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Table 2 Summary of epidemiological studies investigating recreational exposure to cyanobacteria

From: Recreational and occupational field exposure to freshwater cyanobacteria – a review of anecdotal and case reports, epidemiological studies and the challenges for epidemiologic assessment

Country; year study conducted; study author/s; reference

Study design

Main outcomes reported

Study size (n)

Odds ratio (95% confidence interval)

UK, 1990 Philipp [86]

Cross-sectional

No statistically significant findings

246

 

UK, 1990 Philipp & Bates [87]

Cross-sectional

No statistically significant findings

363

 

UK, 1990 Philipp et al [88]

Cross-sectional

No statistically significant findings

246

 

Australia, 1992 El Saadi et al [89]

Case-control

No statistically significant findings

Approx. 48 (subjects reporting recreational exposure)

 

Australia, 1995 Pilotto et al [90]

Prospective cohort

Increased symptoms at 7 days following exposure to more than 5,000 cyanobacterial cells/mL for >1 hour vs non-bathers

852 (total)

338 (no prior exposure or symptoms)

1.3 (0.7–2.6)

3.4 (1.1–10.8)

Australia & USA, 1999–2002 Stewart et al [91]

Prospective cohort

Increased reporting of mild respiratory symptoms and any symptom at 3 days following exposure to cyanobacteria cell surface area >12 mm2/mL vs <2.4 mm2/mL

1,331 (total)

1,137 (no prior symptoms)

1,149 (no prior respiratory symptoms)

1.7 (1.0–2.9) (any symptom)

2.1 (1.1–4.0) (respiratory symptoms)