i p a n t s the f e c a l s t r e p t o c o c c i c o e f f i c i e n t s were s t r o n g l y p o s i t i v e ( r = .629) but not s i g n i f i c a n t l y s o . The c o r r e l a t i o n f o r Ogopogo would l i k e l y have been s i g n i f i c a n t had p r e v a l e n c e r a t h e r than i n c i d e n c e been measured . The c o r r e l a t i o n f o r o t i t i s e x t e r n a and l a k e swimmers becomes even c l e a r e r when as w i t h g a s t r o e n t e r i t i s i t i s v iewed r e l a t i v e to days r a t h e r than weeks . Tab l eaXV I (page 93) l i s t s wa te r q u a l i t y and the r e s p e c t i v e days on wh ich Ogopogo b a t h e r s r e p o r t e d ear a c h e s . A g a i n J u l y 24th and 26th were U n f a v o u r a b l e days f o r f e c a l s t r e p t o c o c c i c o u n t s and o t i t i s e x t e r n a . The f e c a l s t r e p t o c o c c i and o t i t i s e x t e r n a c o r r e l a - t i o n e x p r e s s e d c e r t a i n l y w a r r a n t s f u r t h e r i n v e s t i g a t i o n and i t i s to my knowledge the f i r s t t ime such a c o r r e l a t i o n has been d e m o n s t r a t e d . I f as i n d i c a t e d P s . aeruginosa i s the c a u s a t i v e o rgan i sm i t would be i n t e r e s t i n g to c l a r i f y what r e l a t i o n , i f a n y , pseudomonas has i n t ime and d e n s i t y w i t h f e c a l s t r e p t o c o c c i . The 1973 P s . aeruginosa coun ts d i d not c o r r e l a t e w i t h f e c a l c o l i f o r m s but then o t i t i s e x t e r n a a l s o d i d not c o r r e l a t e to a s i g n i f i c a n t degree ( r = .498 ) w i t h f e c a l c o l i f o r m . Does the p r e sence of h igh f e c a l s t r e p t o c o c c i d e n s i t y i m p l y the p r e sence o f P s . aeruginosa and i f so why? S i n c e pseudomonas i s not common to s k i n f l o r a why would 83 Ps. aeruginosa i n c r e a s e c o n j o i n t l y w i t h f e c a l s t r e p t o c o c c i ? There i s r e a l l y n e g l i g i b l e i n f o r m a t i o n on the c o r r e l a t i o n o f Ps. aeruginosa o r f e c a l s t r e p t o c o c c i w i t h o t i t i s e x t e r n a , on the b e h a v i o u r o f Ps. aeruginosa i n n a t u r a l wa te r s and on t h e r r e l a t i o n s h i p o f f e c a l s t r e p t o c o c c i w i t h pseudomonas. Because of t h i s d i r t h o f i n f o r m a t i o n or i n v e s t i g a t i o n , I cannot f u l l y e x p l a i n why the 1972 Lake Okanagan f e c a l s t r e p t o c o c c i c o r r e l a t e d w i t h o t i t i s e x t e r n a . There i s perhaps a p r o p o r - t i o n a l i t y between f e c a l s t r e p t o c o c c i and pseudomonas s i m i l a r to G e l d r e i c h ' s r a t i o i n wh ich case f e c a l s t r e p t o c o c c i coun ts would i m p l i c a t e p o t e n t i a l pseudomonas l e v e l s . Fo r f u t u r e i n v e s t i g a t i o n s on the b e h a v i o u r o f Ps. aeruginosa and i t s r e l a t i o n to o t h e r f e c a l contaminants I would recommend t h a t wa te r samples g r e a t e r than 100 mis be f i l t e r e d i n o r d e r to s e t a b a s e l i n e o f f l u c t u a t i o n s and a v o i d the l i k e l i h o o d o f ze ro r e a d i n g s . Va lue o f I n d i c a t o r Organ isms The f e c a l c o n t a m i n a t i o n i n d i c a t o r s , f e c a l s t r e p t o c o c c i i n p a r t i c u l a r , c o r r e s p o n d e d more c l o s e l y w i t h the i l l n e s s p a t t e r n s o f l a k e swimmers than w i t h the i l l n e s s i n c i d e n c e o f c h l o r i n a t e d poo l swimmers. The s t r o n g e s t c o r r e l a t i o n s were d i s p l a y e d w i t h upper r e s p i r a t o r y and o t i t i s e x t e r n a i n f e c t i o n s and then to a l e s s e r e x t e n t w i t h g a s t r o e n t e r i t i s . These 84 p o s i t i v e c o r r e l a t i o n s c o n f i r m the i n t r o d u c t o r y h y p o t h e s i s t h a t the i n c i d e n c e o f i l l n e s s amongst l a k e swimmers was a s s o c i a t e d wi th water q u a l i t y . F eca l s t r e p t o c o c c i was t h r o u g h o u t the s t u d y the more f l e x i b l e and r e s p o n s i v e i n d i c a t o r and i t was e v i d e n t t h a t f e c a l s t r e p t o c o c c i c o r r e l a t e d more p o s i t i v e l y than f e c a l c o l i f o r m w i t h a l l l a k e i l l n e s s e s and w i t h g a s t r o e n t e r i t i s f rom the R u t l a n d swimmers. However, n e i t h e r f e c a l c o l i f o r m nor f e c a l s t r e p t o c o c c i c o r r e l a t i o n s can c l a r i f y c a u s e s , and wa te r q u a l i t y , a l t h o u g h i t c o r r e l a t e d w i t h i l l n e s s was not a t any t ime a c t u a l l y proven as the d i r e c t c a r r i e r o f pathogens or the d i r e c t cause o f obse r ved i l l n e s s i n c i d e n c e . C o n t a c t w i t h crowds a t the b e a c h , the f r u i t s e a s o n , t o u r i s t i n f l u x p l u s o t h e r f a c t o r s a l s o c o n t r i b u t e d to the r o u t e s and r a t e s o f i l l n e s s i n c i d e n c e . I f r e c r e a t i o n a l wa te r q u a l i t y does i n f l u e n c e the incr ideneee o f some i l l n e s s e s then where i s the d e m a r c a t i o n p o i n t f o r f e c a l i n d i c a t o r s a t wh i ch c o r r e l a t i o n s e i t h e r become p o s i t i v e or c o n v i n c i n g l y more p o s i t i v e ? The da ta c o l l e c t e d f rom one beach f o r one season was not s u f f i c i e n t i n scope to s e t a b a s i c l i m i t . The h i g h e s t c o i n c i d i n g l e v e l s o f b a c t e r i a and i l l n e s s were d u r i n g the f o u r t h week i n J u l y when f e c a l s t r e p t o c o c c i r eached 775/100 mis and f e c a l c o l i f o r m 251/100 m i s , and f o r Hot Sands swimmers the i n c i d e n c e o f upper r e s p i r a t o r y i n f e c t i o n s was 24% and f o r o t i t i s e x t e r n a 85 1 3 % . However, s t a n d a r d s cannot be e x t r a p o l a t e d from the e v i d e n c e o f one week o f u n r e p l i c a t e d d a t a . E x t r a c t i n g the l i m i t s o f wa te r q u a l i t y a c c e p t a b i l i t y i s not o n l y a s t a t i s t i c a l t a s k but a s u b j e c t i v e one a r b i t r a r i l y dependent on the p o t e n t i a l h e a l t h r i s k s one i s w i l l i n g to a c c e p t . H , : 1. Table XIV Correlation of Fecal Indicator Counts and Illness Amongst Chlorinated Pool Swimmers r 5 0 r > 0 Positive Correlation Not Si g n i f i c a n t Significant Positive Correlation ° " .05, ONE TAIL Rutland Fecal Streptococci Counts and I l l n e s s Incidence Data from Tables VIII and XXII n • 7 d. f. - 5 " t " - 2.015 a UPPER RESPIRATORY GASTROENTERITIS CONJUNCTIVITIS "f'calc " °" 7 4 8 . • . ACCEPT Ho "f'calc * 1 - 3 0 6 ACCEPT Ho "'"calc " - 8 1 4 .-. ACCEPT H, r - -.317 r • .504 r = .342 Fecal Streptococci Uslnq Mean Counts, No Lao, n = 7 d. f. = 5 n t " a - 2.015 • f c a l c - .0499 ACCEPT,H0 " t n c a l c " '- 6 7 3 ACCEPT Ho " t " , = .659 calc ACCEPT H0 r = .022 r = .599 4 - .283 Fecal Streptococci Using Highest Counts, 2 Day Laq n = 8 d. f. ' 6 " t " a - 1.943 "'"calc • - 0 7 1 3 . ". ACCEPT H0 " t " c . l c " 1 - 3 3 2 ! . - . ACCEPT H0 . "'"calc • - 8 2 8 . - . ACCEPT H0 r * .0319 r = .512 r = .347 2. Rutland Illness Incidence Correlated with Ogopogo Fecal Streptococci, No Laq n • 7 d.f. - 5 " t " a - 2.015 Rutland fecal streptococci levels did not s i g n i f i c a n t l y correlate with Illness Incidence In previous tests. Following tests done to check p o s s i b i l i t y of coincidental positive correlation between Rutland Illness Incidence and lake fecal streptococci counts. UPPER RESPIRATORY GASTROENTERITIS : . ' - " t " • - 779 1 calc - 7 1 9 " ^ c a l c = - 2 9 4 ACCEPT H 0 ACCEPT Ho CO r - -.329 r - -.131 YcT'abd e ; ; « I I S t a t i s t i c a l A n a 1 y s i [sg > ̂  C 0 rf.eilflit i 3 nd of a €eg ad u cl n dii eait OKC! C oil nit>s;\a..n.d.. 'Id:l n.esst Amongst Lake Swimmers r < 0 P o s i t i v e Co r r ' o •; S ' •• I f l e a n t r > 0 S i g n i f i c a n t P o s i t i v e C o r r e l a t i o n a : . 0 5 , ONE TAIL Ogopogo Feca l I n d i c a t o r Counts and I l l n e s s I n c i d e n c e Data f rom T a b l e s V111 aa rid/XX11 ^ — - • • • • i i - - ' - II'-. I- a_ /-» _ . . ._ J M _ I ~ „ a n = 6 d . f . = 4 " t " = 2 . 1 3 2 a UPPER RESPIRATORY GASTROENTERITIS OTITIS EXTERNA Feca l c o l i . F e ca l s t r e p . Feca l c o l i . Feca l s t r e p . Feca l c o l i . F e ca l s t r e p . " t " n = .0243 c a l c . ' . ACCEPT H 0 r = .0124 " t " n = .783 c a l c . * . ACCEPT H 0 r = .364 " f ' c a U = 2 - 4 1 8 . ". REJECT H 0 r = .734 " f ' c a l c - 3 - 5 9 8 . * . REJECT H 0 r = .874 " t " , = 1.149 c a l c . ' . ACCEPT Ho r = .498 " t - c a l c " ] ' 6 1 7 . ' . ACCEPT H 0 r = .629 CONTINUED CO V a b iRa bxljei iXiV (Con t i nued ) b. Feca l I n d i c a t o r s Us ing Mean C o u n t s : No Lag n = = 6 d . f . = 4 " t " = 2.132 a UPPER RESPIRATORY GASTROENTERITIS OTITIS . EXTERNA Feca l c o l i . F e ca l s t r e p . Feca l c o l i . Feca l s t r e p . Feca l c o l i . F e ca l s t r e p . " t " = - 271 z c a l c " t" = 7 5 1 z c a l c - / t 5 1 ' • t " c a l c = .854 " f ' ^ T , = 3.054 c a '1: c " t , J c a l c " - 4 0 9 , , t N c a l c = 1 - 3 2 5 .•. ACCEPT H o . ' . ACCEPT H 0 . ' . ACCEPT H 0 . * . REJECT H o . ' . ACCEPT Ho . ' . ACCEPT H 0 r = - .134 r = .351 r = .393 r = .837 r = .200 r = .552 c. Feca l I n d i c a t o r s Us ing H i g h e s t C o u n t s : Two Day Lag n = = 6 d . f . = 4 " t " = 2.132 UPPER RESPIRATORY GASTROENTERITIS OTITIS EXTERNA Feca l c o l i . F e ca l s t r e p . F e ca l c o l i . Feca l s t r e p . Feca l c o l i . F e ca l s t r e p . " t » c a l c - = 1.689 M t " c a l c = - 4 8 9 " f c a l c . - .0975 " f ' c a l c • 2 ' 4 4 1 " t M c a l c = - - 0 7 1 6 " t " c a l c = 1.0132 . ' . ACCEPT H o . ' . ACCEPT H 0 . ' . ACCEPT H 0 .'. REJECT H o . ' . ACCEPT Ho . * . ACCEPT Ho r = .645 r = .238 r = .0487 r = .774 r = -. 358 r = .452 CONTINUED CO CO TabTab l e l XV (Con t i nued ) 2. Hot S a n d . F e c a l I n d i c a t o r Counts Data f rom Tab l e s XI I and XXVI I I a . F eca l I n d i c a t o r s Us ing H i g h e s t C o u n t s : No Lag n = 7 d . f . = 5 " t " = 2.015 a UPPER RESPIRATORY GASTROENTERITIS OTITIS EXTERNA Feca l c o l i . Feca l s t r e p . Feca l c o l i . Feca l s t r e p . Feca l c o l i . F e ca l s t r e p . " t " = 432 z c a l c . ' . ACCEPT H o " t " , = 2 . 3 5 2 c a l c . ' . REJECT H o M t " c a l c " « 8 3 6 . * . ACCEPT Ho " t " , = 1 .674'-c a l c . * . ACCEPT Ho " t " , = .880 c a l c . ' . ACCEPT Ho " t " . = 3.421 ca 1 c .'. REJECT H 0 r = .174 r = .725 r =-.350 r = .599 r = .366 r = .837 CONTINUED CO Tab'iTiaWL'enXiV (Con t i nued ) b. Feca l I n d i c a t o r s Us ing Mean C o u n t s : No Lag n = 7 d . f . = 5 "t " „ , = 2.015 UPPER RESPIRATORY GASTROENTERITIS OTITIS EXTERNA Feca l c o l i . F e ca l s t r e p . Feca l c o l i . Feca l s t r e p . Feca l c o l i . F e ca l s t r e p . 1 1 1 " = 117 1 c a l c ' M / . ' . ACCEPT H o r = .068 " t " a l „ = 3.400 c a l c . *. REJECT H o r = .836 M t " c a l c = K 3 2 6 . •. ACCEPT H 0 r = .608 " ' " c a l c • - 2 - 0 8 3 .*. REJECT H 0 r = .682 " f ' c a l c = - 5 8 3 . * . ACCEPT Ho r = .253 " ' " c a l c - 3 ' 8 6 5 . * . REJECT H o r = .866 c. Feca l Inc i i e a t o r Us i ng H i g h e s t C o u n t s : Two Day Lag n = 8 d.f. = 6 " r = 1 .943 UPPER RESPIRATORY GASTROENTERITIS OTITIS EXTERNA Feca l c o l i . F e ca l s t r e p . Feca l c o l i . Feca l s t r e p . Feca l c o l i . F e ca l s t r e p . " t " n = -.631 c a l c . *. ACCEPT H o r = -2.71 " t " n = 1.855 c a l c . * . ACCEPT H 0 r = .639 " t " , = 6630 c a l c . > . ACCEPT H 0 r = .271 " t " i = 1.881 c a l c . * . ACCEPT Ho r = .644 " t " n = - .220 c a l c . ' . ACCEPT H 0, r = - .098 " ' " c a l c - 2 - 9 9 8 . * . REJECT H 0 r = .802 CONTINUED o T a b l e XV (Con t i nued ) 3. F eca l I n d i c a t o r s Us ing H i g h e s t C o u n t s : One Week Lag n = 5 d . f . = 3 " t " = 2.353 Ogopogo Swimmers UPPER RESPIRATORY Feca l c o l i . Feca l s t r e p . " t M c a l c = ' ° 6 5 6 " f c a l c - = -1 .587 . ' . ACCEPT HQ . * . ACCEPT H 0 r = .0378 r = - .676 Hot Sands Swimmers UPPER RESPIRATORY Feca l c o l i . Feca l s t r e p . " f ' c a l c " - 1 ' 3 4 1 . ' . ACCEPT Ho r = -6612 " t n c a l c = - 1 ' 0 5 9 . • . ACCEPT H o r = - . 522 OTITIS EXTERNA INCIDENCE/IOOO PERSON HOURS and WEEKLY MEAN FECAL STREP ! FIGURE II 93 T a b l e XVI O t i t i s E x t e r n a and Feca l I n d i c a t o r C o r r e l a t i o n Ogopogo Pool Swimmers Date Cases o f O t i t i s E x t e r n a Feca l H i g h e s t C o l i form D a i l y Count Feca l S t r e p t o c o c c i H i g h e s t D a i l y Count J u l y 7 10 1 2 - : 11 2 8 5 16 3 75 ( J u l y 1 4 t h ) * 39 ( J u l y 1 4 ) * 17 2 4 15 18 1 0 18 20 2 0 1 23 2 9 ( J u l y 2 1 s t ) 113 ( J u l y 21 ) 24 5 8 350 25 1 2 75 26 4 72 775 31 1 0 226 Augus t 6 1 80 (August 4 th ) 113 (Aug. 4) I f coun t s not a v a i l a b l e f o r t h a t p a r t i c u l a r day c l o s e s t a l t e r n a t e sample l i s t e d . Chap te r 8 CONCLUSION Both p e r t i n e n t and tenuous r e l a t i o n s h i p s were obse r ved f rom the da ta documented. In b r i e f , l a k e swimmers e x p e r i e n c e d h i g h e r i l l n e s s r a t e s than c h l o r i n a t e d poo l swimmers and these i n c i d e n c e s c o r r e l a t e d p o s i t i v e l y i n v a r y i n g degrees w i t h f e c a l b a c t e r i a c o u n t s . These coun ts i n t u r n were c o n t r i b u t e d by s e v e r a l sou r ce s i n c l u d i n g the c r e e k s and swimmers. The e v i d e n c e g a t h e r e d , wh i ch p e r t a i n e d to one s p e c i f i c age b r a c k e t and one b e a c h , a f f i r m e d the h y p o t h e s i s t h a t i l l n e s s p a t t e r n s v a r i e d c o n c o m i t a n t l y w i t h b a c t e r i a l r e c r e a t i o n a l wa te r q u a l i t y . The l a k e water q u a l i t y , wh ich rema ined w i t h i n the bounds o f t o d a y ' s s t a n d a r d s , was t r a c e d to c o n t a m i n a t i o n f rom the c r e e k s and swimmers. Feca l c o l i f o r m and f e c a l s t r e p t o c o c c i da ta p r o v i d e d the b a s i s f o r t h i s c o n c l u s i o n . The r e l a t i v e r a t i o o f f e c a l c o l i f o r m to f e c a l s t r e p t o c o c c i a l s o a s s i s t e d i n the d i f f e r e n t i a t i o n o f a g r i c u l t u r a l and human c o n t a m i n a t i o n . The c o n t a m i n a t i o n i n M i l l C r e e k was m a i n l y f rom l i v e s t o c k o r i g i n w h i l e the l a k e wate r c o n t a m i n a t i o n was a c o m b i n a t i o n p redomina ted by f e c a l s t r e p t o c o c c i o f human o r i g i n . 94 95 Feca l s t r e p t o c o c c i was a more v e r s a t i l e i n d i c a t o r than f e c a l c o l i f o r m . I t r e p r e s e n t e d c h l o r i n e r e s i s t e n t m i c r o b i a l growth i n the R u t l a n d poo l and was s e n s i t i v e to i n c r e a s e s i n swimming d e n s i t y . Feca l s t r e p t o c o c c i was a l s o the p r e - f e r a b l e o rgan i sm i n terms of p o s i t i v e c o r r e l a t i o n w i t h l a k e i l l n e s s e s . I concur w i t h the commonly e x p r e s s e d o p i n i o n t h a t c o l i f o r m o rgan i sms a l o n e a re not a s u f f i c i e n t c r i t e r i a f o r e s t i m a t i n g r e c r e a t i o n a l wa te r q u a l i t y . The o v e r a l l i l l n e s s p a t t e r n s obse r ved were d i s t i n c t l y d i f f e r e n t f o r each o f the t h r e e g roups s u r v e y e d . The Hot Sands swimmers s u f f e r e d a s i g n i f i c a n t l y g r e a t e r i n c i d e n c e than c h l o r i n a t e d poo l swimmers o f upper r e s p i r a t o r y and o t i t i s e x t e r n a i n f e c t i o n s . The h a r d i e r Ogopogo swimmers were a f f l i c t e d c o n t i n u o u s l y w i t h o t i t i s e x t e r n a but s u f f e r e d i n - f r e q u e n t l y f rom r e s p i r a t o r y ppob lems . The f e c a l s t r e p t o c o c c i c o n v i n c i n g l y c o r r e l a t e d w i t h g a s t r o e n t e r i t i s upper r e s p i r a t o r y and o t i t i s e x t e r n a i n f e c t i o n s o f l a k e swimmers w h i l e f e c a l c o l i f o r m c o r r e l a t e d o n l y w i t h g a s t r o e n t e r i t i s . I d i d not d e t e r m i n e whether the measured conco rdance between wa te r q u a l i t y and i l l n e s s was c a u s a l l y r e l a t e d to wa te r ha rboured pathogens o r to o t h e r v a r i a b l e s such as c o n t a c t w i t h beach d e n s i t y . The i n c i d e n c e , however , o f o t i t i s e x t e r n a amongst l a k e swimmers was q u i t e st r i ik i i ing riavn"dt I d o n ' t t h i n k i t would be premature to i m p l i c a t e wa te r q u a l i t y as the v a r i a b l e r e s p o n s i b l e . The p resence o f 96 Ps. aeruginosa i n the l a k e and s u r r o u n d i n g c r e e k s was v e r i f i e d but whether t h i s o rgan i sm was the p r o v o k i n g pathogen was not p r o v e n . My r e s e a r c h e v o l v e d from the l o n g s t a n d i n g s u p p o s i - t i o n t h a t the h e a l t h of swimmers s u f f e r e d because o f exposu re to degraded o r unsa fe wate r q u a l i t y and i n essence the da ta v a l i d a t e d the h y p o t h e s i s . However i t i s e q u a l l y i m p o r t a n t to r e a l i z e t h a t the wate r q u a l i t y c o r r e l a t i o n w i t h i l l n e s s i n c i d e n c e was f a r l e s s damaging than i t p o t e n t i a l l y c o u l d have been . From the v i e w p o i n t o f most t o u r i s t s and r e s i d e n t s i t i s the i n t a n g i b l e a s p e c t s o f r e l a x a t i o n , f r e s h a i r or s u n s h i n e wh ich are memorable and not the i n c o n v e n i e n c e s r e l a t e d i n t h i s s t u d y . One cannot c h a r t the enjoyment g a i n e d from s p l a s h i n g about i n a b l u e l a k e as c o n c i s e l y as one can count b a c t e r i a grown f rom the same wa te r and the comfo r t o f i g n o r a n c e h e l p s the l a k e to f e e l as r e f r e s h i n g as i t l o o k s . For some f a m i l i e s the prob lems wh ich I o u t l i n e d i n t h i s s tudy are j u s t now b e g i n n i n g to become s e r i o u s enough to i n t e r f e r e w i t h l e i s u r e en joymen t . The i n f l u e n c e o f l iake Okanagan 's b a t h i n g wate r q u a l i t y i s s t a r t i n g to sp read beyond the immedia te r e l a t i o n s h p w i t h h e a l t h and i n t o the rea lm o f s o c i a l i m p l i c a t i o n s . In c o n s i d e r a t i o n o f both the r e s e a r c h f i n d i n g s p r e - s e n t e d and the f u t u r e p o t e n t i a l impac t o f wa te r q u a l i t y on r e c r e a t i o n a l en joyment I have two c o n c l u s i o n s o r recommenda- t i o n s to make. One s u g g e s t i o n i s t h a t a d d i t i o n a l p u b l i c 97 beaches s h o u l d be made a v a i l a b l e i n Kelowna to r e l i e v e the d e n s i t y o f the park b e a c h . The beach i t s e l f has o n l y a narrow p e r i p h e r y o f sand where sometimes c rowd ing i s so e x t - me t h e r e i s i n s u f f i c i e n t space on the sand and peop l e must occupy the b l e a c h e r s . The Hot Sands o r c i t y park beach i s the o n l y l a k e b a t h i n g a rea i n the v i c i n i t y o f Kelowna wh ich p r o v i d e s l i f e g u a r d i n g . Extended s e r v i c e s to o t h e r beaches would a l s o he lp reduce d e n s i t y . My second s u g g e s t i o n i s t h a t the B r i t i s h Co lumbia r e c r e a t i o n a l wa te r s t a n d a r d s f o r both c h l o r i n a t e d and f r e s h wa te r a reas s h o u l d be re-examined f o r t h e i r purpose and p r o - t e c t i v e v a l u e . I f c h e c k i n g wate r q u a l i t y i n t e r m i t t e n t l y f o r t o t a l o r f e c a l c o l i f o r m i s not r e l e v a n t to e x i s t e n t prob lems such as the o t i t i s e x t e r n a i n c i d e n c e d e s c r i b e d , then the s t a n d a r d s s h o u l d be changed or augmented to s u i t a b l y r e p r e s e n t r e c r e a t i o n a l wa te r q u a l i t y . •B I B L I 0 6 R A P H Y A l o c k , F.R. 1960 . " Su rvey o f Swimming A s s o c i a t e d I n f e c t i o n s a t the Kelowna A q u a t i c Poo l and R u t l a n d P o o l . " U n p u b l i s h e d p a p e r , South Okanagan H e a l t h U n i t . Amer i can P u b l i c H e a l t h A s s o c i a t i o n . Standard Methods for Examination of Water and Waste Water." 13th E d i t i o n , New Y o r k . Ames, Wende l . 1969 . "Doub le S t anda rds f o r Swimmers . " New England Journal of Medicine* V o l . 2 8 1 , p. 52 . B a r t l e y , C , L. S l a n e t z . 1960 . "Types and S a n i t a r y S i g n i f i - cance o f Eeca l S t r e p t o c o c c i . " American Journal of Public Health* V o l . 5 0 , pp . 1545-1552 . C a m p b e l l , J . J . Oc tobe r 1 0 , 1972 . P e r s o n a l c o m m u n i c a t i o n , Dep t . o f M i c r o b i o l o g y , The U n i v e r s i t y o f B r i t i s h Columbi a . Canada , B r i t i s h Co lumb ia Okanagan B a s i n Agreement . June 1972 . P r e l i m i n a r y Study Data - B u l l e t i n No. 2. Water Quality of the Okanagan Basin. F i n l a y P r i n t i n g , Ke l owna , B . C . , 4 p. Canada ,BBri:tishC66iliumb\i.a Okanagan B a s i n Agreement . June 1972 . P r e l i m i n a r y Study Data - B u l l e t i n No. 4 . Land Use and Water Demand. 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Chap te r 5, " D i s e a s e s T r a n s m i t t e d f rom Person to P e r s o n , "Preventive Medicine and Public Health*" 9 th E d i t i o n , M e r i d i t h P u b l i s h i n g C o . , New Y o r k , 1070 p. S e n t u r i a , B . H . , C. C a r r u t h e r s . 1954. " P r o p h i l a x i s o f E x t e r n a l O t i t i s . " The Annals of Otology, Rhinology and Laryngology, V o l . L X I I I , No. 1, pp . 97-100 . S e n t u r i a , B . H . , F .M. L i ebman . 1956. " E v a l u a t i o n o f F a c t o r s Which may be o f Impor tance i n the P r o d u c t i o n o f E x t e r n a l Ear I n f e c t i o n s . " J. of Invest. Derm., Vol . 2 7 , pp . 291-317 . South Okanagan H e a l t h U n i t , U n p u b l i s h e d P a p e r . 1971 . " South Okanagan F e c a l ' C o l i f o r m P r o j e c t , P e n t i c t o n . " O p p o r t u n i t y f o r Youth Programme, 51 p. S t e v e n s o n , A . 1953 . " S t u d i e s o f B a t h i n g Water Q u a l i t y and H e a l t h . " A.JJp.H., V o l . 4 3 , pp . 529-538. S u t t e r , V . L . , V. H u r s t , C. Lane . 1 967 . " Q u a n t i f i c a t i o n o f Ps. aeruginosa i n Feces o f H e a l t h y Human A d u l t s . " Health Lab Science, V o l . 4 , No. 4 , pp . 245-249 . T e n n a n t , A . D . , J . A . P. B a s t i e n . 1971 . " B a c t e r i o l o g i c a l Water Q u a l i t y S t u d y , G a t i n e a u Park L a k e s , " B a c t e r i o l o g i c a l H a b o r a t o r i e s Water P o l l u t i o n C o n t r o l D i r e c t o r a t e , Env i ronment Canada , Repor t N o . : OR 7 1 - 3 , 169 p. 1 02 W e i n s t e i n , S. O c t . 2 9 , 1972 . P e r s o n a l C o m m u n i c a t i o n , B i o q u e s t C o c k e y s v i 1 1 e , M a r y l a n d . W r i g h t , D o n a l d , M a j o r i e , D i n e e n . 1972 . "A Model f o r the Study o f I n f e c t i o u s O t i t i s E x t e r n a . " Arch Otolaryng., V o l . 9 5 , pp . 243-248 . W r i g h t , D o n a l d , J . A l e x a n d e r . 1974 . " E f f e c t o f Water on B a c t e r i a l F l o r a o f Swimmers 1 Ear •." Arch otolaryng., Vol . 9 9 , pp . 15-18 . APPENDIX 1 HEALTH BRANCH PROVINCE OF B . C . RECOMMENDED.WATER • QUALITY STANDARDS P u b l i c Swimming P o o l s (1968) 6 .04 Water sample f rom p o o l s f o r b a c t e r i o l o g i c a l e x a m i n a t i o n s h a l l be taken a t a t ime when the pool i s i n use a t a p o i n t near the o u t l e t o f the swimming-pool and a t such a d d i t i o n a l s a m p l i n g p o i n t s as may be s e l e c t e d to i n d i c a t e the q u a l i t y o f the wate r i s be ing m a i n t a i n e d t h r o u g h o u t the sw imming-poo l . Not more than 15 per cen t o f any s e r i e s o f s a m p l e s , nor more than two c o n s e c u t i v e samples i n any s e r i e s o f s a m p l e s , t aken a t l e a s t one week a p a r t , s h a l l show the p resence o f o rgan i sms o f the c o l i f o r m group i n any o f the f i v e 1 0 - m i l l i l i t r e p o r t i o n s examined . 6 .04 A l l b a c t e r i o l o g i c a l t e s t s s h a l l be made i n acco rdance w i t h the p r o c e d u r e recommended i n the l a t e s t e d i t i o n o f " S t a n d a r d Methods f o r the E x a m i n a t i o n o f Water and Waste - w a t e r , " p u b l i s h e d by the Amer i can P u b l i c H e a l t h A s s o c i a t i o n . 6.06 The pH (hydrogen i o n c o n c e n t r a t i o n ) t e s t s h a l l be made on the pool wa te r a t l e a s t once eve ry day the poo l i s i n o p e r a t i o n . A pH v a l u e o f not l e s s than 7.4 s h a l l be m a i n t a i n e d . R e c r e a t i o n Waters (1969) The s t a n d a r d s s t i p u l a t e t h a t b a t h i n g , swimming and r e c r e a t i o n a l a reas i n c l e a r wa te r l a k e s and upper a reas o f s t reams s h o u l d have median l e s s than 240 o rgan i sms per 100 m i l l i l i t e r s f o r t o t a l c o l i f o r m s and t h a t t h i s v a l u e s h o u l d not be exceeded i n more than 20% o f the s a m p l e s . 1 03 104 R e c e n t l y , the H e a l t h Branch has a d o p t e d , f o r p r i m a r y c o n t a c t r e c r e a t i o n a l w a t e r s , a f e c a l c o l i f o r m s t a n d a r d o f a l o g mean o f 200 o rgan i sms per 100 m i s ; w i t h not more than 10% o f the t o t a l samples d u r i n g any 30 day p e r i o d to exceed 400 o rgan i sms per 100 m i s . T h i s s t a n d a r d i s based on a minimum o f not l e s s than 5 samples f o r any 30 day p e r i o d o f the r e c r e a t i o n a l s e a s o n . APPENDIX 2 LIMNQLOGICAL INFORMATION, 19721 Lake Okanagan Mean Annual Tempera ture 46°F Average Annua l P r e c i p i t a t i o n 1 2 . 2 " Average Net I n f l o w 355 ,000 a c r e f e e t pH Range 7.4 - 8 .6 pH Mean 8 .0 Streams pH Mean F l ow C . F . S . Max. F l ow C . F . S . N i t r a t e N mg/1 B .O.D. Average T o t a l C o l i forms Medi an MPN Feca l C o l i forms Log Mean M i l l , Creek J8.C0 • 40 178 3.5 1 .6 » 5,420 <1 ,122 B r a n d t ' s Creek 8.0 2.9 19 .8 .5 287 >169,000 < 980 M i l l C r e e k : H i g h e s t f l o w i s d u r i n g J u l y and A u g u s t , 1972 U n u s u a l l y h i g h run o f f B r a n d t ' s C r e e k : H i g h e s t f l o w i s d u r i n g Ma r ch . L y n c h , 1972 , Okanagan Bas in S tudy B u l l e t i n 2 , Okanagan B a s i n S tudy B u l l e n t i n 4 . 1 05 APPENDIX 3 v T a b l e s XVI I - XXI I 106 Table XVII Lake Okanagan Air and Water Temperatures, 1972 A i r : Highest Daily Temperature °F Water.: Surface Temperature °F Date Highest Air Temperature Water Temperature July 1 72 2 79 3 82 59° 4 87 60° 5 91 6 88 7 80 8 65 9 64 10 71 11 72 12 63 60° 13 76 62° 14 76 15 81 16 82 17 88 68° 18 70 60° 19 80 20 80 63° 21 81 63° 22 85 23 83 24 87 25 83 62° 26 86 67° 27 88 67° 28 91 67° 29 87 30 89 31 91 69° Aug. 1 86 70° 2 85 3 88 70° 4 91 5 91 1 C 95 7 97 72° 8 95' 72° 9 92 74° 10 91 72° 11 83 72° 12 81 • 13 81 14 73 70° 15 73 69° Date Highest Air Temperature Water Temperature Aug. 16 76 70° 17 66 18 72 19 79 20 87 21 75 22 76 68° 23 80 68° 24 85 25 86 26 87 27 89 1 28 93 72° 29 89 30 72 31 75 Sept. 1 76 2 79 3 82 4 80 5 75 6 65 7 70 8 63 64° 9 63 10 65 11 , 67 12 73 58° 13 74 ' 1 4 80 15 80 16 71 17 63 18 61 19 60 20 62 21 62 22 53 60° 23 56 24 48 25 54 26 56 56° 27 49 .28 47 29 60 58° 30 64 o 108 T a b l e XV I I I Water pH of Samp l ing S i t e s B r a n d t ' s Creek Mouth M i l l Creek Date pH Date pH J u l y 4 , 1972 9.1 J u l y 4 , 1972 8.5 11 I !J. 8.0 1 1 , 7.5 1 8 , "• 8.7 1 8 , " 8.6 2 7 , 8.6 2 7 , 8.5 A u g . 4 , 7.8 Aug . 4 , 8.1 1 1 . " 6 .8 1 1 , 8.4 2 5 , 8.1 2 5 , 8.4 S e p t . 3, 8.4 S e p t . 3, " 8.2 8 , " 8 .0 8 , " 7.9 2 0 , 8.4 20 8 .3 R u t l a n d Pool Ogopogo Pool Date pH Date pH J u l y 2 2 , 1972 8.4 J u l y 4 , 1972 8.4 2 7 , 8.1 1 1 , " 7.2 Aug . 6 , " 7.4 1 8 , " 8 .0 1 1 , " 6 .9 2 7 , " 8 .3 2 3 , 11 6.8 Aug . 4 , 7.9 S e p t . 3, " 8.4 1 1 , " 8.3 8 , " 7.1 2 5 , " 7.6 1 7 , " 8.6 S e p t . 3 , " 8.2 8 , ( 8 . 4 ) 2 0 , " 8.4 2 4 , 8.1 1 09 TABLE XIX Ogopogo P o o l : F eca l i n d i c a t o r c o u n t s : s u r f a c e v s . sed iment wate r s a m p l e s . Date August 1972 S u r f a c e Feca l C o l i f o r m Sediment Feca l C o l i f o r m S u r f a c e Fe ca l S t r e p t o c o c c i Sediment Feca l S t r e p t o c o c c i 8 0 40 8 88 9 8 36 1 02 64 10 4 44 18 35 11 14 52 12 72 14 4 14 206 6 15 12 0 9 1 16 0 5 6 0 17 6 0 0 2 18 0 0 35 68 21 0 8 12 1 24 22 12 150 23 0 0 - Dep th : 6 f e e t to 9 f e e t . Table XX Fecal Indicator Counts: Ogopogo Pool vs. Hot Sands Date Ogopogo Hot Sands Ogopogo Hot Sands Fecal Coliform Fecal Coliform Fecal Streptococci Fecal Streptococci June 1972 4 4 8 5 0 2 7 0 0 9 14 0 12 12 2 13 40 10 15 2 32 17 100 126 20 16 2 21 7 10 22 7 16 23 30 24 26 2 18 27 0 2 28 1 4 August 1 2 14 0 50 2 10 27 3 22 10 110 16 4 80 6 7 20 18 21 135 8 0 34 8 62 9 8 1 102 94 10 4 16 18 35 11 14 22 12 82 14 4 0 206 4 15 12 0 9 16 0 4 6 57 17 6 0; - 18 0 0 35 9 21 0 20 12 338 22 0 2 12 0 23 100 . 0 0 2 24 • 0 1 25 2 8 37 45 28 18 12 8 62 30 10 4 0 21 31 0 0 1 0 Table XXI Weekly Il lness Incidence per 1000 Person Hours Swimming Expo July and August 1972 Rutland Swimmers Date Upper Respiratory Ot i t i s Externa Gastroenteritis Conjunctivitis Shistosomiasis July 1st wk 2nd wk 3rd wk 4th wk Aug. 1 2 3 4 17.23 57.66 .16.66 11.10 8.33 45.83 40.00 6.66 4.16 12.5 4.16 6.66 6.66 4.16 4.16 13.3 - Hot Sands Swimmers July 1 2 3 4 Aug. 1 2 3 4 10.76 34.30 47.63 79.33 28.96 43.46 10.73 21 .16 42.3 14.5 29.0 16.16 21.16 29.0 29.0 - 5.43 32.3 5.30 29.0 Ogopogo Swim Team July 1 2 3 4 Aug. 1 2 3 3.84 15.38 11 .54 11 .54 7.77 38.60 15.38 30.78 61 .54 3.86 11 .54 - 7.69 Table XXII Ogopogo Fecal Indicator Counts Used for Product Moment Correlations Weekly Highest Total : Total of highest dai ly counts for f ive days in a given week. Weekly Mean: Arithmetic mean of a l l counts in a given week including zero counts. DATE WEEKLY HIGHEST TOTAL WEEKLY MEAN Ogopogo Fecal Coliform Ogopogo Fecal Streptococci Rutland Fecal Streptococci Ogopogo Fecal Coliform Ogopogo Fecal Streptococci Rutland Fecal Streptococci July • 2nd wk 127 111 3 31.286 24.428 1.0 3rd wk 13 142 0 1 .875 14.700 0 4th wk 339 1 560 38 27.625 133.334 6.33 August i 1st wk 172 603 107 24.428 55.714 26.75 2nd wk 168 758 173 16.667 77.134 34.60 3rd wk 122 135 32 8.714 9.650 8.00 4th wk 242 267 54 16.500 —L 23.50 9.00 I

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