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Submitted:
26 December 2023
Posted:
27 December 2023
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Toxins procuding genera | Toxin category | Toxin classification (based on effects on humans and animals) | WHO guideline value in recreational watera | References |
---|---|---|---|---|
Anabaenopsis, Aphanizomenon, Dolichospermum (formerly, Ananbaena), Mycrocystis, Oscillatoria, Phormidium, Planktothrix | Microcystins | Hepatotoxins | 24 µg/L | [70,71] |
Nodularia, Nostoc | Nodularins | Not established | [70,71,72] | |
Aphanizomenon, Cylindrospermopsis, Dolichospermum (formerly, Ananbaena), Lyngbya, Oscillatoria, Raphidopsis, Umezakia | Cylindrospermopsin | Cytotoxins | 6 µg/L | [70,73] |
Aphanizomenon, Cylindrospermopsis, Dolichospermum (formerly, Ananbaena), Oscillatoria | Anatoxins | Neurotoxins | 60 µg/L | [74,75] |
Aphanizomenon, Cylindrospermopsis, Dolichospermum (formerly, Ananbaena), Lyngbya, Planktothrix Raphidiopsis | Saxitoxins | 30 µg/L | [70,76,77] | |
Aphanizomenon, Dolichospermum (formerly, Ananbaena), Mycrocistis, Nodularia, Nostoc | b-Methylamino L-Alanine (BMAA) | Not established | [78,79] | |
Anacystis, Dolichospermum (formerly, Ananbaena), Microcystis, Oscillatoria, Schizothrix, Synechococcus | Lypopolysaccharides | Dermatoxins | Not established | [80,81] |
Lyngbya | Lyngbyatoxins | Not established | [82,83] | |
Lyngbya, Oscillatoria, Schizothrix | Aplysiatoxins | Not established | [84] |
Author | Year | Country | Types of Recreational Water | Kingdom | Exposure route | Population | Outcome syndrome |
---|---|---|---|---|---|---|---|
Codd, G.A. 1994 ]130] |
1878 | Australia | Lake water | Cyanobacteria Nodularia spumigena | Ingestion | Several hundred livestock deaths; 1 human |
Undescribed illness in human |
Dillenberg, H.O. 1960 [131] |
1959 | Saskatchewan, Canada | Lake water | Cyanobacteria Anabaena circinalis |
Ingestion | Multiple livestock, fish, geese, dogs died >2 human events |
Gastrointestinal illness |
Griffiths 2003 [132] |
1979 | Palm Island, Australia | Potable water reservoir | Cyanobacterium Cylindrospermopsis raciborskii | - | 140 children and 10 adults hospitalized |
Hepatoenteritis, acute kidney disease and liver failure |
Hawkins 1985 [133] |
1979 | Australia | Fresh water | Cylindrospermopsis raciborskii | 138 people | Hepatoenteritis | |
Jeffery 2004 [134] |
1987 | Canada | Sea water | Pseudo-nitzschia spp. Nitzschia spp. |
Ingestion | 150 people with 19 hospitalization and 4 deaths | Gastrointestinal effects and/or neurological signs |
Texeira 1993 [135] |
1988 | Brazil | Fresh water | Chlorophyll-a | Drinkingwater from the Itaparicareservoir | 88 human fatalities and 2000 people poisoned |
|
Azevedo 2002 [136] |
1996 | Brazil | In the filtration system | Cyanobacterium | Dyalisis | 116 human cases | Headache, blurred vision, eye pain, nausea,and vomiting. Of these, 100 patients developed acute liver failure and more than half of them died |
Backer 2003 [137] |
1999 | Sarasota and Jacksonville, Florida, USA |
Sea water | Karenia brevis | Inalation | 129 adults (≥18 years) who spent time (10 min to ∼8 h; average of 71 min) on beaches during February and October 1999 | Upper and lower respiratory irritation |
Stewart 2006 [138] |
2006 | Southern Queensland and the Myall Lakes area of New South Wales, Australia; Northeast and central Florida, USA | Lake water | Phytoplankton | Ingestion | 1331 study participants (n = 216 in Florida) comprised of adults and children |
Difficulty breathing, dry and productive cough, runny nose, unusual sneezing sore throat, wheezy breathing, cutaneous, fever |
Bean 2011 [139] |
2011 | Sarasota, Florida, USA | Sea water | Karenia brevis | Inalation | 125 asthmatic patients residents of the Sarasota, Florida for ≥6 months | |
Kirkpatrick 2011 [140] |
2011 | Sarasota, Florida, USA | Sea water | Inalation | 52 participants (≥12 years) with self-report of physician-diagnosedasthma |
Increased symptoms of asthma and suppressed respiratory function, suppression for several days after 1 h of exposure to the brevetoxin aerosols | |
Li 2012 [141] |
2011 | China | Sea water | Amphidoma languida, Azadinium spinosum, Protoceratium reticulatum, Lingulodinium polyedrum, Gonyaulax spinifera, Dinophysis spp, Prorocentrum lima, Dinophysis spp | Consumption of contaminated shellfish | More than 200 people | Diarrheic shellfish poisoning: diarrhea, nausea, vomiting, and abdominal pain |
Giannuzzi 2011 [142] |
2011 | Uruguay | Fresh water | Cyanobacteria | Drinking water | Human acute intoxication |
Intoxication |
Levesque 2014 [143] |
2014 | Quebec province, Canada | Lake water | Cyanobacteria | 267 families consisting of 466 subjects |
Gastrointestinal symptoms | |
Trevino-Garrison 2015 [144] |
2015 | Kansas, USA | Lake water | Cyanobacteria | Direct contact, 100% (7/7), ingestion, 43% (3/7), inhalation, 14% (1/7). The median time from exposure to symptom onset was 24 h, with a range of 3–48 h | 13 humans. Seven confirmed illnesses, median age 40 years | Nausea, vomiting, diarrhea, cough, sore throat, rash and liver damage |
Berdalet 2022 [145] |
2022 | Sant Andreu de Llavaneres, Catalonia, Spain |
Sea water | Ostreopsis | 16 staff of a nearby indoor-outdoor restaurant directly exposed to marine aerosols at least 8 h daily |
Malaise, runny nose, sore eyes, headaches | |
Veldee 1931 ]146] |
1930–1931 | United States | River water | Cyanobacteria Anabaena flos-aquae |
drinking water | > 6 events | Gastrointestinal illness |
Backer 2005 [147] |
2001 and 2003 | Sarasota and Manatee, Florida, USA |
Sea water | Exposure to aerosolized brevetoxins |
28 healthy lifeguards (≥18 years) who are occupationally exposed to red tide toxins during daily work activities | Upper respiratory symptoms and headache | |
Lee 2022 [148] |
2005–2017 | South Korea | Fresh water | Neurodegenerative disease outcomes including motor neuron disease, Alzheimer’s disease, and Parkinson’s disease | |||
Figgatt 2016 [149] |
2008 - 2014 | New York, USA | Fresh water | 228 hospital visits: 5.3% of them were hospitalized | |||
Wu 2021 [150] |
2008–2011 | Greater Boston area, Massachusetts, USA | Fresh water | Cyanobacteria | Human patients who visited the emergency rooms of approximately 70 Massachusetts hospitals | Gastrointestinal, respiratory and dermal illnesses | |
Hilborn 2014 [151] |
2009–2010 | USA | Lake water | Cyanobacteria | Recreational activities | 41 cases | Gastrointestinal, general, dermatologic, eye/ear, neurologic, respiratory symptoms |
Roberts 2020 [152] |
2016–2018 | USA | 366 fresh water (94%), 1 brackish, 22 unknown (6%) | Cyanobacteria, Dinoflagellates, Raphidophyceans, Diatoms | Exposure: Public outdoor area 235 (60%), Beach 63 (16%), Private residence 53 (14%), Other 57 (15%), Park 27 (7%), Unknown 22 (6%) | 389 human cases: 341 probable (88%), 14 confirmed, 34 suspected, 153 were < 18 years | Gastrointestinal 262 (67%), generalized 169 (43%), dermatologic 104 (27%), ear, nose, or throat 62 (16%), neurologic 56 (14%), cardiopulmonary 41 (11%), ophthalmologic 30 (8%), other 30 (8%), musculoskeletal 13 (3%), genitourinary 6 (2%), unknown 9 (2%). No deaths were reported |
Backer 2008 [153] |
3 days in August of 2006 | Unspecified lakes, USA | Lake water | Microcystisaeruginosa | 97 participants | Respiratory (sore throat; congestion; cough; throat irritation; eye irritation; other), dermatologic (itchy skin, red skin, hives, skin irritation, rash, other); other (earache, agitation, headache, abdominal pain, diarrhoea) | |
Backer 2010 [154] |
August 2007 | Two lakes in Siskiyou County, California, USA |
Lake water | Respiratory (sore throat; congestion; cough; throat irritation; eye irritation; other), dermatologic (itchy skin, red skin, hives, skin irritation, rash, other); other (earache, agitation, headache, abdominal pain, diarrhea) | |||
Stumpf 2022 [155] |
August 2006–January 2019 |
Sarasota and Manatee Counties, Florida, USA |
Sea water | Volunteers | Respiratory irritation conditions | ||
Diaz 2019 [156] |
Between 2005 and 2009 | 6 counties in Southwest Florida, USA |
Sea water | Karenia brevis | Emergency department (ED) visitsin patients ≥55 years | Headache | |
Tichadou 2010 [157] |
Between 2006 and 2009 | French Mediterranean coast | Sea water | French Mediterranean Ostreopsis | 47 patients | General flu-like symptoms, including headache, joint pain, vertigo, fever, fatigue, and diarrhea | |
Lavery 2021 [158] |
Between January 2009 and April 2019 | USA | Lake water | 380 records in the Commercial database and 178 records in the Medicaid database | Cough, allergy, other malaise and fatigue, headache, routine general medical examination, shortness of breath, hypertension, acute pharyngitis, and acute upper respiratory infection | ||
Abdullah 2022 [159] |
Between June 2019 and August 2021 |
5 counties in Southwest Florida, USA |
Sea water | Karenia brevis | Exposure to aerosolizedbrevetoxins | 258 participants | Respiratory tract symptoms (coughing, sneezing, sore throat,nasal congestion); neurological (headaches and dizziness); andsystemic outcomes (fever, chills, nausea) |
Mchau 2019 [160] |
December 2018 | Ukerewe Island, Tanzania |
Lake water | Phytoplankton Chlorophyceae, Cyanophyceae, Bacillariophyceae and Dinophyceae | 134 subjects (31%) used lake water, 229 (53%) used well water and 69 (16%) used treated supplied pipe water as their main source of water for drinking and other domestic uses |
432 subjects > 18 years (mean age 42) | Vomiting, diarrhea, skin irritation, eye irritation, throat irritation and stomach upset |
Vila 2016 [161] |
From June toDecember 2013 | Sant Andreu de Llavaneres,Catalonia, Spain | Sea water | Ostreopsis | 16 staff of a nearby indoor-outdoor restaurant directly exposed to marine aerosols at least 8 h daily |
Eye irritation, nose irritation, rhinorrhoea, and general malaise | |
Lavery 2021 [162] |
January 1, 2017–December 31, 2019 | USA | Lake water | Unspecified Cyanobacteria | Inhalation, ingestionor skin contact | Patients aged 18–44 years (37%) and 45–64 years (30%) | 133 respiratory (41%), 44 gastrointestinal (14%), 33 neurologic (10%), and 27 dermatologic (8%) |
Illoul 2012 [163] |
July 2009 | Beaches in Western area ofAlgiers Wilaya, Algeria | Sea water | Ostreopsis | 300 patients | Fever, rhinitis, conjunctivitis, cough and skin irritations | |
Figgatt M. 2015 [164] |
June–September 2015 | New York, USA | Fresh waters | Unspecified Cyanobacteria | Recreational activities included swimming (28 patients; 88%); wakeboarding, jet skiing, waterskiing or tubing (seven; 22%); boating (seven; 22%); wading (six; 19%); and using personalwatercraft (four; 13%) |
32 human cases, median age 24 years (2–63 years) |
Skin problems, cough, abdominal pain, diarrhea, nausea, vomiting and other symptoms (e.g. chills, muscle aches, or watery eyes), fatigue/general weakness, Sore throat, Neuroglogic (e.g., headache or seizure); no hospitalizations or deaths were reported |
Fleming 2005 [165] |
March 2003 | Sarasota, Florida, USA | Sea water | Exposure to aerosolizedbrevetoxins during red tide events | 59 persons (≥12 years) with physician-diagnosed asthma |
Respiratory symptoms and respiratory impairment |
|
Fleming 2009 [166] |
March 2005 and September 2006 | Sarasota, Florida, USA | Sea water | Exposure to aerosolized brevetoxins |
87 persons (≥12 years) with physician-diagnosed asthma |
Respiratory symptmos like cough, wheezing, shortness of breath and other like throat irritation, nasal congestion, eye irritation, headache, itchy skin, diarrhoea |
|
Hoagland 2014 [167] |
Monthly emergency department (ED) data 2005–2009 and monthly hospital inpatient data from 1999 to 2009 | 6 counties in Southwest Florida, USA |
Sea water | Karenia brevis | Emergency department (ED) visits in patients ≥55 years |
Adverse respiratory and digestivehealth effects | |
Hoagland 2009 [168] |
October 2001–September 2006 | Sarasota, Florida, USA | Sea water | Karenia brevis | Exposure to aerosolized brevetoxins |
Daily emergency department (ED) visits |
Pneumonia, bronchitis, asthma, upper airway disease UAD |
Kirkpatrick 2006 [169] |
October 1–December 31, 2001 (red tide period) and October 1–December31, 2002 (non-red tide period) |
Sarasota, Florida, USA | Sea water | Red tide | Emergency room (ER) visits | Pneumonia 31%, bronchitis 56%, asthma 44%, and upper airway disease 64% |
|
Chomerat 2022 [170] |
September 2020 and 2021 | Several beaches on the French Basque coast |
Sea water | Ostreopsis | Direct contact with water and/or after inhalation of aerosols | 674 confirmed cases | Difficulty breathing, irritations, headaches, dry cough, nose irritation, eye irritation and/or dermatitis, and general malaise |
Kirkpatrick 2010 [171] |
September 1–December 31, 2001, and thenon-bloom period during the fall of 2002, September 1–December 31, 2002 |
Sarasota, Florida, USA | Sea water | Exposure to aerosolized brevetoxins |
Number of emergency room (ER) admissions during the Florida red tide bloom |
Gastritis, duodenitis, and non-infectious enteritis and colitis (acute, chronic, unspecified, and other) |
|
Vila 2008 [172] |
Summer 2004 | Sant Andreu de Llavaneres, Catalonia, Spain |
Sea water | 62 people | Rhinorrhea (74.2%), nose irritation (66.1%), throat irritation (62.9%), coughing (59.7%), expectoration (51.6%), eye irritation (41.4%) and migraine (40.3%) | ||
Galitelli 2006 [173] |
Summers of 2003 and 2004 |
Coasts of Bari, Italy | Sea water | Ostreopsisgenus | Recreational or working activities on the beach |
28 patients ( 1 child; mean age, 38.6 years) |
Rhinorrhoea 100%; cough 43%; fever 14%; and bronchoconstriction with mild dyspnoea and wheezes 43%. Conjunctivitis 11% |
Bresciani & Durando 2007 [174] |
Summers of 2005 and 2006 | Genova and La Spezia, Italy |
Sea water | Ostreopsis ovata | 209 patients (mean age 35.9 ± 20.1 years, range 1–89 years). 43 patients seeking medical help at the emergency departments needed hospitalization | Fever (63.6%), sore throat (50.2%), cough (40.2%), and dyspnoea (38.8%) | |
Milian 2007 [175] |
Unexposed period: March 2003 and March 2005; exposed period: January 2003, May 2004 October 2004 |
Sarasota, Florida, USA | Sea water | Exposure to aerosolized brevetoxins |
97 persons (≥12 years) with physician-diagnosed asthma |
Respiratory symptoms like eye and/or throat irritation; nasal congestion; cough; wheeze; chest tightness |
|
Fleming 2007 [176] |
Unexposed period: March 2003 and March 2005; exposed period: January 2003, May 2004 October 2004 |
Sarasota, Florida, USA | Sea water | Exposure to aerosolized brevetoxins |
97 persons (≥12 years) with physician-diagnosed asthma |
Respiratory symptoms like eye and/or throat irritation; nasal congestion; cough; wheeze; chest tightness |
QAC | Formula | CAS-Number | Molecular weight |
Half-life | Log Koc | Log Dow/Kow |
ATMACs | CH3(CH3)7-17 N(CH3)3Cl | C8:10108-86-8 C10: 10108-86-9 C12: 112-00-5 C14: 4574-04-3 C16: 112-02-7 C18: 112-03-8 |
C8: 207.8 C10: 235.8 C12: 263.9 C14: 291.9 C16: 320.0 C18: 348.0 |
- | C8: 2.78 C10: 3.30 C12: 3.82 C14: 4.34 C16: 4.36 C18: 5.38 |
C8: -1.05 C10: -0.189 C12: 0.857 C14: 1.77 C16: 2.43 C18: 3.25 |
DDACs | [CH3(CH3)7-17]2 N(CH3)2Cl | C8: 5538-94-3 C10: 7173-51-5 C12: 3401-74-9 C14: 10108-91-5 C16: 1812-53-9 C18:107-64-2 |
C8: 306.0 C10: 362.1 C12: 418.2 C14: 474.3 C16: 530.4 C18: 586.5 |
180 days in river water (EPA, 2017) 1048 days in soil [189] |
C8:4.64 C10: 5.68 C12: 6.73 C14: 7.71 C16: 8.81 C18: 9.86 |
C8: 1.57 C10: 2.59 C12: 4.31 C14: 6.25 C16: 9.98 C18: 9.52 |
BACs | CH3(CH3)5-17N(Cl) (CH3)2 CH2 C6H5 | C6: 22559-57-5 C8: 959-55-7 C10: 965-32-2 C12: 139-07-1 C14: 139-08-2 C16: 122-18-9 C18: 122-19-0 |
C6: 255.8 C8: 283.9 C10: 311.9 C12: 340.0 C14: 368.0 C16: 396.1 C18: 424.1 |
379 days (in water at pH 9) [190] |
C6: 3.87 C8: 4.39 C10: 4.91 C12: 5.43 C14: 5.96 C16: 6.48 C18: 7.00 |
C6: -0.763 C8: 0.233 C10: 1.31 C12: 2.10 C14: 2.78 C16: 3.54 C18: 4.28 |
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