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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)