Objectives: With the goal of quantifying the risk of children contracting gastroenteritis while playing at interactive waterscape facilities and evaluating the adequacy of current water quality regulations, risk assessment was performed with Escherichia coli as pathogen. Methods: Abundances of E. coli in the waters of interactive water features in South Korea were acquired from survey reports. A gamma distribution describing the volume of water swallowed by children during swimming activities was adopted. Exposure rate and risk were calculated by Monte Carlo simulation and dose-response models for various pathogenic E. coli. Results: E. coli was detected in 25 out of 40 facilities, with range of ~1,600 CFU/100 ml. The abundance fitted an exponential distribution. Simulated exposures ranged ~1.9 × 1010 CFU, varying greater along E. coli abundance than the volume of water. Risk of children being infected by enterohemorrhagic E. coli was high, with range of ~0.85. When E. coli abundance was <200 CFU/100 ml, which is the current government threshold, the risk decreased to <0.43. Although the guideline successfully reduced the risk of adults being infected by a less virulent E. coli strains (<0.03), the risk for children could not be quantified due to lack of dose-response models for those pathogens for children. Conclusions: Under the current guideline, children are at risk of being infected if water is contaminated with by enterohemorrhagic E. coli. For other E. coli strains, the risk appears to be considerably less. The result warrants need for developing dose-response models for children for each pathogenic E. coli strain.
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