Water Sanitation Health

Guidelines for safe recreational water environments
Volume 1 : Coastal and fresh waters

Executive summary

Algae and cyanobacteria in fresh water

Many species of freshwater algae may proliferate quite intensively in eutrophic (i.e., nutrient-rich) waters. However, they do not form dense surface scums or “blooms,” as do some cyanobacteria. Toxins they may contain therefore are not accumulated to potentially hazardous concentrations. For this reason, most adverse health impacts from recreational use of fresh waters have been associated with cyanobacteria rather than with freshwater algae.

Progress in analytical chemistry has enabled the isolation and structural identification from toxic cyanobacteria of three neurotoxins (anatoxin-a, anatoxin-a(s) and saxitoxins), one general cytotoxin, which inhibits protein synthesis (cylindrospermopsin), and a group of toxins termed microcystins (or nodularins, found in brackish waters), which inhibit protein phosphatases. Most of them have been found in a wide array of genera, and some species contain more than one toxin.

Allergic or irritative dermal reactions of varying severity have been reported from a number of freshwater cyanobacterial genera (Anabaena, Aphanizomenon, Nodularia, Oscillatoria, Gloeotrichia) after recreational exposure. Bathing suits and particularly wet suits tend to aggravate such effects by accumulating cyanobacterial material and enhancing disruption of cells and liberation of cell content. It is probable that these symptoms are not due to recognized cyanotoxins but rather to currently largely unidentified substances. In contrast to dermal contact, uptake of cyanobacteria though ingestion or aspiration involves a risk of intoxication by cyanotoxins. Most documented cases of human injury through cyanotoxins involved exposure through drinking-water, and they demonstrate that humans have become ill — in some cases seriously — through ingestion or aspiration of toxic cyanobacteria. Symptoms reported include abdominal pain, nausea, vomiting, diarrhoea, sore throat, dry cough, headache, blistering of the mouth, atypical pneumonia and elevated liver enzymes in the serum, as well as hay fever symptoms, dizziness, fatigue, and skin and eye irritations.

Health impairments from cyanobacteria in recreational waters must be differentiated between the chiefly irritative symptoms caused by unknown cyanobacterial substances and the potentially more severe hazard of exposure to high concentrations of known cyanotoxins, particularly microcystins. A single guideline value therefore is not appropriate. Rather, a series of guideline values associated with incremental severity and probability of health effects is defined at three levels.

For protection from health outcomes not due to cyanotoxin toxicity, but rather to the irritative or allergenic effects of other cyanobacterial compounds, a guideline level of 20 000 cyanobacterial cells/ml (corresponding to 10 µg chlorophyll-a/litre under conditions of cyanobacterial dominance) can be derived. A level of 100 000 cyanobacterial cells/ml (equivalent to approximately 50 µg chlorophyll-a/litre if cyanobacteria dominate) represents a guideline value for a moderate health alert in recreational waters. The presence of cyanobacterial scum in swimming areas represents the highest risk of adverse health effects, due to abundant evidence for potentially severe health outcomes associated with these scums.

Because adequate surveillance is difficult and few immediate management options are available (other than precluding or discouraging use or cancelling water sports activities such as competitions), provision of adequate public information is a key short-term measure. Medium- to long-term measures are identification of the sources of nutrient (in many ecosystems phosphorus, sometimes nitrogen) pollution and significant reduction of nutrient input in order to effectively reduce proliferation not only of cyanobacteria, but of potentially harmful algae as well.