The seaside is wrought deep into the hearts of British people. Donkey rides, ice-cream, and tentative paddling in the shallows are staples of our culture. For the more adventurous, however, our shores are an aquatic playground – particularly in the South West, with an estimated 11.7% of all UK surfers residing in East Devon alone.
The results of a recent study by the University of Exeter’s own Anne Leonard revealed regular surfers and bodyboarders are three times more likely to have antibiotic resistant E. coli in their bodies than non-surfers. Such news, therefore, is particularly concerning for the region.
“The wider issue appears to be the unnecessary use of antibiotics that are resulting in the development of such superbugs.”
I spoke with Dr Leonard about her findings: “We conducted the Beach Bum survey, inviting surfers and people who don’t go in the sea to take part, and asked participants to collect a sample of their gut bacteria using a rectal swab, which they returned to us for analysis.”
“We tested the gut bacteria for resistance to antibiotics and found that a greater proportion of surfers had resistant bacteria in their gut compared to people who don’t go in the sea,” Dr Leonard stated. “In fact, surfers were three times as likely as the control group to have resistant bacteria in their gut.” The study, published in the journal Environmental International and assisted by the charity Surfers Against Sewage, used a sample of around 300 people – of this, half were regular users of the sea, such as surfers, with surfers swallowing ten times more sea water than sea swimmers.
Having become interested in microbiology during her undergraduate degree at the University of Exeter – completing a final year project with Dr Chris Thornton on “an emerging fungal pathogen, called Pseudallescheria boydii, in estuarine muds and the dropping of migratory birds” – Dr Leonard focused on more human factors for her Masters in the Biology and Control of Disease Vectors at the London School of Hygiene and Tropical Medicine. Returning to Exeter in 2013 with the Medical School, Dr Leonard began her PhD, titled “Are bacteria in the coastal zone a threat to human health?”.
In it she explains: “I started out by conducting a systematic review on the risk of people experiencing symptoms of ill health after going in the sea, and what types of microorganisms – bacterial, viral, fungal – are associated with sea bathing.”
“There was only one study I found out of the hundreds that I read that investigated exposure to coastal waters as a risk factor for infections with antibiotic resistant bacteria.” This lack of investigation led to the Beach Bums study that has revealed the worrying state of contamination in UK seawater.
The faecal samples taken in the study assessed whether the surfers’ guts contained E.coli bacteria that grew in the presence of cefotaxime – an antibiotic prescribed to destroy bacteria that has seen some acquire genes that survive the clinical treatment.
With 13 of 143 (9%) surfers revealing the presence of the cefotaxime-resistant bacteria – compared to just four of 130 (3%) non-surfers – the study reveals that ingesting seawater during activities such as surfing comes with it health risks. Researchers also discovered that regular surfers were four times more likely to register bacteria with mobile genes – segments of DNA that “facilitate the movement of genetic material between bacterial chromosomes” – than non-surfers, increasing the likelihood of antibiotic-resistant abilities to be spread between bacteria.
focus is shifting to dealing with the environmental dissemination of antibiotic resistance
This is a particularly concerning revelation – particularly considering the UN Environment Assembly’s recent recognition that the environmental presence of antibiotic-resistant material is one of the greatest threats to the planet. Dr. Leonard expanded on this topic.
“Antibiotic resistant bacteria pose an enormous threat to our health, and resistance in the environment is really an emerging issue that could play an important role in the emergence and spread of antibiotic resistant bacteria. Coastal waters are regularly polluted by faecal matter – from both humans and animals – which carry diverse communities of microorganisms, including antibiotic resistant bacteria, into bathing waters.”
I also spoke with the University of Exeter’s Surf Club to discuss their views on the Beach Bums study. The Club was keen to reiterate that, despite the clear concerns that arise from the study, their commitment to surfing would remain resolute: “Surfing is a physically demanding sport like no other, working the whole body. For this reason, you’ll rarely see a ‘proper’ surfer that’s unfit – you simply cannot surf properly unless you’re fit.”
“This is not neglecting the fact that the finding is certainly scary. The wider issue appears to be the unnecessary use of antibiotics that are resulting in the development of such superbugs.”
“It would be good to see greater sewage control and information, though, as currently in winter months no information is made available – something that seems to be an excuse for processing plants to overflow all they like. Greater information would allow both surfers to avoid areas of high pollution, and provide the processors – and polluters, who may be surfers – with an incentive to reduce pollution.”
The issue of coastal contamination is one the charity Surfers Against Sewage works to limit. Whilst human and animal faecal matter entering the ecosystem is apparent, other pollutants include run-off from farm crops treated with manure. The World Health Organisation warning that we may be entering an antibiotic-resistant era – where previously treatable bacterial infections such as pneumonia and tuberculosis could prove to be fatal – and solutions to the issue have previously focused on prescription and use of the drug.
Now, the focus is shifting to dealing with the environmental dissemination of antibiotic resistance, where spreading occurs via the food we eat and from personal contact with other people. Despite the worrying implications, David Smith, Science and Policy Officer for Surfers Against Sewage, reassured people bathing in and using British waters for sport: “While the Beach Bums study highlights an emerging threat to surfers and bodyboarders in the UK it should not prevent people from heading to our coast.”
Smith continued: “Water quality in the UK has improved vastly in the past 30 years and is some of the cleanest in Europe. Recognising coastal waters as a pathway for antibiotic resistance can allow policy makers to make changes to protect water users and the wider public from the threat of antibiotic resistance.”
“We would always recommend water users check the Safer Seas Service before heading to sea,” he continued, “to avoid any pollution incidents and ensure the best possible experience in the UK’s coastal waters.”
Despite the worrying threat antibiotic-resistance poses, the Surf Club reiterated their commitment to the sport and maintaining the health of local coastal ecosystems: “We are all consciously trying to cut down on single use plastic, and use gentle, biodegradable washing powders and other detergents that can otherwise pollute the water.”
you’ll rarely see a ‘proper’ surfer that’s unfit – you simply cannot surf properly unless you’re fit.
“We won’t be cutting down on how much we surf in the UK.”
To read more about antibiotic resistance and our solutions try this article where Sophie Carr looks into the rise of antibiotic resistance and what YOU can do about it