Getting More Than You Expected at the Beach

A day at the beach can net you more than fun and mild sunburn. You can also come home with gastroenteritis, swimmer’s ear and conjunctivitis. Earlier this month, researchers from UC Riverside and UC Irvine published a study calculating the health care burden associated with swimming in polluted waters at two popular Southern California beaches. The study is forthcoming in the Journal of Environmental Management (see the “Articles in Press” link).

Their analysis indicates that $3.3 million per year is spent on health-related expenses, based on lost wages and medical care, to treat more than 74,000 incidents of stomach illness, respiratory disease and eye, ear and skin infections caused by exposure to the polluted waters in a typical year. Additional costs for purchases of over-the-counter medicine and losses to the local tourism industry (“surf Newport Beach – get the crud” really brings people out) were not included in the analysis, so the $3.3 million figure is undoubtedly on the low side.

An interesting aside was that both beaches had water quality well within accepted levels, as defined by EPA and the state of California standards. The study also noted that bacteria levels in these coastal waters that achieved water quality standards would be associated with health cost greater than $7 million per year.

“The ultimate value of this research is for policymakers, who are well aware of the substantial costs involved with cleaning up water pollution, but need to know the other side of the equation – the costs associated with not cleaning up the water,” said UC Irvine’s Ryan Dwight, one of the authors of the study.

Of course there’s a problem here, if the costs are not calculated properly. The costs for adequate water treatment are going to be well in excess of $3.3 million (this probably wouldn’t cover the design costs for new wastewater treatment plants). This doesn’t take into account that a decision maker could look at these data and conclude that the disease burden, on a cost basis, is acceptable. It could lead a decision maker to the conclusion that additional water treatment isn’t warranted. I can hear it now, “we’re talking about the runs and earaches, not cancer and birth defects!”

Risk-based analyses such as this one are prone to be misused, if all stakeholders are not at the table when making the decisions. It’s possible that in the larger scheme of things, all parties involved (local governments, state governments, tourist-related industries, hospitals and public health officials, beach-front residents, beach users and surfers), might concur that 74,000 disease episodes and $3.3 million/year in health care costs represent acceptable risks associated with a day at the beach under the current water quality standards. But that has to be a group decision. Once again, I’ll say that we need to be absorbing the lessons from books such as “Understanding Risk: Informing Decisions in a Democratic Society” published in 1996 by the National Academy of Sciences (NAS), to anchor risk and impact analyses within democratic institutions.

The researchers ended their work with a call for further studies to fully understand the economic impact of coastal water pollution on tourism, recreational values and other related factors. Of course they did. That’s what researchers do. However, developing the total cost analysis associated with coastal water quality is merely a detail. The real work, where the research is really needed, is how to better integrate this kind information into decision making processes.