Utilizing Quantitative Microbial Risk Assessment Combined With Disability‐Adjusted Life Years to Evaluate the Health Risks of River Rowing Athletes and Inversely Determine the Critical Levels of Fecal Coliforms

The participation frequency and duration of water-based activities are typically higher for training rowing athletes than for rowing tourists, resulting in great exposure risks of polluted water for training rowing athletes. Thus, evaluating the health risks of training rowing athletes is essential to ensure their safety. In this study, quantitative microbial risk assessment (QMRA) combined with disability-adjusted life years (DALYs) was used to probabilistically examine the health risks of training rowing athletes in the Dongshan River Watershed, Taiwan, and to inversely determine the critical levels of river fecal coliforms (FCs) for risk benchmarks of 10^-4, 10^-5, and 10^-6 per person per year (pppy). Monte Carlo simulation was employed to quantify the variability of QMRA and DALY parameters. The relationship between FC observations and critical FC levels was investigated to identify suitable risk benchmarks for river environmental management. The results indicated that the risk of disease burden (DB) for training rowing athletes ranged from 108.4 × 10^-6 to 267.2 × 10^-6 pppy. These risks posed potential health threats to training rowing athletes. Given the ratios of observations exceeding critical FC levels, preliminary environmental management for river water quality was suggested at a DB risk of 10^-5 pppy. The representative value of critical FC concentrations corresponding to this risk level was found to be 2603 colony-forming units/100 mL.