water World Health Organization

Regional Office for Europe

Eutrophication
EUROPEAN COMMISSION

and health

40
preface
Eutrophication and health

Algal blooms, “red tides”, “green tides”, fish kills, inedible shellfish,
blue algae and public health threats. What is the common link ?

The answer is, EUTROPHICATION: a complex process which occurs

both in fresh and marine waters, where excessive development
of certain types of algae disturbs the aquatic ecosystems and becomes
a threat for animal and human health. The primary cause
of eutrophication is an excessive concentration of plant nutrients
originating from agriculture or sewage treatment.

The purpose of this booklet is to describe in a simple way the causes

of eutrophication, the environmental effects, the associated nuisances
and health risk as well as the preventive and mitigating measures.

It is hoped that the booklet, which represents a collaborative effort

between the European Commission and the WHO, will contribute
to a better understanding of the problem of eutrophication and a more
effective control of nutrient enrichment in our lakes, rivers ans seas.

Dr Günter KLEIN Prudencio PERERA

Head of office Director
WHO European Centre for Environment Environment Quality and Natural Resources
and Health Bonn Office European Commission

A great deal of additional information on the European Union is available on the Internet.
It can be accessed through the Europa server (http://europa.eu.int).
Cataloguing data can be found at the end of this publication.
Luxembourg: Office for Official Publications of the European Communities, 2002
ISBN 92-894-4413-4
© European Communities, 2002
Reproduction is authorised provided the source is acknowledged.
Printed in France - PRINTED ON WHITE CHLORINE-FREE PAPER
 Local authorities - this publication is meant for you

WHO’s Regional Office for Europe is regularly

approached to provide technical or practical advice
on a large number of questions related to health and
the environment.

Experts and many other partners have together

drawn up a series of documents which will help you
solve your environment and health problems.

The recommendations are ranked by priorities,

so that strategies can be developed which are
appropriate to the local context.

marks the recommendations that must be put

into effect in order to ensure a safe and clean
environment. All local authorities have a duty to
tackle these tasks immediately.

identifies the recommendations that will yield

marked improvements in people’s health and should
be regarded as priority actions.

marks the recommendations that will, if they are

implemented, substantially improve the local
Scientific advisers
environment. Everyone’s quality of life will benefit
Pr Laura Volterra
from these.
Has been since 1983 research mana-
ger at Istituto Superiore di Sanita’ in The unranked recommendations are designed to
Rome (Italy). She has worked in algal
biotoxin problem, and has a wide expe- help you draw up strategies at local level and will
rience in microbiology of drinking water not, in general, have a direct effect on health.
and bathing water.

This pamphlet has been written to enable local

authorities to take fully informed decisions. The
Dr Marc Boualam annexes contain practical information which will help
Marc Boualam has a PhD in Chemistry technical personnel and those in charge of public
and Microbiology of Water from the
University of Nancy, France. He has relations in their daily work.
been working in fields related to the
quality of drinking and raw waters in
collaboration with scientific and indus-
Titles already published or in preparation are listed
trial organizations. on the inside back cover.

Other main contributors

Prof. Alain Ménesguen, Mr Jean-Pierre Duguet, Xavier Bonnefoy
f1
Mr Jean Duchemin, Mr Xavier Bonnefoy. Conseiller régional pour l’environnement et la santé/écologie
 Algal bloom in sea-water

f2
The word “Trophi” in Greek means food or nutrient, whereas the words “oligo”,
“meso”, “eu” and “hyper” stand respectively for rare, moderate, abundant and
excessive. Therefore, the words oligotrophic, mesotrophic, eutrophic and hypertro-
phic have been used by biologists to describe the various nutritional statuses of a
marine or fresh water environment. These words are used to describe the poten-
tially available quantitative biomass.

Eutrophic waters, or waters where one can find

“abundant” food (nutrients) will favour “greedy” and
Typical scenario leading
quickly developing plants and algae. Long living
to eutrophication
(and slow growing) flora species, which cannot resist
The mechanisms that lead to eutrophication, i.e. to
competition, although important for biodiversity
this new status of the aquatic environment, are com-
(including as habitat for a varied fauna), generally
plex and interlinked. Figure 1 describes the process of
develop in oligo or mesotrophic waters. Therefore in
eutrophication.
terms of biodiversity and ecological quality eutrophic
waters are often of little interest. “Hypertrophic”
The main cause of eutrophication1 is the large input of
waters have so much food available that they almost
nutrients to a water body and the main effect is the
die of indigestion!
imbalance in the food web that results in high levels of
phytoplankton2 biomass in stratified water bodies. This
The word “eutrophication” is also now being used in
can lead to algal blooms3. The direct consequence is
a perspective of preserving the ecological quality of
an excess of oxygen consumption near the bottom of
waters, e.g. in the Directives of the European Union
the water body. The additional factors supporting this
and various international treaties. “Eutrophication is
an accelerated growth of algae on higher forms of
Fig 1. The process of eutrophication
plant life caused by the enrichment of water by
nutrients, especially compounds of nitrogen and/or Cause
phosphorus and inducing an undesirable distur- High nutrient
bance to the balance of organisms present in the
Supporting Factors
water and to the quality of the water concerned”.
Top layer
Direct Effect
Thus, today “eutrophication” is more of a status than High phytoplankton
a trend and the term describes the qualitative condi- biomass

tions of an aquatic environment that has been dis- Supporting Factors

rupted, more than its quantitative (biomass) produc- Bottom layer Indirect Effects
tivity. It is this definition that is adopted in this
Oxygen depletion,
document. flora/fauna changes

1 Druon J.N., the eutrophication risk index, internal document for DG ENV.
2 Phytoplankton: microalgae, with a silicon skeleton (diatom) or not, mobile
(dinoflagelates) or not, in suspension in fresh or marine waters. They can
be green, brown or even red.
3 Blooms: characterized by the explosive growth of algae or cyanobacte-
ria, usually observed in eutrophic waters. They are generally dominated by
a single or few species. The blooms can be seen by the naked eye when
f3
the density reaches several millions of cells per litre of water.
 Fig 2 Ecosystem disruption process can be divided into two categories depending
on whether they are linked to the nutrient dispersion
and the phytoplankton growth, or to the oxygen cycle
near the bottom of the water body (for example,
containment, light and water movements). Various
effects can be observed depending upon the severity
of the eutrophication.
Phytoplankton
(low concentration) The various steps of the ecosystem disruption are
described in Figure 2.

In addition to carbon, oxygen and hydrogen that plants

can find directly from water, and carbon dioxide in the
atmosphere, two major nutrients are necessary for the
Seagrass
Fucus on rocks
development of aquatic life: Nitrogen (N) and phos-
phorus (P). A third one, silica (Si), is necessary for the
Pristine situation development of diatoms. During eutrophication, the
concentration of nutrients in the water changes. In
some cases one out of the three nutrients may be
totally bound to the aquatic life and will not be avai-
lable for further growth of algae. This nutrient is then
called the limiting factor.
Phytoplankton
(high concentration)
The ratio of nitrogen to phosphorus compounds in a
water body is an important factor determining which of
the two elements will be the limiting factor, and conse-
quently which one has to be controlled in order to
Phytoplankton
(high concentration) reduce a bloom (Table 1).
Epiphytes on fucus

Generally, phosphorus tends to be the limiting factor

for phytoplankton in fresh waters. Large marine areas
Start of eutrophication
frequently have nitrogen as the limiting nutrient, espe-
cially in summer. Intermediate areas such as river
plumes are often phosphorus-limited during spring,

Anoxic waters with

Table 1: Nitrogen/Phosphorus ratios (expressed in
H2S bubbles weight) for various limiting conditions
in freshwater and estuarine/coastal water

N-limiting Intermediate P-limiting

Dead fishes and (Ratio N/P) (Ratio N/P) (Ratio N/P)
crustaceans
Freshwater ≤ 4.5 4.5-6 ≥6
Estuarine/
coastal water4 ≤5 5-10 ≥ 10
Green filamentous
Bottom anoxia algae
4 The literature dealing with the marine environment usually uses the atom
for atom ratio. With such a method these figures would range between 12
f4
Extreme eutrophication and 24.
 but may turn to silica or nitrogen limitation in summer.
When phosphorus is the limiting factor, a phosphate
Causes of eutrophication
concentration of 0.01 mg l-1 is enough to support
and supporting factors
plankton and concentrations from 0.03 to 0.1 mg l-1 or
The enrichment of water by nutrients can be of natural
higher will be likely to promote blooms.
origin but it is often dramatically increased by human
activities. This occurs almost everywhere in the world.
In coastal areas, the growth and proliferation of dia-
There are three main sources of anthropic5 nutrient
toms is promoted by the presence of silica. When the
input: runoff, erosion and leaching from fertilized agri-
silica concentration is low diatoms cannot develop.
cultural areas, and sewage from cities and industrial
Then other opportunistic toxic algal species, which are
wastewater. Atmospheric deposition of nitrogen (from
no longer submitted to competition, can grow and
animal breeding and combustion gases) can also be
form blooms. Species from the genus Phaeocystis
important.
and several dinoflagellates (Prorocentrum, Dinophy-
sis, Gymnodynium) are known to proliferate under
According to the European Environment Agency, “the
such conditions.
main source of nitrogen pollutants is run-off from agri-
cultural land, whereas most phosphorus pollution

5 Anthropic: of human origin

C A S E S T U D Y

Mapping N from agriculture - European Commission Nitrates

Based on DG ENV / Eurostat / ERM / AB-DLO / JRC CIS
Total N pressure from • atmospheric deposition
• biological fixation From the year 1950 until 2000 the use of mineral
• livestock manure and nitrogen in fertilizers for agriculture in the 15 EU
• mineral fertiliser (1997)
member states has been increased tenfold, from 1 to 9-
10 million tons. At the same time the amount of
Biological Fixation (2.2%) nitrogen released by animal husbandry rose to nine
Atmospheric million tons. The nitrogen pressure on the environment
Deposition (9.5%)
Mineral
currently reaches 18 millions tons6 solely from
Fertiliser agriculture.
(9.5%) Livestock
Manure (39.5%)

= 10 % of EU 15 Agricultural practices have led to a reduction of

Density (kg/ha UAA)
permanent grassland, and other “buffer” areas such as
No data ditches, hedges and wetlands a situation which favours
0.1 - 50
erosion, run-off and quick drainage of nutrient to the
51 - 75
76 - 100
water bodies.
101 - 125
al ric ck
he ral
126 - 150 gic osp on sto ne er
iolo ion tm siti
Live ure Mi rtilis
151 - 200 B at A po n tal
Fix De Ma Fe To
201 - 250 Country % % % % 1000 t
Austria 3.4 19.1 45.4 32.1 349.4
> 250
Belgium 0.8 9.5 56.9 32.9 480.9
Denmark 3.4 8.2 40.5 47.9 596.3
Finland 2.3 3.7 29.9 64.1 272.9
France 3.0 9.6 34.4 52.9 4760.1
Germany 1.5 13.7 35.5 49.3 3627.3
Greece 1.2 4.8 37.3 56.7 541.4
Ireland 0.3 4.7 53.9 41.1 960.4
Italy 1.3 9.5 38.5 50.7 1805.9
Luxembourg 0.5 9.5 39.6 50.4 35.7
Netherlands 0.3 7.7 52.5 39.6 935.0
Portugal 3.1 4.6 50.6 41.7 270.3
Spain 4.3 7.3 37.6 50.7 2047.9
Sweden 3.4 3.8 37.8 55.0 373.9
United Kingdom 1.6 9.3 42.4 46.8 2674.3
EU 15 2.2 9.5 39.5 48.9 19731.7

6 Source: European commission report. Implementation of the nitrates

directive, COM (2002) 407 f5
 Fig. 2: Nitrogen and phosphorus in major EU Fig. 3: Phosphorus emissions from some
rivers large industries
4.0 Nitrate nitrogen (mg/l)
3.5 Tonnes Kemira
3.0 16 000
Bayer
2.5
2.0 14 000 Norsk Hydro
1.5
Denmark
1.0 12 000
0.5
0 10 000
1980 1985 1990 1995
Total phosphorus (mg/l) 8 000
0.4

0.3 6 000

0.2 4 000

0.1 2 000

0 0
1980 1985 1990 1995 1990 1991 1992 1993 1994 1995 1996

Source: EEA-ETC / IW based on country returns under EC Note: Total loading from Denmark added for comparison
Exchange of Information Decision (77/795/EEC) Source: wwwhomepages of the companies; Windolf, 1996.

comes from households and industry, including phos- wastewater treatment and less phosphorus in house-
phorus-based detergents. The rapid increase in indus- hold detergents. Phosphorus release from industry
trial production and in in-house consumption during has also fallen sharply (Figure 3) whereas phosphorus
the 20th century has resulted in greater volumes of from agriculture, despite a reduction in the consump-
nutrient-rich wastewater. Although there has been tion of phosphate fertilizers in the EU, remains an
recently a better management of nitrogen and phos- important source of phosphorus pollution.
phorus in agricultural practices, saturation of soils with
phosphorus can be noted in some areas where sprea- Unfortunately, due to the main role of nitrogen in the
ding of excessive manure from animal husbandry eutrophication process in summer in the coastal zone,
occurs. Nutrient removal in sewage treatment plants the reduction in the discharge of phosphorus from
and promotion of phosphorus-free detergents are vital rivers into the sea has not been visible, except in very
to minimize the impact of nitrogen and phosphorus specific sites. In most cases the phosphorus released
pollution on Europe’s water bodies” . 7 by the sediments into the open sea is sufficient to
allow eutrophication to occur, although external inputs
Since 1980, nitrate concentrations in major EU have sharply decreased. In fact, only the Dutch coast
rivers have generally remained constant. There is no has benefited from the improvement of the water of
evidence that reduced application of nitrogen fertili-
zers to agricultural land has resulted in lower nitrate
concentrations in rivers. Indeed, concentrations in
some regions in Europe, such as Brittany, or Poitou in
France, and Catalunya in Spain, are still increasing.
More detailed information on nitrates are to be found
in the companion pamphlet in this series “nitrate and
health” and in the E.C. report mentioned in (6).

Phosphorus concentrations have shown a decline

in major EU rivers (figure 2) mainly due to improved

f6
7 http://reports.eea.eu.int/signals-2000/en/page014.html Slurry spreading
the Rhine, everywhere else the situation is stable or
has worsened.

Some activities can lead to an increase in adverse

eutrophication and, although they are very specific,
they should be noted:
• Aquaculture development: Expansion of aquacul-
ture contributes to eutrophication by the discharge of
unused animal food and excreta of fish into the
water;
Eel grass bed in June 1987
• The transportation of exotic species: Mainly via the
ballasts of big ships, toxic algae, cyanobacteria and
nuisance weeds can be carried from endemic areas
to uncontaminated ones. In these new environments
they may find a favourable habitat for their diffusion
and overgrowth, stimulated by nutrients availability;
• Reservoirs in arid lands: The construction of large
reservoirs to store and manage water has been
taking place all over the world. These dams are built
in order to allow the collection of drainage waters
through huge hydrographic basins. Erosion leads to
Eel grass covered with green filamentous algae in June 1988
the enrichment of the waters of these reservoirs by
nutrients such as phosphorus and nitrogen.
In other cases, due to tidal effects, and/or streams,
some areas that would seem to be prone to contain-
Factors supporting the development ment see their waters regularly renewed and are not
of eutrophication contained at all and are therefore very unlikely to
become eutrophic.
Besides nutrient inputs, the first condition supporting
eutrophication development is purely physical - it is
Other physical factors influence eutrophication of
the containment (time of renewal) of the water. The
water bodies. Thermal stratification of stagnant water
containment of water can be physical, such as in a
bodies (such as lakes and reservoirs), temperature
lake or even in a slow river that works as a batch
and light influence the development of aquatic algae.
(upstream waters do not mix with downstream
Increased light and temperature conditions during
waters), or it can be dynamic.
spring and summer explain why eutrophication is a
phenomenon that occurs mainly during these sea-
The notion of dynamic containment is mostly relevant
sons. Eutrophication itself affects the penetration of
for marine areas. Geological features such as the
light through the water body because of the shadow
shape of the bottom of the sea, the shape of the
effect coming from the development of algae and
shores, physical conditions such as streams, or large
other living organisms and this reduces photosynthe-
turbulent areas, and tidal movements, allow some
sis 8 in deep water layers, and aquatic grass and
large marine areas to be really “contained”, exhibiting
weeds bottom development.
very little water renewal. This is known as dynamic
containment.
8 Photosynthesis: the process in which the energy of sunlight is used by
organisms, especially green plants to synthesize carbohydrates from car-
f7
bon dioxide and water.
 Fig. 4: Development of plant life in coastal
Main consequences waters with increased level of nutrients10
of eutrophication
phytoplankton

The major consequence of eutrophication concerns

filamentous
the availability of oxygen. Plants, through photosyn- algae
light penetration
thesis, produce oxygen in daylight. On the contrary, in
darkness all animals and plants, as well as aerobic macrophyte

microorganisms and decomposing dead organisms,

respire and consume oxygen. These two competitive
processes are dependent on the development of the sedimented organic material
biomass. In the case of severe biomass accumulation,
the process of oxidation of the organic matter that has 10 Funen City Council, Eutrophication of coastal waters, published by
Funen City Council, Denmark, 1991
formed into sediment at the bottom of the water body
will consume all the available oxygen. Even the oxy-
gen contained in sulphates (SO42-) will be used by • Changes in algal population: During eutrophica-
some specific bacteria. This will lead to the release of tion, macroalgae, phytoplankton (diatoms, dinoflagel-
sulphur (S ) that will immediately capture the free oxy-
2-
lates, chlorophytes) and cyanobacteria9, which
gen still present in the upper layers. Thus, the water depend upon nutrients, light, temperature and water
body will loose all its oxygen and all life will disappear. movement, will experience excessive growth. From
This is when the very specific smell of rotten eggs, ori- a public health point of view, the fact that some of
ginating mainly from sulphur, will appear. these organisms can release toxins into the water or
In parallel with these changes in oxygen concentration be toxic themselves is important.
other changes in the water environment occur:
• Changes in zooplankton11, fish and shellfish popu-
lation: Where eutrophication occurs, this part of the
Effects of nutrient enrichment on ecosystem is the first to demonstrate changes. Being
biodiversity
most sensitive to oxygen availability, these species
Under normal conditions, i.e. outside eutrophication
periods, macrophytes at the bottom of the water body
9 Cyanobacteria: also called cyanophyte or blue/green algae, are orga-
develop normally, the amount of phytoplankton is such nisms capable of plant-type photosynthesis and have close relationship
that light can penetrate down to the bottom and fish with both bacteria and algae.
11 Zooplankton: community of animals with or without limited active loco-
and shellfish can live and reproduce. If the amount of motion, suspended in a water body.
nutrient increases, mainly short-living macrophytes will
grow much faster and larger and new species will
develop that will compete with those originally present.
In some cases phytoplankton will also multiply. This
development of macrophytes, including free-floating
algae, and phytoplankton will prevent a large
proportion of the light from reaching the bottom.
The first signs of the reduction of oxygen concentration
will become visible. Should the situation become
extreme, oxygen concentrations will reach levels that
make aquatic life impossible. Only those species that
require very little oxygen will survive in these
conditions. The amount of organic sediment will
increase, as will the demand in oxygen. The final step
will be the end of all aerobic life.
Growth of white sulfure bacteria on black (anoxic) sediments between
f8
colonies of common mussels
 Cyanobacteria have been largely studied in fresh
water systems, due to their ability to proliferate, to
form massive surface scums, and to produce toxins
that have been implicated in animal or human poiso-
ning. Some species of algae may also contain toxins,
but incidents where fresh water algae are at the origin
of cases of human or animal illness have very seldom
been reported.

Coloured toxic tides caused by algal overgrowth have

been known to exist for many centuries. In fact the

Localised occurence of white sulfur bacteria and oxygen depletion in the

Bible (Exodus, 7: 20-24) states “all the water of the
sea bed following heavy oxygen demand during the decomposition of a Nile river became red as blood and fish which were in
mat of filamentous algae
the river died. And the river was poisoned and the
Egyptians could not drink its waters”.
may die from oxygen limitation or from changes in the
chemical composition of the water such as the exces- Algal blooms were observed in 1638 by fishermen in
sive alkalinity that occurs during intense photosynthe- north west of Iceland. Fjords were reported to be stai-
sis12. Ammonia toxicity in fish for example is much ned blood red and during the night produced a kind of
higher in alkaline waters. phosphorescence. The fishermen thought that the
colours could be due to the blood of fighting whales or
to some marine insects or plants (Olafsson and Palm-
Effects of eutrophication sson, 1772). The first scientific report of domestic ani-
mals dying from poisoning as a consequence of drin-
The effects of eutrophication on the environment may, king water that was affected by a blue/green algae
have deleterious consequences for the health of expo- bloom was in 1878 in lake Alexandrina, Australia.
sed animal and human populations, through various
pathways. Specific health risks appear when fresh In coastal and estuarine systems, however, where
water, extracted from eutrophic areas, is used for the conditions are less favourable to the proliferation of
production of drinking water. Severe impacts can also cyanobacteria, which need oligo-elements such as
occur during animal watering in eutrophic waters. iron, toxic algae such as dinoflagellates have been
observed and have been at the origin of health
Macroalgae, phytoplankton troubles. There is growing evidence that nutrients,
and cyanobacteria blooms especially nitrogen, favour the duration and frequency
of such toxic “blooms”, and concentrations of toxin in
Algae display varying degrees of complexity depen- the cells.
ding on the organization of their cells. Macroalgae,
phytoplankton and cyanobacteria may colonize Health effects linked to toxins of cyanobacteria in
marine, brackish or fresh waters wherever conditions fresh waters
of light, temperature and nutrients are favourable. Some cyanobacteria have the capacity to produce
toxins dangerous to human beings. Toxins can be
found either free in the water where the bloom occurs
or bound to the algal or cyanobacterial cell. When the
12 During intense photosynthesis, living organisms will catch all the CO2
that is available, including CO2 coming from carbonates in the waters. As a cells are young (during the growth phase), 70 to 90%
consequence, alkalinity of the water will increase during daytime, and aci-
dity during the night. of the toxins are cell bound, whereas when the cells f9
 Tab 2. Target organs of the cyanotoxins and species of cyanobacteria involved (Chorus and Bartram, 1999)
Toxin group Primary target organ Cyanobacterial genera
in mammals
Cyclic peptides
Microcystins Liver Microcystis, Anabaena, Oscillatoria,
Nostoc, Hapalosiphon, Anabaenopsis
Nodularin Liver Nodularia
Alkaloids
Anatoxin-a Nerve synapse Anabaena, Oscillatoria, Aphanizomenon
Anatoxin-a(S) Nerve synapse Anabaena
Aplysiatoxins Skin Lyngbia, Schizothrix, Oscillatoria
Cylindrospermopsins Liver Cylindrospermopsis, Aphanizomenon,
Umezakia
Lyngbyatoxin-a Skin, gastrointestinal tract Lyngbia
Saxitoxins Nerve axons Anabaena, Aphanizomenon, Lyngbia,
Cylindrospermopsis
Lipopolysaccharides
Potential irritant, affects any exposed tissue All

are ageing, free toxins can reach 70% of the total. It is fresh waters. People may be exposed to toxins
difficult to remove free toxins in the water by the nor- through the consumption of contaminated drinking
mal processes used in treating water for drinking pur- water, direct contact with fresh water or the inhalation
poses. It is usually much easier to remove cyanobac- of aerosols. Toxins induce damage in animals and
terial cells than free toxins (see technical annex). humans by acting at the molecular level and conse-
quently affecting cells, tissues and organs (Table 3).
The resistance and persistence of toxins in the envi- The nervous, digestive, respiratory and cutaneous
ronment depend on the nature of the compound. systems may be affected. Secondary effects can be
Investigations have shown the ability of certain toxins observed in numerous organs. Age or physiological
to withstand physico-chemical and biological conditions of the affected individual may determine the
constraints, especially high temperatures (up to severity of the symptoms. A variety of symptoms,
300°C). Generally, the cumulative effects of these depending on the toxins implicated, are observed
constraints cause toxin degradation in the natural such as fatigue, headache, diarrhoea, vomiting, sore
environment after one to three weeks. In dark natural throat, fever and skin irritations.
waters toxins can possibly persist for several months
or even years.

To date there are more than 50 identified species of

cyanobacteriae able to produce toxins. In Europe, the
most frequently observed genera in fresh waters
during blooms are Microcystis, Anabaena, Aphanizo-
menon, Oscillatoria, Nodularia and Nostoc.

Numerous experiments have been carried out to cha-

racterise the effects induced by toxins released by
f10
cyanobacteria, also called cyanotoxins, particularly in
Cyanotoxins can be classified into three groups: rapid death by respiratory arrest, sometimes occurring
• Hepatotoxins. in a few minutes.
These are the most frequently observed cyanotoxins.
Experiments using mice indicate that they cause liver • Dermatotoxins.
injury and can lead to death from liver haemorrhage These induce irritant and allergenic responses in tis-
and cardiac failure within a few hours of exposure at sues by simple contact.
acute doses. Chronic exposure induces liver injury
and promotes the growth of tumours. The global toxicity of a cyanobacterial proliferation is
not constant in time or space, making it difficult to
Questions remain concerning the effects of repeated assess the health threat although some acute poiso-
exposures to low levels of toxins. Animal experiments nings have led to death (Tables 3 and 4).
have shown liver injury from repeated oral exposure to
microcystins, the most frequently observed cyano- The release of cyanotoxins in water has been at the
toxins. It is thought that the high prevalence 13 of liver origin of several outbreaks affecting animal or human
cancer observed in some areas of China could be due health (Case studies p. f12). About 75% of cyanobac-
to the presence of microcystins in water supplies. terial blooms are accompanied by toxin production.
The presence of cyanobacterial toxins after potabiliza-
• Neurotoxins. tion treatment represents a health threat for patients
These are generally less common and act on the ner- undergoing renal dialysis treatment.
vous system. In mice and aquatic birds, they cause

Table 3. Cases of toxic cyanobacterial blooms reported in drinking waters

(Chorus and Bartram, 1999, Draft AFSSA, 200114)

Location and date of

Cyanobacterial bloom Species Symptoms Consequences
Drinking water
USA, 1931 Microcystis Gastro-enteritis No data
USA, 1976 Schizotrix, Plectonema, Gastro-enteritis 62% of the population fed
Phormidium, Lyngbia by the network became ill
Australia, 1979 Cylindrospermopsis Hepatitis 141 hospitalizations
raciborskii
Australia, 1981 Microcystis Gastro-enteritis No data
Liver injury
Brazil, 1988 Anabaena, microcystis Gastro-enteritis 2000 people affected
88 deaths
Sweden, 1994 Planktothrix agardhii Gastro-enteritis 121 people affected
Brazil, 1996 Aphanizomenon, Hepatitis 166 people affected
Oscillatoria, Spirula 60 deaths

Table 4. Cases of toxic cyanobacterial blooms reported in recreational waters

(Chorus and Bartram, 1999, Draft AFSSA, 2001)

Recreational water
Canada, 1959 Microcystis Gastro-enteritis, headaches, 30 people affected
Anabaena circinalis nausea, muscular pains
UK, 1989 Microcystis Gastro-enteritis, vomiting, 20 people affected
sore throats 2 hospitalizations

13 Prevalence: The number of instances of a given disease or other condition in a given population at a designated time (Last, 1988).
14 Coquet Sandrine, Évaluation des risques lies à la présence de cyanobactéries dans les eaux destinées à la consommation humaine, rapport AFSSA,
f11
Paris, 2001
 and Prorocentrum. Carriers are filtering shellfish such
as oysters, mussels15, cockles and clams. No fatality
has been observed.

• Paralytic shellfish poisoning (PSP). Intoxication

leads to muscular paralysis, difficulty in breathing,
shock and in extreme cases death by respiratory
arrest. Species frequently implicated are from the

15 A mussel can filter up to 30-40 litters of water per day.

C A S E S T U D Y
Release of cyanotoxins in water has been at the origine of outbreaks
affecting animal health A typical outbreak16

During summer 1988, around Fécamp, Seine-Maritime,

C A S E S T U D Y
France, the public health authorities were warned by
Fatalities after the consumption of drinking the local hospital that an unusual number of patients
water contaminated by cyano toxins had been admitted with vomiting and diarrhoea. After a
short investigation with the local pharmacists on duty
In 1988 in Brazil 2000 cases of gastroenteritis, with 88 that weekend it appeared that there were additional
deaths were reported in an area supplied with drinking cases that did not go to the hospital.
water from a dam contaminated by cyanobacteria
(Anabaena and Microcystis). Cases were observed even More than 200 people were affected. Thanks to the
in patients who boiled their water before drinking and existing network of pharmacists the outbreak was well
were only observed in the areas supplied with drinking monitored, as shown in the graph below.
water from the dam, pointing to the origin as being a
toxin produced by algae. 200 number of cases The epidemiological
survey showed that
the origin of this
150 outbreak was the
ingestion of mussels
Algal toxins in marine waters
collected by tourists
Algal toxins are observed in marine ecosystems and local residents
100

where they can accumulate in shellfish and more during the spring tides.
generally in seafood, reaching dangerous levels for The mussels had
filtered a large amount
human and animal health. 50
of dinophysis (a toxic
28/08 29/08 30/08 31/08 1/09 2/09 3/09 4/09 phytoplankton).
Around 40 algal species able of producing toxins
harmful to human or marine life have been identified in As a consequence, it was decided to expand the
monitoring system (Réseau de surveillance du
european coastal areas. Among these microalgae,
phytoplancton et des phycotoxines: REPHY; see
Dinophysis, Alexandrium, Gymnodinium, Pseudo-nitz- p. f19) set up by the IFREMER*, which was previously
schia are frequently observed and represent a risk for dedicated to commercial shellfish growing, to this area
seafood consumers. of France, in parallel with the existing “Diamoule”
pharmacists network, coordinated by the public health
authority (DDASS).
The various effects are:
• Diarrhoeic shellfish poisoning (DSP). Intoxication
leads to gastrointestinal symptoms (for example diar- *Institut français de recherche pour l’exploitation de la mer
rhoea, vomiting and abdominal pain). Species fre- 16 Coquillages et santé publique, du risque à la prévention, Lesne Jean
et al, édition de l’ENSP, 1991
f12
quently implicated are from the genus Dinophysis
 Table 5 Cases of intoxications due to seafood C A S E S T U D Y
consumption (MAP Technical Reports, 1996)
A newly discovered side effect of eutrophica-
Intoxication Country Date Consequences
tion of sea waters17
PSP Philippine 1983 300 cases
21 deaths
The presence of bacteria potentially harmful to human
United Kingdom 1968 78 cases health such as Escherichia coli, Salmonella spp or
Spain 1976 63 cases Vibrio Cholerae can represent a threat to people
France 1976 33 cases bathing in water. Under normal conditions, these
bacteria do not survive very long in seawater. The
Italy 1976 38 cases
major reasons for this are the relative poverty of
Swiss 1976 23 cases nutrients in seawaters, the exposure of bacteria to UV
Germany 1976 19 cases rays which have a bactericidal effect, and, finally, the
DSP Japan 1976-1982 1300 cases osmolarity18 of sea water which is much higher than
that of bacteria.
France 1984-1986 4000 cases
Scandinavia 1984 300-400 cases
During blooms, the conditions are reversed, food
VSP Japan 1889 81 cases becomes abundant, light is diminished and it has been
51 deaths recently established that some algae may even release
Japan 1941 6 cases chemicals that produce osmo-protection for the
bacteria.
5 deaths
Norway 1979 70 cases As a consequence, during blooms, if bacteria already
ASP Canada 1987 153 cases pollute the seawater, the situation may deteriorate due
3 deaths to the new conditions allowing them to survive and
perhaps multiply.
NSP Florida 1977 (?) ND

genus Alexandrium and Gymnodinium. Carriers can • Neurotoxic shellfish poisoning (NSP). Intoxication
be oysters, mussels, crustacean and fish. Fatality rate leads to muscular paralysis, state of shock and
is estimated at close to 10% of people intoxicated. sometimes death. Species frequently implicated are
from the genus Gymnodinium. Carriers are oysters,
• Amnesic shellfish poisoning (ASP). Intoxication clams and crustaceans. Human fatalities have been
leads to mental confusion and loss of memory, diso- observed. They have been at the origin of ecological
rientation and sometimes coma. Species frequently catastrophes with the death of huge numbers of fish
implicated are diatoms from the genus Nitzschia. and other aquatic life.
Carriers are filtering shellfish, such as mussels. Fata-
lities have been observed in elderly people. • Venerupin shellfish poisoning (VSP). Intoxication
leads to gastrointestinal, nervous, haemorrhagic,
hepatic symptoms and in extreme cases delirium
C A S E S T U D Y
and hepatic coma. Species frequently implicated are
Severe health effects due to recreational
from the genus Prorocentrum. Carriers are oysters
exposure to water contaminated by toxic
blue algae (Chorus and Bartram, 1999) and clams. A high fatality rate has generally been
observed among intoxicated populations.
Ten out of twenty army recruits in the United Kingdom
(1989) showed symptoms indicating intoxication
(vomiting, diarrhoea, central abdominal pain and sore
throats) after training in water with a dense bloom of
Microcystis spp. Two of them developed severe
pneumonia and needed hospitalisation and intensive 17 M.Ghoul et al, Marine Macroalgae as a source of Osmoprotection for
Escherichia coli, in Microb Ecol, 1995, vol 30, pp 171.181
care. 18 Osmolarity: a chemical characterisitc of water mainly linked to its
f13
concentration in dissolved salts
 Microphytes blooms
There are some possible individual effects of microal-
gal blooms in seawater that may have large economic
consequences. Blooms of blue/green algae, diatoms
and Prymensiophytes can produce mucus forming
“blankets” floating on the surface (“marine-snow” as
observed in 1999 in the Euboikos Gulf, Greece). The
same occurs almost each year, in spring, with phaeo-
cystis along belgian coasts (thick white foam).

Massive amounts of gelatinous aggregations were

noted floating on the Aegean Sea in 1982 and 1983.
Almost similar events are described p. f15.

Macrophytes19 mass developments

Macroalgal proliferations, also called green tides, are
repeatedly observed in the marine environment. Such
proliferation's are directly related to the nitrogen Fresh growth of Cladophora. At high magnification, the alga is clearly seen
enrichment of waters and often occur in bays and to be branching

estuarine systems. The opportunistic species implica-

ted are frequently from the genus Ulva (Ulva armori- (Monostroma obscurum), Enteromorpha (Enteromor-
cana, Ulva rotundata, Ulva rigida), Monostroma pha intestinalis, Enteromorpha linza, Enteromorpha
clathrata, Elodea Myrisphyllus in fresh waters) and to
C A S E S T U D Y a lesser extent Chaetomorpha and Cladophora. The
Trends in the Black Sea main periods for the massive developments of
macroalgae are spring and summer. The proliferation
Over the last 30 years the environmental quality of the of these short-living macroalgae can compete with,
Black Sea has deteriorated due to the eutrophication
and be detrimental to, autochtonous long-living (e.g.
of the water, resulting in alarming algal overgrowth.
Following the break up of the ecosystem between the Fucus) species, much more interesting for biodiver-
1970s and the 1980s, fish deaths were estimated at sity. In coastal areas their accumulation on beaches
five million tons between 1973 and 1990, representing can reach thousands of tons and induce numerous
US$ 2 billion at market cost. A further consequence is
nuisances including odour, making it impossible to use
that tourists have stopped visiting the coasts of the
Black Sea leading to losses for the tourist industry. A
the beaches. In the Brittany region of France, it has
study performed in the framework of the Black Sea been estimated that more than 50 000 tons of
Environmental Programme estimated in 1995 that the macroalgae are deposited on the beaches every year,
annual economic loss due to tourist disaffection in this requiring costly mechanical removal.
region was close to US$ 360 million for a 10%
decrease in the environmental quality.
The effects of these macrophyte blooms on public
The collapse of the economy in Central and Eastern health, including well-being and safety, are mostly lin-
Europe, and large Danube water protection ked to the recreational use of the water bodies,
programmes have led to a decrease in nutrients
unpleasant aspect and decomposition odours.
discharge and a decrease in the eutrophication (Roger
Aertgaerts: personal communication). Recreational activities sometimes become impossible
or dangerous, and in all cases unpleasant in areas
19 Macrophyte: literally meaning a large plant as opposed to the single cel- affected by macrophyte blooms. Rare cases of aller-
led phytoplankton, includes seaweeds and flowering plants such as sea
f14
grass.
gies linked with macrophytes have been described.
Finally, the consequences of these macrophyte
blooms due to eutrophication can be seen on fishing
activities. For instance some filamentous and mat-for-
ming green algae such as Cladophora, have increa-
sed their coverage in many Baltic sites. Some of them
are alleged to produce compounds toxic to herring'
eggs. In addition, they induce fishnets clogging resul-
ting in breakage and loss.

C A S E S T U D Y

Aesthetic effects Mechanical removal of macroalgae (July 1985, Lannion Bay)

Some algae, particularly of the taxa “Phaeocystis”,

produce a mucus, which when disturbed produce a In fresh waters, similar macrophytes, but also prolife-
foam. These algae are more prone to develop when rating aquatic plants (for example Renunculus and
there is little competition. It seems that in areas such
Myriophyllum) can also strongly disturb the ecosys-
as the south-east coast of the North sea, where all the
silica has been captured by diatoms in estuarine tem, navigation and recreational use of rivers and
regions, the residual nitrogen is used by Phaeocystis to lakes.
bloom. They produce large amount of mucus which, if
the weather is windy, will in turn be transformed into
Effect of eutrophication on drinking
large amounts of foam covering extensive areas of
beach and lake shores. Besides the impact on the
water
landscape and the nuisance it represents for tourists,
this foam is suspected of disturbing flat fish larvae In some specific cases, local authorities must rely on
development. eutrophic waters for producing drinking water. There
are two major risks for health in using such waters:
This phenomenon is frequently observed at the Belgian
and Dutch coasts, and appears from time to time in 1. Risks linked to the presence of organic matter:
Germany. Treating raw water with high levels of organic matter is
always technically difficult. It can lead to the creation
of carcinogenic by-products (Trihalomethanes
(THMs), other chlorinated components or ozonides)
as a result of their reaction with disinfectants. If the
water is eutrophic, then on the top of the organic mat-
ter that would be present under normal circum-
stances, there will also be the organic matter produ-
ced by the cyanobacteriae (toxins and intracellular
materials). An apparent association between bladder
cancer and THMs has been demonstrated in one epi-
demiological study20. However, as chlorinated water
contains a large number of by-products it is not pos-
sible from such epidemiological studies to conclude

Foam originating from Phaeocystis bloom (May 1988, “Côte d’Opale”,

France) 20 US EPA. Preliminary assessment of suspected carcinogens in drinking
f15
water. Report to Congress. Washington, DC, 1975.
 that specific THMs are human carcinogens. The When faced with eutrophication of the water reservoir
World Health Organization (WHO) propose guideline the best option, where possible, is to rely on an alter-
values for THMs in drinking water that range between native resource for the water production. If it is not
25 to 100 mg/l depending upon the compounds. possible, then some changes can be made to the
However, and this point is the most important, WHO existing treatment chain, but there is no guarantee
also points out “compliance with THM guideline values that the end product will be totally safe. Information of
must not, under any circumstances, be at the expense the receiving population is necessary. Distribution of
of microbiological standards.” bottled water to the population at risk can be an option
to consider. More detailed information on the changes
For similar reasons, the EU directive 75/440 EEC has that can be made to the treatment process and on the
set guideline values for the organic matter content of resistance of toxins to various disinfectants can be
raw surface waters used for drinking water production found in the technical annex.
(30 mg/l for COD 21 and 7 mg/l for BOD5 ). These
22

values are often exceeded during blooms.

Monitoring of eutrophication
2. Risks linked to the presence of specific cyanobacte-
ria in fresh waters: When eutrophication leads to the Monitoring is useful if it is performed for a purpose.
development of cyanobacteria that are potentially The main reasons for monitoring a water body for
toxic, the elimination of these toxins is complex. eutrophication are:
• To prevent the occurence of eutrophication;
• Early warning purposes. Public health authorities
need to know when eutrophication is likely to start in

Fig. 5: Possible health effects of chlorination order to allow them to implement preventive actions;
of water with organic matter • To know the level of development of the process,
and have a precise picture of the quality of the water.
participate to This is mostly relevant for water companies, which
Cyanobacteria due Excessive
to “eutrophication” organic matter have to deal with eutrophic waters;
• Research.
release
The reality is that monitoring systems are often multi-
Plus disinfectant
purpose.
release
Toxins
Monitoring and management
Disinfection by Biodegradable
products especially dissolved organic of cyanobacterial growth in fresh waters
THMs carbon (BDOC) for public health purposes

Non treated Chorus and Bartram (1999) have proposed the follo-
Treated Treated with Non treated
adequately actived carbon
wing monitoring and management scheme to water
treatment plant operators and managers as an alert
Bacterial
OK regrowth level framework. It provides a graduated response to
the onset and progress of a cyanobacteria bloom.
Health effects
This tool initially comes from Australia. Three res-
ponse levels are defined:

21 COD: chemical oxygen demand

f16
22 BOD: biochemical oxygen demand after 5 days • Vigilance Level is defined by the detection of one
 concentration in the raw water. A consultation should
be held with the health authorities for on-going
assessment of the status of the bloom and of the sui-
tability of treated water for human consumption. Moni-
toring should be conducted at least once per week. It
may also be appropriate at this time to issue advisory
notices to the public through the media or other
means. Government departments or interested autho-
rities or those with legal responsibilities should also be
contacted, as should organizations that treat or care
for members of the public with special needs.

• Alert Level 2 is initiated when 100,000 cells per ml

or 10-mm3/l biovolume or 50 µg/l chlorophyll-a are
detected, with the presence of toxins confirmed by
chemical or bioassay techniques. This density of
cells corresponds to an established, toxic bloom with
high biomass and possibly also localized scums. In
this situation there is a need for effective water treat-
ment systems and an assessment of the perfor-
mance of the system. Hydro-physical measures to
reduce cyanobacteria growth may still be attempted.

If efficient water treatments are not available (see

technical annex), a contingency water supply plan
should be activated. In extreme situations, safe drin-
king water should be supplied to consumers in tanks
Ulva Armoricana and bottles. Media releases and contact with consu-
mers should be undertaken via mail of leaflets infor-
ming that water may present danger for human
consumption but is still suitable for the purposes of
colony, or five filaments, of a cyanobacterium in a 1 ml
washing, laundry and toilet flushing.
water sample. When the Vigilance Level is exceeded,
it is recommended that the affected water body is
National water quality monitoring
sampled more frequently - at least once a week, so
programs
that potentially rapid changes in cyanobacteria bio-
mass can be monitored.
Few national water quality monitoring programmes
include parameters which indicate eutrophication or a
• Alert Level 1 is initiated when 2,000 cyanobacterial
risk of algal or cyanobacterial overgrowth. In Europe,
cells per ml or 0.2 mm3/l biovolume23 or 1 µg/l chloro-
North America, Japan and Australia, local monitoring
phyll-a 24 are detected. Alert Level 1 condition
plans which check the occurrence of toxic species in
requires an assessment to be made of the total toxin
areas where shellfish or fish are consumed, are imple-
mented. This is based on sampling at strategic points
23 Biovolume: ratio of the volume of cells to the volume of water. and analysis of phytoplankton and/or shellfish. The
24 Chlorophyll-a: the green pigment found in most plants, responsible for
light absorption to provide energy for photosynthesis. frequency of sampling generally depends on the sea- f17
 Table 6: Frequency of monitoring of water bodies for phytoplankton and shellfish programs in EEC
Member States

Country Frequency of monitoring Frequency of monitoring

for Phytoplankton shellfish areas
Belgium --- Weekly
France Twice a month from Sept to April Only during alert:
Once a week from May to August Same as phytoplankton
Once a week during alerts
Germany Continuous Weekly
Ireland Once a month from Nov to April Beginning of June and mid-July
Twice a month in May
Once a week from June to Sept
Italy --- Weekly
Portugal Once a month from Dec to April Systematic over 30 stations
Twice a month from May to Nov
Once a week during alerts
Spain Once a month from Dec to March Only during an alert
Twice a month from April to June Same as phytoplankton
Once a week from July to Nov
The Netherlands Weekly (Wadden Sea) In the disgorging facilities
United Kingdom --- Mussel sampling on the East coast

son. Table 6 summarizes the monitoring systems in is the exception rather than the rule, this makes it diffi-
some EU Member States. They only allow the monito- cult to test eutrophication using a case-by-case
ring of toxic blooms, which are only a part of the eutro- approach.
phication consequences.
Nevertheless, as the first signs of adverse eutrophica-
Technologies such as satellite imaging can be used to tion is a decrease in the oxygen concentration in the
monitor large water bodies. The same technique can lower layers of the water body of stagnant waters, and
be applied to monitor the extent of high chlorophyll-a an increase in pH due to photosynthesis (CO2 deple-
concentrations reflecting the phytoplankton biomass of tion), these parameters, together with direct microsco-
the upper layers of the eutrophic area. pic observations, are likely to be the only ones that
can help forecast the likelihood of the start of such a
Possible parameters used process as long as a model integrating physical condi-
for monitoring purposes tions, nutrient inputs and biological effects has not
been locally validated.
According to the definition of eutrophication, it is clear
that formulae such as “an increase of x grams of bot-
tom macrophytes per square meter” or “y micrograms
chlorophyll-a per litre” are not suitable to define a
threshold, which, when exceeded, will describe eutro-
phication. Such unique parameter does not exist.

Moreover, in order to define the magnitude of eutro-

phication, two measurements are required: That of the
system in its reference conditions, and in its current or
f18
predicted future condition. As baseline data for a site
C A S E S T U D Y

REPHY (Réseau de surveillance du 1st alert level

phytoplancton et des phycotoxins)
Count of Dinophysis cells
in sea water. Threshold
The French Research Institute for Exploitation 300 per liter
of the Sea (IFREMER) has created a
phytoplankton and phycotoxins monitoring
network (known as REPHY). It is limited to the
coastline of continental France. Its objectives
are to improve the knowledge of the spatio- 2nd level - Mice test
temporal distribution of various phytoplankton
species and to protect the consumers. 3 mice are injected
extracts of mussel’s liver.
Should the three mice die
within 5 hours, shellfish
IFREMER undertakes regular sampling of
collection is immediately
seawater in order to identify both in quantitative prohibited.
and qualitative terms the presence of various
species of phytoplankton and to monitor the
toxicity of the water. This monitoring network
has been in place since 1984 and has led to 3rd level - «Réseau Diamoule»
the identification of hundreds of episodes of
toxic blooms. Only 12 of the 43 monitoring Medical doctors and
pharmacists established
sites, representative of the whole continental along the sea shore are
taking careful notice of any
French coastline, have never been affected. case of diarrhoea. All
When toxicological tests (on mice) are positive, cases that would occur
within 12 hours after
the information is provided to local authorities. consumption of mussels
They have the power to forbid recreational must be reported to public
(From J. Duchemin ) health autorities.
collection and professional sale of all filtering
shellfish originating from the areas designated
as contaminated. The three species that have a
potential to lead to toxic episodes for human
that have been identified so far along French
coasts are Dinophysis, Alexandrium minutum
and Pseudo-Nitzschia.

Maximum cell-counts cells per liter

1992 - 2001
The three main potentially toxic genus in France.
The maximum cell count includes toxic and non
toxic species of these genus

Dinophysis Pseudo-nitzschia Alexandrium

> 10 000 > 1 million > 1 million

1 000 to 10 000 10 000 to 1 million 10 000 to 1 million

< 1 000 < 10 000 < 10 000

f19
 The potentially toxic dinoflagellate Dinophysis norvegica

Table 7. Parameters relevant to eutrophication monitoring

Parameter Relevance to monitoring eutophication Cost per analysis*

(Euros)
Nitrogen and Indicators of eutrophication and potential bloom occurrence. 60
phosphorus Reflect the balance between a large number of physical and
biological processes. Information is needed on both inorganic
and dissolved organic forms of N and P.
Silicon (Si) Indicator of freshwater dispersion and of potential for diatoms blooms. 10
Si deficiency in coastal waters can favor dinoflagellates blooms.
Suspended solids Relevant indicator for drinking water production. 15
Dissolved oxygen Essential information with regard to eutrophication effects. 5
It is the key indicator to detect the beginning of an eutrophication process
Bacteria Microbial processes happen within the cycle of aquatic life and 10
are relevant in the assessment of eutrophication and nutrients budgets.
Algal Increased algal or cyanobacterial biomass is a characteristic Variable
or cyanobacterial of eutrophication. Information is also useful for assessing the effects
biomass of eutrophication on the ecosystem. Biomass can be determined directly
by microscopic counts or indirectly by measurement of pigments
such as chlorophyll a. Others measures are available such as the
determination of the amount of suspended particulate organic matter or
the automated analysis of number and size of particles.
It is a useful indicator for managers.
Development of short Relevant indicator of a potential disturbance of the recreational Variable,
living species ue of the waters and of a disbalance of the aquatic ecosystem. depends upon the
of macrophytes observation mode
f20
* Costs are indicative
Prevention25,26 Diffuse anthropogenic nutrient sources can be control-
led by soil conservation techniques and fertilizer res-
The causes that drive eutrophication are multiple and
trictions. Knowledge of the agronomic balance (ratio of
the mechanisms involved are complex. Several ele-
fertilizer contribution to plant use) is very relevant to
ments should be considered in order to assess the
optimize the fertilization practice and to limit the loss of
possible actions aimed at counteracting nutrient
nutrients. Diffuse nutrient losses will be reduced by
enrichment of water supplies. The use of computeri-
implementation at farm level of good practices such
sed models now allows a better understanding of the
as:
role of each factor, and forecasting the efficiency of
• Fertilization balance, for nitrogen and phosphorus,
various curative and preventive measures. The best
e.g. adequation of nutrients supply to the needs of
way to avoid eutrophication is to try to disrupt those
the crop with reasonable expected yields, taking into
mechanisms that are under human control; this clearly
account soil and atmospheric N supply.
means to reduce the input of nutrients into the water
• Regular soil nutrients analysis, fertilization plans and
basins. Such a control unfortunately does not have a
registers at plot level.
linear effect on the eutrophication intensity. Integrated
• Sufficient manure storage capacities, for spreading
management should comprise:
of manure at appropriate periods.
• Green cover of soils during winter, use of “catch-
• Identification of all nutrient sources. Such infor-
crops” in crop rotations.
mation can be acquired by studies of the catchment
• Unfertilized grass buffer strips (or broad hedges)
area of the water supply. Knowledge of industrial
along watercourses and ditches.
activities, discharge practices and localization, as
• Promotion of permanent grassland, rather than tem-
well as agricultural practices (fertilizer
porary forage crops.
contribution/plant use and localization of crops) is
• Prevention of erosion of sloping soils.
necessary in order to plan and implement actions
• Precise irrigation management (e.g. drip irrigation,
aiming at limiting the nutrient enrichment of water.
fertilisation, soil moisture control).
The identification of sewage discharge points, agri-
cultural practices, the nature of the soil, the vegeta-
In coastal areas, improvement in the dispersion of
tion, and the interaction between the soil and the
nutrients, either through the multiplication of discharge
water can be of great help in knowing which areas
points or through the changing of their localization,
should be targeted.
can help to avoid localized high levels of nutrients.

• Knowledge of the hydrodynamics of the water

Reuse and recycling, in aquaculture and agriculture,
body, particularly the way nutrients are transported,
of waters rich in nutrients can be optimized in order to
and of the vulnerability of the aquifer, will allow deter-
avoid discharge into the water body and direct
mination of the ways by which the water is enriched
consumption of the nutrients by the local flora and
with nutrients.
fauna.

Anthropogenic nutrient point sources such as non-

treated industrial and domestic wastewater discharge
can be minimized by systematic use of wastewater
treatments. In sensitive aeras, industries and local
authorities should control the level of nutrients in the
treated wastewater by the use of specific denitrifica-
tion or phosphorus removal treatments. 25 see also “Nitrates” Directive 91/676/EEC-Annexes II and III
f21
26 see also the Urban Wastewater Treatment Directive -91/271/EEC
 Recommendation 1 Recommendation 3

Should eutrophic water be the In the marine environment, it is

only source available for the possible, with a reasonable level
production of drinking water, of certainty, to forecast the occur-
all necessary preventive mea- rence of algal blooms, and in some
sures should be taken, among cases to predict the occurrence of
which the most important are: toxic algae associated with the
• To limit to the maximum extent possible the amount process of eutrophication.
of organic matters present in the water before final All measures should be taken by local authorities in
chlorination; order to make such monitoring mechanisms available
• To ensure that there is free chlorine available at the which allow implementation of the necessary protec-
distribution point. Chlorination itself can ensure the tive measures to be taken in good time. As a conse-
destruction of most of the toxins released by fresh quence public health will be protected more efficiently
water blue/green algae blooms and is necessary for than if waiting until a crisis occurs.
bacteriological safety.

Recommendation 2

Although all water receiving

bodies do not have the same sus-
ceptibility to become eutrophic,
all possible efforts should be made
in order to reduce the discharge
of nutrients such as phosphorus
and nitrogen into the environment.
This can be achieved though various policies, two of
which are particularly important:
• Reduction in the use of chemicals based on nitrogen
and phosphorus (for example fertilizers, or P-builders
in washing powders);
• Advanced treatments of wastewaters before their
discharge into the environment.

f22
water Eutrophication
and health

T E C H N I C A L A N N E X

Table of contents

Measurements of toxins 24
Treatment of water bodies affected
by blooms 25
Treatment of eutrophic water
for producing drinking water 25
Crisis management 27
• Public information 27
• Drinking water 27
• Adjacent water bodies 27
Bibliography, further reading
0
f23
and useful websites 28
 (b) Those allowing the identification and methods are less specific but allow the
Measurements of toxins
quantification of toxins present in a assessment of the global toxicity of the
water sample. These are more event. The specificity, duration and
Analytical methods capable of
complex, usually based on physico- indicative costs of the major methods
detecting algal toxins require specific
chemical methods, and used on purified are presented in Table 8.
laboratory experience and trained staff.
water samples.
They belong to two major classes:
Whichever method is used the water
Physico-chemical methods are very sample should be kept in dark and cold
(a) Those that detect whether toxins are
sensitive and can be highly specific (i.e. conditions and the analysis should be
present or not in a water sample. These
able to selectively detect one toxin). performed as soon as possible after
are based on biological, enzymatical, or
However, they are not always sampling to avoid the possible
immunological methods.
conclusive about the global toxicity of degradation of some toxins.
the event. On the other hand, biological

Table 8: Detection of toxins (After Chorus and Bartram, 1999; AFSSA, 2001)

Method Toxins Cost Response Remark

Cap Con Pers time27

Biological
Mouse Global toxicity, Limited sensitivity
H H H h-d28
hepatotoxins, neurotoxins and specificity
Artemia Global toxicity L L H h-d Limited sensitivity and specificity
Daphnia Global toxicity L L H / No correlation with human sensitivity
Bacteriological
Microtox Global toxicity H H L mn29 No specific, contested method
Enzymatical
Phosphatase Hepatotoxins M M L h High sensitivity
Acetylcholinesterase Anatoxins (a) M M L / Good sensitivity
Immunological
Elisa Microcystins,
Monoclonal Nodularin, M H L / Highly sensitive
Polyclonal saxitoxin
Physico-chemical
A N N E X

HPLC/UV Variable sensitivities and

/MS specificities available
/fluorescence Identification and quantification
LC/MS of toxins
All toxins H/VH M L/M Var
GC/MS Detection of very low
/ECD concentrations
T E C H N I C A L

NMR Analysis of numerous samples

MECK Research application
Cap = Capital, Con = Consumable, P = Personnel, VH = Very High, H = High, M = Medium, L = Low.
HPLC = High Performance Liquid Chromatography, UV = Ultra-Violet, MS = Mass Spectrometry, LC = Liquid Chromatography, GC = Gas Chromatography,
ECD = Electron Capture Detection, MECK = Miscellar Electrokinetic Chromatography.

27 Response-time : time needed for the labora-

tory to provide the result
28 h-d : hours or days
f24
29 mn : minutes
 The case of intermediate artificial reservoirs
Treatment of water bodies
affected by blooms
Reservoirs that collect water coming from a large area can accumulate high
levels of nutrients which may lead to a bloom. Pre-reservoirs that temporarily
When a bloom affects a water body,
store the water can reduce total phosphorous input by 50 to 65%. The
preventative measures can be taken
removal of the sediment from these “pre-reservoirs” has to be done regularly
either to limit its spread over unaffected in order to prevent the phosphorus being re-released, although not too often
areas or to treat the contaminated in order to allow the assimilation of the phosphorus by the biomass in the
areas. prestorage zone. When nutrients come from a single major inflow,
phosphorous removal through chemical processes can be very effective.
When the regulations of countries
Another way of controlling the proliferation of algae and/or cyanobacteria in
permit it, algicides can be used if no
sufficiently deep reservoirs is by physical means such as limiting the
other solutions are available or efficient.
penetration of light or mechanically destratifying the water column.
Several algicides such as copper
sulphate, chlorine and citrate copper
are capable of killing algal and
cyanobacterial cells. This will result in • Oxidants such as chlorine or
Treatment of eutrophic
the release of their intracellular charge, potassium permanganate.
water for producing
including the undesirable toxin. This
drinking water
approach is radical and should be In many countries the use of algicides is
undertaken with caution. Algicide prohibited or strictly limited. Where they
The presence of large numbers of algal
treatment of water bodies may result in are permitted care should be taken not
or cyanobacterial cells in raw water
adverse taste and odour of the affected to allow the use of the water supply for
used for drinking water production
water. Moreover, some of the algicides drinking water production, for animal
creates four major problems:
have undesirable environmental watering or as a recreational site during
• The mass of cells can disrupt the
impacts which can lead to the selection the treatment and until the toxins are
hydraulics of the water treatment
of resistant species of algae or degraded. This can take several weeks.
process (resulting in clogging of filters
cyanobacteria. The efficiency of the Algicides should be applied when the
and bulking of sludge)
algicide depends on the features of the cell density is low to avoid a massive
• The cells and their by-products can
water and especially the quality of the release of toxins, which generally
degrade the aesthetic quality of the
contact made between the product and appears between three and 24 hours
water, causing abnormal colour, taste
the target. Examples of algicides after the treatment.
and odour or, worse, produce harmful
include:
by-products
If the bloom is well established,
• In some cases, toxins may be
• Copper sulphate algicides could be the last option.
released into the water, creating a
This has been frequently used due to its These should only be used if the
health concern
efficiency and low cost. Copper, which reservoir can be disconnected for
A N N E X

• An indirect effect may be the release

is not biodegradable, can accumulate in several days.
of an increased amount of
sediments and could in turn affect
biodegradable organic matter in the
phytoplankton, macro-invertebrates or Reservoirs which frequently receive
treated water that will in turn support
even fish directly or indirectly by water from lakes have their intake
T E C H N I C A L

the growth of undesirable bacterial

depleting the available oxygen. system equipped with a possibility of a
populations. It is referred to in the
catchment at different depths, allowing
literature as Biodegradable Dissolved
• Copper chelates such as copper an intake from uncontaminated areas of
Organic Carbon.
citrate the water column.
In addition to the treatment of such
These can be used in hard and alkaline
waters there is a need for the use of
waters, where copper sulphate is less
higher doses of reagents, which impact
efficient.
on the cost of the treatment. f25
 A “typical” drinking water treatment chain able to head water with high coods of organic matters

coagulation / flocculation
granular activated
sedimentation / flotation chlorine disinfection
filters carbon filter

raw-water
pre-filtration
post-ozonation drinking water
raw-water pumping station
pumping chlorination tank

Source: Michel Plumer, SAGEP, 2002

Conventional drinking water treatment, • Filtration: The major mechanisms biodegradation of algal toxins.
when carried out effectively (screening- that occur during filtration lead to the Powdered activated carbon (PAC) is
prefiltration, coagulation-clarification, physical retention of particles, added to the water at the beginning of
filtration), allows a good removal of including large amounts of the treatment chain. PAC, which can be
algae and cyanobacteria. microorganisms and algae. Different added during the relevant periods i.e.
Unfortunately, such a treatment is types of materials can be used for this algal blooms in the water, is more
much less efficient to remove free purpose, e.g. sand or anthracite coal. flexible in its use. Regular absorption
toxins. Depending upon the filtration rate the tests in the laboratory are
techniques are called rapid sand recommended to best adapt the doses
• Screening-prefiltration: Water filtration, rapid mixed bed filtration, to the amount of organic matter and to
treatment plants usually use screens slow sand filtration etc. These the specific toxins to be removed.
to remove debris from the water. techniques, depending upon their
Screens have almost no effects on the design and operation, lead to a • Oxidation is used for several reasons
removal of cyanobacterial cells, only medium to high rate of algal and in drinking water treatment: For
the finest screens are able to retain cyanobacterial removal. Nevertheless disinfection purposes, in order to
the larger species. filtration is not an efficient process for improve the coagulation/flocculation,
removing dissolved chemicals, in or to control the colour and the odour
• Coagulation-clarification: The aim particular algal toxins. of the water. Frequently used
of the coagulation process is through products are chlorine, ozone,
the use of chemicals (the so-called The second mechanism which occurs chloramines, chlorine dioxide and
coagulants) to bring very fine particles during slow sand filtration is the potassium perman-ganate. Strong
to agglomerate with the coagulant in biodegradation of some of the organic oxidants such as ozone (used after
the form of larger particle called “floc”. matter. It has a very limited effect on clarification) and free chlorine (used
In turn, the floc is then removed during toxin removal. after filtration) can, to a large extent,
the clarification step (by remove free toxins30. Ozonation used
A N N E X

sedimentation, flotation or filtration). Other water treatments can be at low doses in the pretreatment step
The efficiency of such treatment considered in addition to the can improve the efficiency of
depends on numerous factors conventional ones: flocculation.
including the dose, the nature of the
T E C H N I C A L

coagulant and the water quality. This • Activated carbon adsorption is an • Providing there is an efficient
process is a good way to remove cells additional treatment, frequently used pretreatment of the raw water,
without bursting them. It is relatively to remove dissolved organic matter. It membrane processes such as
inefficient at removing free toxins. can be used as a continuous or microfiltration, ultrafiltration or
Flotation is more efficient at removing discontinuous treatment. Granular
30 Duguet J.P., Efficacité des traitements de
cells than sedimentation because the activated carbon (GAC) and potabilisation des eaux destinées à la consom-
flocs formed have a density very close particularly “biological” GAC is very mation humaine vis à vis des toxines algales, in
Techniques et sciences municipales, 9, pp75-83,
f26
to 1. effective in the retention and Sept 2001
nanofiltration are very effective for enough dose of chlorine should be release not only toxins but also
removing the few algal and applied. The presence of free chlorine allergizing compounds;
cyanobacterial cells left after the will help minimizing the possible
pretreatment. Reverse osmosis and release of toxins from cyanobacteria. • The health risk connected to collecting
nanofiltration removes all the existing The toxins that are left after this and eating fish and shellfish during a
toxins. Ultrafiltration, associated with treatment stage will have to be bloom event;
PAC, is efficient for toxin removal. removed, if necessary, at a further
stage (see graphic p. f26). The need to discourage domestic
When treating waters that contain animals from drinking or bathing in
potentially toxic cyanobacterial cells it is fresh water affected by blooms and
important to ensure that at the end of Crisis management from grazing along the shore where
the treatment process there is free scum has accumulated and dried.
chlorine available for a sufficiently long In the event of algal blooms, short-term
time period. If insufficient doses of action such as those described below Drinking water
chlorine are used there will be an should be undertaken:
absence of free chlorine, and the • Contaminated water supplies should
toxins, in particular mycotoxins, will not Public information not be used for drinking water
be oxidized. The “CT” factor production during an alert or during a
(concentration x time) is extremely In areas at risk from toxic algal bloom event.
useful in this respect. A rule of the phytoplankton or cyanobacterial • If no alternative water supply is
thumb is that a CT31 of 45 mg.min.l-1, for blooms, it is important that information available, immediate action should be
free chlorine, is efficient to reduce the is provided by local authorities to the taken in order to check the quality of
microcystin-LR level by a factor of ten. general public. The written press, radio, the water and especially to find out if it
For example, a water containing television and internet are all helpful is affected (or likely to be affected) by
20 µg.l of microcystin-LR exposed to
-1
supports that need to be associated a toxic bloom. If it is the case, the
a free chlorine concentration of with. At the same time temporary water should be treated accordingly to
0.5 mg.l-1 during three hours (180 min) warning signs should be posted along ensure it remains safe.
will be left with less than 0.2 µg.l-1 of the water bodies affected by the bloom
toxins (0.5*180=90, divided by a CT of or adjacent land. At an early stage, the • If suitable water treatment processes
45 equals 2, i.e. a reduction of one in health officer and local medical are not available, specific measures
102 or a division of the concentration by personnel need to be provided with should be taken such as preventing
100). information on health issues associated the consumption of the drinking water
with the bloom, including how to from the contaminated distribution
Disinfection with chlorine should be diagnose and treat affected individuals. network. Bottled or tanked water
added to the treatment, with the should be distributed as an alternative
necessary “CT”, depending upon the It is of good practice to inform people drinking source.
A N N E X

toxin concentration in the raw water. It about:

is not sufficient to rely exclusively on the Adjacent water bodies
efficiency of a treatment with activated • The risks of bathing or sporting
carbon. activities in abnormally coloured or During a bloom event, in addition to the
T E C H N I C A L

turbid waters; information measures, protection of the

Prechlorination, as a preoxidation step, uncontaminated areas should remain a
should be avoided in order to limit the • The anaphylactic phenomena, which priority.
production of THMs. If, for practical may be experienced by allergic
reasons, this cannot occur, then a high bathers or people walking along
shores of a water body, affected by
31 Duguet J.P. Is really algal toxins a health pro- blooms. This may happen due to the
blem in disinfected waters? AIDIS/IWA Interna-
ability of many algae to produce and f27
tional Seminar, Santa Fe, Argentina, Oct 2000.
 Bibliography, further reading and
useful websites

• Chorus, I. and Bartram, J. Editors. (1999). Toxic The WHO websites:

cyanobacteria in water, London, E & FN Spon.
Headquaters:
• Menesguen, A. et al. (2001). L’eutrophisation des http://www.who.int/water_sanitation_health/index.html
eaux marines et saumâtres en Europe, en particulier
en France. Rapport IFREMER pour la Commission Regional office for Europe:
Européenne DG.ENV.B1. http://www.euro.who.int

• Environmental Resources Management (2001). The European Commission website

Criteria used for the definition of Eutrophication in http://europa.eu.int
marine and coastal waters. ERM report for the Euro-
pean Commission DG-ENV. The European Environment Agency website
http://www.eea.eu.int
• Vollenweider, R.A. et al. (1996). Assessment of the
state of eutrophication in the Mediterranean Sea.
MAP Technical Reports series n°106, UNEP,
Athens.

• Stanners, D. and Bourdeaux, Ph. Editors. (1995).

Europe’s Environment - The Dobris Assessment.
European Environment Agency (EEA), Copenhagen.

Acknowledgements
• European Environment Agency (1998). Europe’s
The WHO Regional Office for Europe thanks the
environment: the second assessment. Elsevier following experts for their invaluable contribution
to writing this document: Pr A.Menesguen (IFRE-
Science Ltd, Oxford. MER, Brest, France), Mr J. Duchemin (Commis-
sion Européenne, DG ENV), Mr J.P. Duguet
(SAGEP, Paris, France), Dr G. Klein (WHO/ECEH
Bonn office, Germany), Dr J. Bartram (WHO/PEH
Geneva, Switzerland), Dr E Nush ( Ruhrverband,
Essen, Germany), Pr O.Gotsis-Skretas (Institute
of Oceanography, Athens, Greece), Dr S.Fraga
(Instituto Español de Oceanografía, Vigo, Spain),
Mr R. Aertgeerts (WHO/ECEH Rome office, Italy),
Dr F. de Oliveira Araujo (Direcção da Saude, Lis-
Eutrophication and health
bon, Portugal), Dr I. Chorus (UBA, Berlin, Ger-
(Local authorities, health and environment briefing pamphlet series; 40) many), Dr. G. Kamizoulis (WHO/MEDPOL
1.Eutrophication 2.Risk factors 3.Public health 4.Water pollution - prevention and Athens, Greece), Dr P.Lassus (IFREMER,
control 5. Food contamination - prevention and control 6.Water supply 7.Water Nantes, France).
purification 8.Environmental monitoring 9.Local government 10.Europe
Dr Kathy Pond (Robens Centre for Public and
Environmental Health, University of Surrey) edited
© World Health Organization 2002 the document.
All rights in this document are reserved by the WHO Regional Office for Europe. The document may be Mr Roger Laüt painted the picture reproduced on
freely reviewed or abstracted provided due acknowledgement is made to the source. The Regional Office the front cover
encourages the translation of this document, but permission must be sought first. Anyone interested in Mr Pierre Finot was in charge of designing the
whole document.
producing a translated version of this document should therefore contact WHO Regional Office for Europe,
Scherfigsvej 8, DK-2100 Copenhagen, Denmark to discuss their plans. Any views expressed by named Photo credits:
authors are solely the responsibility of those authors. p.f2, R. Oliveri, IFREMER - p.f5, Joint Research
Centre - p.f6, Bjarne Andresen, Fyn County Coun-
European Commission cil - p.f7-f8-f9, Nanna Rash, Funen County Council
Eutrophication and health - p.f12, Stig E. Petersen, Funen County Council -
p.f14, Annette Sode, Fyn County Council - p.f15a,
Luxembourg: Office for Official Publications of the European Communities cliché IFREMER - p.f15b, H. Grossel, IFREMER -
2002 — 28 pp. — 21 x 29,7 cm p.f17, J.-Y. Piriou, IFREMER - p.f20, Per Ander-
f28
ISBN 92-894-4413-4 sen, Bio/consult.
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