"Swimmer's ear" among children of kindergarten age and water quality of swimming pools in 11 Kibbutzim.
In an effort to determine if bacterial water quality was related to the incidence of otitis externa ("swimmer's ear") in kindergarten children, a prospective study was conducted between May and September 1980 in 11 communal agricultural settlements (kibbutzim) in Israel. High total bacterial count, total coliforms and fecal coliform counts were found to be positively associated with otitis externa. This association was enhanced when nondivers were separated from divers. Among the divers, the rate of ear inflammation was high regardless of water quality. Among nondivers at the time of the study, the rate of otitis externa was as high as 35.7% in swimming pools with poor quality water, and as low as 17.0% in those with good quality water (P = 0.03). Younger children had a slightly higher risk of otitis externa than had older children.