Italian beaches are eagerly awaited all year round, loved and crowded, but unfortunately often neglected. According to Legambiente’s Beach Litter 2025 report, over 56,000 discarded items were found on just 63 sections of coastline, averaging almost 900 items per 100 metres. The most common types of waste were plastic, glass, cans and sanitary materials. This waste not only damages the environment, but can also become a vehicle for intestinal bacteria and viruses, including E. coli, Salmonella, Campylobacter and Norovirus.
While the Italian National System for Environmental Protection (SNPA) ensures high standards, extreme weather events such as heavy rainfall and uncontrolled discharges can cause sudden contamination.
How can we protect ourselves from negative experiences during our well-deserved holidays? We talked to Professor Maria Rosaria Gualano, a lecturer in General and Applied Hygiene at UniCamillus University. Professor Gualano told us about places that are unexpectedly dangerous and habits that are often taken for granted. However, she reassured us that we can all protect ourselves by being cautious and taking good precautions.
Professor Gualano, we inevitably become terrified when we read reports and medical articles about health conditions at the beach and elsewhere which refer to infectious pathogens such as Norovirus, MRSA and resistant bacteria. Do beachgoers in Italy have much to fear?
“First of all, the real risk of these infections for healthy swimmers spending time on Italian beaches is low. However, it is important to remember some good hygiene rules and, above all, to consider people whose health conditions make them more vulnerable. For example, those with immunodeficiency or temporary clinical conditions, such as open wounds, can be at greater risk. This is particularly important because, according to some studies and surveys, traces of E. coli and other resistant species have been found in samples taken from the Mediterranean.
One of the basic rules is certainly to shower after swimming in the sea and, in general, to avoid handling food without first washing your hands properly after touching the sand. We now know that it is always an excellent idea to wash your hands thoroughly, both at the beach and elsewhere!
Furthermore, it is worth bearing in mind that Italy is one of the European countries most affected by antimicrobial resistance. Therefore, observing correct behaviour is even more important.
As for Norovirus and other faecal-oral pathogens, infections linked to bathing are even less frequent because, although they are highly contagious, they are mainly transmitted between people or through contaminated food or drinking water.
In conclusion, to avoid dermatological or gastrointestinal infections, good hygiene practices must be followed, particularly among vulnerable individuals such as children and the elderly.
Furthermore, if we want to take our pets to beaches where they are allowed, it would be good practice to protect their health by consulting our vet, who can advise us on what to do before leaving!”
Is there any ongoing monitoring of antibiotic-resistant bacterial strains on Italian beaches?
“Although there are no regulatory requirements in place yet, greater attention to human and environmental health is becoming more prevalent. Consequently, guidelines and recommendations have been established at the European institutional level, and some Regional Environmental Protection Agencies in Italy are experimenting with best practices for monitoring antibiotic-resistant species. Researchers at the regional level are also taking action, and their initiatives can make an important contribution to assessing the extent of the issue”.
Are microbiological checks carried out on both water and sand?
“With regard to bathing water, the main standard is European Directive 2006/7/EC, which was implemented in Italy by Legislative Decree 116/2008. The directive aims to assess the quality of this type of water and ensure its safety by monitoring, classifying and managing it in a way that takes public health into account. The main parameters assessed in mandatory sampling relate to the detection of Escherichia coli and intestinal enterococci, which are considered the best indicators of faecal contamination.
As far as sand is concerned, there are currently no binding checks, but several institutional guidelines, such as those of the WHO, indicate it as a possible vehicle of microbiological risk. In Italy, various institutions and agencies, such as the Regional Agency for Environmental Protection (ARPA), take it into account in their monitoring, as do programmes such as the international eco-label Bandiera Blu, which is awarded to coastal destinations that meet high standards in terms of water quality, environmental education, safety, and sustainable tourism.
In recent years, greater attention has also been given to these quality aspects, so our beachgoers are increasingly protected. However, they must also play their part by adopting good habits that respect other people and the environment.”
When it comes to beaches, we all know that they are often sadly full of rubbish. Could this increase the risk of spreading pathogens?
“Respectful habits are important, as rubbish on beaches can be dangerous in many ways. For example, microplastics can act as a vehicle for various pathogens, while organic waste can promote the development of toxic algae and the growth of faecal pathogens. Therefore, it is essential to pay close attention to hygiene guidelines, primarily by disposing of any rubbish produced during a day at the beach in the appropriate bins.
The longer waste remains on the beach, the more it encourages the development of pathogens such as Pseudomonas, which could damage our health. For example, decomposing organic waste releases nutrients and creates a vicious circle that favours pathogens”.
Now let’s move on to ‘swimmer’s itch’: can microscopic jellyfish in Italian seas also cause it?
“The microscopic jellyfish found in the Mediterranean Sea can cause skin irritation, resulting in itchy rashes and blisters, as well as contact dermatitis. Particular care should be taken not to keep wet swimwear on for too long, as the larvae of these ‘invisible jellyfish’ can become encysted between the skin and swimwear, causing skin irritation.
Therefore, I reiterate my advice to always pay attention to hygiene and educate even the youngest children so that they continue these good habits of changing their swimsuits and showering after swimming as they grow up”.
This applies from swimming in the sea or a lake to using public showers. Legionella is a bacterium that can be contracted in beach showers. How can we protect ourselves?
“Legionella proliferates in stagnant water at warm temperatures, as found in water systems including beach showers. It can cause serious infections such as pneumonia, particularly in vulnerable and immunocompromised individuals. Firstly, facility managers should ensure cleanliness by regularly disinfecting water systems. This is recommended and regulated in some regions. Bear in mind that the bacterium proliferates at average temperatures, so keep the water either below 20°C or above 50°C.
As users, we should avoid stepping under the first jet of water immediately and let it run for a while. We should also try not to inhale the steam emitted in closed showers and be careful if we have wounds or are wearing contact lenses, as transmission is by aerosol. Clearly, greater hygiene precautions are required for frail and immunocompromised individuals”.
Is there a risk of hepatitis A from water sports? Should surfers get vaccinated?
“The HAV virus causes infections that typically present with symptoms such as fever, jaundice and fatigue. It can be contracted by people who practise water sports, particularly in areas contaminated by sewage, for example. Therefore, people who do sports such as surfing or swimming in open water are strongly recommended to get the appropriate vaccination, especially if they are going to countries that are at a higher risk. I would therefore advise contacting the relevant travel medicine clinics at local health authorities and public facilities for further information. For people in Italy, I would recommend consulting the Ministry of Health‘s website, where critical conditions affecting bathing waters are promptly reported. This advice is for everyone, not just surfers!”
So, how can we protect ourselves during the holidays? Could you give us a few tips?
“Taking into account what we have discussed so far and the best practices based on available scientific evidence, I would recommend the following:
- Observe good hygiene practices, such as handwashing, which is even more important at the beach.
- Pay particular attention to vulnerable individuals, such as the elderly, children, and immunocompromised people.
- If you are taking your pets with you, please follow the hygiene rules for their protection and yours.
- Check the official websites for information on bathing conditions at the beaches you plan to go to.
- If you have open wounds, always cover them with waterproof plasters.
- Do not leave wet swimwear on for too long.
- Remember that it is always good practice to shower after swimming in the sea.
- If you do water sports, make sure you are vaccinated against hepatitis A.
- Do not leave behind any plastic, cigarette butts or other organic waste, as this encourages the proliferation of pathogens.
- Respect the natural environment and the people around you by following common-sense rules, such as leaving the beach clean after a day at the seaside.
Ultimately, we should not be overly obsessed with hygiene and cleaning; rather, we should simply observe basic rules of cleanliness and good manners while trying to enjoy our well-deserved holidays to the fullest!”