Water-Related DiseasesNCT06413485
Canadian Beach Cohort Study
An observational study of Water-Related Diseases and Gastrointestinal Diseases, run by Toronto Metropolitan University at 5 sites in Canada.
Trial summary
Swimming and other water activities at public beaches are increasingly popular leisure activities among Canadians. However, these activities can lead to increased risks of acquiring acute gastrointestinal illness and respiratory, skin, ear, and eye infections among beachgoers. Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Water-Related Diseases, Gastrointestinal Diseases
- What is being tested?
- Level of recreational water contact activities
- Type of treatment
- Lifestyle or therapy programme
- How many people
- 5,000 participants
- Where
- 5 sitesCanada
- Study dates
- 16 Jun 2023to 31 Mar 2029
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Study population: Beachgoing households and individuals present at one of the targeted study beach sites during the recruitment period.
Who may be able to join
- Ability to provide informed consent for the study and complete the surveys in English or French
- Home address in Canada or the U.S.
- Must not have participated in the study in the past 21 days
Who cannot join
- Not a Canadian or U.S. resident.
Trial locations and contacts
5 sites in 1 country.
5 sites in 1 country
Canada5 sites
Bay Beach and Nickel Beach
Fort Erie, Ontario
Birch Cove Beach
Halifax, Nova Scotia
Sunnyside and Marie Curtis Park East beaches
Toronto, Ontario
English Bay Beach and Kitsilano Beach
Vancouver, British Columbia
Grand Beach
Winnipeg, Manitoba
About this study
Official title: Canadian Beach Cohort Study: Prospective Study to Assess the Burden of Recreational Water Illness
Swimming and other water activities at public beaches are increasingly popular leisure activities among Canadians. However, these activities can lead to increased risks of acquiring acute gastrointestinal illness and respiratory, skin, ear, and eye infections among beachgoers. These illnesses have a significant health and economic burden on society, with young children having much higher rates of illness than other age groups. Currently, baseline data are lacking on the risk of recreational water illness in Canada, and beachgoers may lack awareness and understanding of these risks and how to prevent them. This study will identify the burden of recreational water illness among Canadian beachgoers. The results will be used to develop recommendations for improving recreational water quality guidelines for safe swimming in Canada, as well as public health risk management and communication strategies with beachgoers. The study will use a mixed-methods approach, consisting of a prospective cohort study and a qualitative study of beachgoers. The investigators will determine the risk of acquiring recreational water illness outcomes in beachgoers that engage in different levels of water and sand contact. The investigators will examine differences in illness risks by beachgoer gender, age, and location. The investigators will examine relationships between fecal indicator bacteria (E. coli), environmental conditions, and host-specific biomarkers with the risk of gastrointestinal illness among beachgoers. The investigators will also evaluate beachgoer risk perceptions and behaviours toward recreational water quality. The study will take place at five targeted beach sites in British Columbia, Manitoba, and Ontario. The study will be coordinated by a multidisciplinary research team, with activities guided by a stakeholder steering group consisting of key knowledge users. The long-term goal is to reduce the burden of recreational water illness in Canada, contributing to improved public health.
Read the detailed description
Swimming and other beach water activities are increasingly popular outdoor leisure activities among Canadians. However, these activities increase the risk of acquiring acute gastrointestinal illness (AGI) and other acute illnesses among beachgoers. Recreational water illness (RWI) has a significant health burden, with young children having the highest rates of illness. These illnesses result in substantial costs to society due to healthcare costs and lost productivity. Data are lacking in Canada on the risk and burden of RWI, and beachgoers may lack awareness and understanding of RWI risks and how to prevent them. There is a critical need to conduct timely research on the burden of RWI in Canada to inform recreational water quality guidelines and public health risk management.
The purpose of this study is to identify the burden of RWI among Canadian beachgoers and to develop recommendations for improving recreational water quality risk management, communication, and pollution source prevention. The objectives are to:
- Measure the risk and burden of five different RWI outcomes (AGI, respiratory, eye, ear, and skin infections) in beachgoers that engage in different levels of water and sand contact;
- Identify differences in RWI risks by beachgoer gender, age, and beach location;
- Determine relationships between fecal indicator bacteria, environmental parameters, host-specific biomarkers, and the risk of AGI among beachgoers; and
- Understand beachgoer risk perceptions and behaviours related to recreational water quality and socio-political issues that may impact RWI risks among beachgoers.
The study will use a mixed-methods approach, consisting of a prospective cohort study (Objectives 1-3) with embedded qualitative research (Objective 4). The cohort study will involve enrolling participants at public beaches, ascertaining their water and sand contact exposure status, then following-up to determine the incidence of acute RWI outcomes. The investigators will combine beachgoer exposure data with routinely collected secondary data on environmental parameters and E. coli levels in beach water. The investigators will also test for enterococci as another fecal indicator using rapid molecular methods and will conduct microbial source tracking to determine the contribution of different sources of fecal contamination (e.g., human, avian) to AGI. The study will take place at eight targeted freshwater and marine beach sites in British Columbia, Manitoba, and Ontario. The qualitative research will consist of focus groups to determine beachgoer risk perceptions and behaviours toward recreational water quality and key informant interviews with stakeholders to provide additional socio-political insights and context.
The long-term goal of this study is to reduce the burden of RWI in Canada, contributing to improved public health. The study will be led by an experienced, diverse, and multi-disciplinary research team, including engagement with public health and environmental authorities. Activities will be guided by a stakeholder steering group consisting of key knowledge-users (KUs). This integrated KT approach will help to ensure that the results are relevant and useful to KUs, facilitating their direct uptake to influence recreational water quality policies and practice.
- Conditions
- Water-Related Diseases, Gastrointestinal Diseases
- Being tested
- Level of recreational water contact activities
- Keywords
- Epidemiology, Beach water, Water quality, Fecal pollution, Cohort study, Mixed methods, Environmental health
- Medical subject headings
- Waterborne Diseases, Gastrointestinal Diseases
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Level of recreational water contact activitiesBehavioural
Also called Sand contact at beaches
We will examine a graded classification of this exposure based on individuals' minimum level of water contact: 1) no water contact; 2) minimal contact; 3) body immersion; 4) swallowed water. Minimal contact is defined as water contact that does not result in body immersion (e.g., wading below one's waist, boating, fishing). Body immersion is defined as entering the water above one's waist (e.g., swimming, surfing, snorkelling), and swallowing water as ingestion of any amount of water.
| Study group | Role | What they receive |
|---|---|---|
| Beachgoers | Beachgoing families and households to one or more Canadian beaches during the summers of 2023 to 2026. Receives: Behavioral: Level of recreational water contact activities |
What is being measured
The primary outcome is the main question the study is designed to answer.
Acutre gastrointestinal illness (AGI)
Self-reported AGI in the 7-day period following beach water contact. Defined as one or more of: (a) diarrhea (≥3 loose stools in 24 hrs); (b) vomiting; (c) nausea with stomach cramps; or (d) nausea or stomach cramps that interfere with regular daily activities (e.g., missed work or school).
Measured: Within 7 days of beach visit/water contact
Secondary outcomes (4)
Acute respiratory illness
Self-reported fever with sore throat, fever with nasal congestion, or cough with phlegm
Measured: Within 7 days of beach visit/water contact
Skin infection
Self-reported rash or itchy skin
Measured: Within 7 days of beach visit/water contact
Ear infection or earache
Self-reported ear infection or earache
Measured: Within 7 days of beach visit/water contact
Eye infection or irritation
Self-reported eye infection or irritation
Measured: Within 7 days of beach visit/water contact
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 May 2024
- Study start16 Jun 2023
- Primary completion15 Sep 2026 (estimated)
- Study completion31 Mar 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Water-Related DiseasesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 5,000 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Toronto Metropolitan University
- Sponsor type
- University, hospital or other
- Collaborators
- University of Waterloo, University of Guelph, Health Canada, Public Health Agency of Canada (PHAC), Toronto Public Health, Vancouver Coastal Health, Government of Manitoba, Niagara Region Public Health, McMaster University, Halifax Regional Municipality
- Responsible party
- Principal investigator, Ian Young, Toronto Metropolitan University
- Investigators
- Ian Young, Principal investigator, School of Occupational and Public Health, Toronto Metropolitan University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06413485
- Sponsor's protocol ID
- PJT-192023
- Status last verified
- Sep 2025
- First submitted
- 9 May 2024
- Last updated
- 9 Sep 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Anonymized data will be made publicly available following the study conclusion and publication of results.
Study at a glance
From the registry record, last updated by the sponsor on 9 Sep 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Canadian Beach Cohort Study: Prospective Study to Assess the Burden of Recreational Water Illness
- ClinicalTrials.gov ID
- NCT06413485
- Acronym / sponsor ID
- PJT-192023
- Conditions
- Water-Related Diseases, Gastrointestinal Diseases
- Keywords
- Epidemiology, Beach water, Water quality, Fecal pollution, Cohort study, Mixed methods, Environmental health
- Study type
- Observational
- Recruitment status
- Active, not recruiting
- Enrolment
- 5,000 participants (estimated)
- Lead sponsor
- Toronto Metropolitan UniversityUniversity, hospital or other
- Collaborators
- University of Waterloo, University of Guelph, Health Canada, Public Health Agency of Canada (PHAC), Toronto Public Health, Vancouver Coastal Health, Government of Manitoba, Niagara Region Public Health, McMaster University, Halifax Regional Municipality
- Study start
- 16 Jun 2023 (actual)
- Primary completion
- 15 Sep 2026 (estimated)
- Study completion
- 31 Mar 2029 (estimated)
- First posted
- 14 May 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Swimming and other water activities at public beaches are increasingly popular leisure activities among Canadians. However, these activities can lead to increased risks of acquiring acute gastrointestinal illness and respiratory, skin, ear, and eye infections among beachgoers. These illnesses have a significant health and economic burden on society, with young children having much higher rates of illness than other age groups. Currently, baseline data are lacking on the risk of recreational water illness in Canada, and beachgoers may lack awareness and understanding of these risks and how to prevent them. This study will identify the burden of recreational water illness among Canadian beachgoers. The results will be used to develop recommendations for improving recreational water quality guidelines for safe swimming in Canada, as well as public health risk management and communication strategies with beachgoers. The study will use a mixed-methods approach, consisting of a prospective cohort study and a qualitative study of beachgoers. The investigators will determine the risk of acquiring recreational water illness outcomes in beachgoers that engage in different levels of water and sand contact. The investigators will examine differences in illness risks by beachgoer gender, age, and location. The investigators will examine relationships between fecal indicator bacteria (E. coli), environmental conditions, and host-specific biomarkers with the risk of gastrointestinal illness among beachgoers. The investigators will also evaluate beachgoer risk perceptions and behaviours toward recreational water quality. The study will take place at five targeted beach sites in British Columbia, Manitoba, and Ontario. The study will be coordinated by a multidisciplinary research team, with activities guided by a stakeholder steering group consisting of key knowledge users. The long-term goal is to reduce the burden of recreational water illness in Canada, contributing to improved public health.
Detailed description
Swimming and other beach water activities are increasingly popular outdoor leisure activities among Canadians. However, these activities increase the risk of acquiring acute gastrointestinal illness (AGI) and other acute illnesses among beachgoers. Recreational water illness (RWI) has a significant health burden, with young children having the highest rates of illness. These illnesses result in substantial costs to society due to healthcare costs and lost productivity. Data are lacking in Canada on the risk and burden of RWI, and beachgoers may lack awareness and understanding of RWI risks and how to prevent them. There is a critical need to conduct timely research on the burden of RWI in Canada to inform recreational water quality guidelines and public health risk management.
The purpose of this study is to identify the burden of RWI among Canadian beachgoers and to develop recommendations for improving recreational water quality risk management, communication, and pollution source prevention. The objectives are to:
- Measure the risk and burden of five different RWI outcomes (AGI, respiratory, eye, ear, and skin infections) in beachgoers that engage in different levels of water and sand contact;
- Identify differences in RWI risks by beachgoer gender, age, and beach location;
- Determine relationships between fecal indicator bacteria, environmental parameters, host-specific biomarkers, and the risk of AGI among beachgoers; and
- Understand beachgoer risk perceptions and behaviours related to recreational water quality and socio-political issues that may impact RWI risks among beachgoers.
The study will use a mixed-methods approach, consisting of a prospective cohort study (Objectives 1-3) with embedded qualitative research (Objective 4). The cohort study will involve enrolling participants at public beaches, ascertaining their water and sand contact exposure status, then following-up to determine the incidence of acute RWI outcomes. The investigators will combine beachgoer exposure data with routinely collected secondary data on environmental parameters and E. coli levels in beach water. The investigators will also test for enterococci as another fecal indicator using rapid molecular methods and will conduct microbial source tracking to determine the contribution of different sources of fecal contamination (e.g., human, avian) to AGI. The study will take place at eight targeted freshwater and marine beach sites in British Columbia, Manitoba, and Ontario. The qualitative research will consist of focus groups to determine beachgoer risk perceptions and behaviours toward recreational water quality and key informant interviews with stakeholders to provide additional socio-political insights and context.
The long-term goal of this study is to reduce the burden of RWI in Canada, contributing to improved public health. The study will be led by an experienced, diverse, and multi-disciplinary research team, including engagement with public health and environmental authorities. Activities will be guided by a stakeholder steering group consisting of key knowledge-users (KUs). This integrated KT approach will help to ensure that the results are relevant and useful to KUs, facilitating their direct uptake to influence recreational water quality policies and practice.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Beachgoers | – | Behavioral: Level of recreational water contact activitiesBeachgoing families and households to one or more Canadian beaches during the summers of 2023 to 2026. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
- Study population
- Beachgoing households and individuals present at one of the targeted study beach sites during the recruitment period.
Key inclusion criteria (3 listed)
- Ability to provide informed consent for the study and complete the surveys in English or French
- Home address in Canada or the U.S.
- Must not have participated in the study in the past 21 days
Key exclusion criteria (1 listed)
- Not a Canadian or U.S. resident.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Level of recreational water contact activitiesAlso: Sand contact at beachesWe will examine a graded classification of this exposure based on individuals' minimum level of water contact: 1) no water contact; 2) minimal contact; 3) body immersion; 4) swallowed water. Minimal contact is defined as water contact that does not result in body immersion (e.g., wading below one's waist, boating, fishing). Body immersion is defined as entering the water above one's waist (e.g., swimming, surfing, snorkelling), and swallowing water as ingestion of any amount of water. | Behavioural | Beachgoers |
Primary outcome
Acutre gastrointestinal illness (AGI)
Time frame: Within 7 days of beach visit/water contact
Self-reported AGI in the 7-day period following beach water contact. Defined as one or more of: (a) diarrhea (≥3 loose stools in 24 hrs); (b) vomiting; (c) nausea with stomach cramps; or (d) nausea or stomach cramps that interfere with regular daily activities (e.g., missed work or school).
4 secondary outcomes
Acute respiratory illness
Time frame: Within 7 days of beach visit/water contact
Skin infection
Time frame: Within 7 days of beach visit/water contact
Ear infection or earache
Time frame: Within 7 days of beach visit/water contact
Eye infection or irritation
Time frame: Within 7 days of beach visit/water contact
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Sep 2025.
- Individual participant dataSharing planned: Yes. Anonymized data will be made publicly available following the study conclusion and publication of results.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ian Young principal investigator
School of Occupational and Public Health, Toronto Metropolitan University
5 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Water-Related Diseases and Gastrointestinal Diseases, run by Toronto Metropolitan University at 5 sites in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 9 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 5 sites in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Acutre gastrointestinal illness (AGI) (time frame: Within 7 days of beach visit/water contact). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Sep 2025.