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Article

Quantitative Microbial Risk Assessment of E. coli in Riverine and Deltaic Waters of Northeastern Greece: Monte Carlo Simulation and Predictive Perspectives

by
Agathi Voltezou
1,
Elpida Giorgi
1,
Christos Stefanis
1,*,
Konstantinos Kalentzis
1,
Elisavet Stavropoulou
1,
Agathangelos Stavropoulos
2,
Evangelia Nena
3,
Chrysoula (Chrysa) Voidarou
4,
Christina Tsigalou
1,
Theodoros C. Konstantinidis
1 and
Eugenia Bezirtzoglou
1
1
Laboratory of Hygiene and Environmental Protection, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
2
School of Social and Political Sciences, University of Glasgow, Glasgow G12 8RT, UK
3
Laboratory of Social Medicine, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece
4
Department of Agriculture, School of Agriculture, University of Ioannina, 47100 Arta, Greece
*
Author to whom correspondence should be addressed.
Toxics 2025, 13(10), 863; https://doi.org/10.3390/toxics13100863 (registering DOI)
Submission received: 30 August 2025 / Revised: 29 September 2025 / Accepted: 9 October 2025 / Published: 11 October 2025

Abstract

This study presents a comprehensive Quantitative Microbial Risk Assessment (QMRA) for Escherichia coli in northeastern Greece’s riverine and deltaic aquatic systems, evaluating potential human health risks from recreational water exposure. The analysis integrates seasonal microbiological monitoring data—E. coli, total coliforms, enterococci, Salmonella spp., Clostridium perfringens (spores and vegetative forms), and physicochemical parameters (e.g., pH, temperature, BOD5)—across multiple sites. A beta-Poisson dose–response model within a Monte Carlo simulation framework (10,000 iterations) was applied to five exposure scenarios, simulating varying ingestion volumes for different population groups. Median annual infection risks ranged from negligible to high, with several locations (e.g., Mandra River, Konsynthos South, and Delta Evros) surpassing the World Health Organization (WHO)’s benchmark of 10−4 infections per person per year. A Gradient Boosting Regressor (GBR) model was developed to enhance predictive capacity, demonstrating superior accuracy metrics. Permutation Importance analysis identified enterococci, total coliforms, BOD5, temperature, pH, and seasons as critical predictors of E. coli concentrations. Additionally, sensitivity analysis highlighted the dominant role of ingestion volume and E. coli levels across all scenarios and sites. These findings support the integration of ML-based tools and probabilistic modelling in water quality risk governance, enabling proactive public health strategies in vulnerable or high-use recreational zones.
Keywords: QMRA; public health; E. coli; dose–response model; Monte Carlo; river water; deltas; health risk; pathogens QMRA; public health; E. coli; dose–response model; Monte Carlo; river water; deltas; health risk; pathogens

Share and Cite

MDPI and ACS Style

Voltezou, A.; Giorgi, E.; Stefanis, C.; Kalentzis, K.; Stavropoulou, E.; Stavropoulos, A.; Nena, E.; Voidarou, C.; Tsigalou, C.; Konstantinidis, T.C.; et al. Quantitative Microbial Risk Assessment of E. coli in Riverine and Deltaic Waters of Northeastern Greece: Monte Carlo Simulation and Predictive Perspectives. Toxics 2025, 13, 863. https://doi.org/10.3390/toxics13100863

AMA Style

Voltezou A, Giorgi E, Stefanis C, Kalentzis K, Stavropoulou E, Stavropoulos A, Nena E, Voidarou C, Tsigalou C, Konstantinidis TC, et al. Quantitative Microbial Risk Assessment of E. coli in Riverine and Deltaic Waters of Northeastern Greece: Monte Carlo Simulation and Predictive Perspectives. Toxics. 2025; 13(10):863. https://doi.org/10.3390/toxics13100863

Chicago/Turabian Style

Voltezou, Agathi, Elpida Giorgi, Christos Stefanis, Konstantinos Kalentzis, Elisavet Stavropoulou, Agathangelos Stavropoulos, Evangelia Nena, Chrysoula (Chrysa) Voidarou, Christina Tsigalou, Theodoros C. Konstantinidis, and et al. 2025. "Quantitative Microbial Risk Assessment of E. coli in Riverine and Deltaic Waters of Northeastern Greece: Monte Carlo Simulation and Predictive Perspectives" Toxics 13, no. 10: 863. https://doi.org/10.3390/toxics13100863

APA Style

Voltezou, A., Giorgi, E., Stefanis, C., Kalentzis, K., Stavropoulou, E., Stavropoulos, A., Nena, E., Voidarou, C., Tsigalou, C., Konstantinidis, T. C., & Bezirtzoglou, E. (2025). Quantitative Microbial Risk Assessment of E. coli in Riverine and Deltaic Waters of Northeastern Greece: Monte Carlo Simulation and Predictive Perspectives. Toxics, 13(10), 863. https://doi.org/10.3390/toxics13100863

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