U.S. Environmental Protection Agency (USEPA) claims that marine and fresh water users will see increased incidence rates of gastrointestinal illness when Enterococcus standards are exceeded in fresh and marine waters of Hawaiian islands. But, Hawaii State Department of Health (HI DOH) has declared for over a decade that USEPA's fecal bacteria standard (Enterococcus) does not indicate fecal contamination of surface water in Hawaiian islands.
In a 2006 Natural Resources Defense Council report, HI DOH said they do not enforce USEPA Enterococcus fresh or marine water standards because they found Enterococcus in soil of lower elevations of the Hawaiian island O‘ahu and Pacific equatorial island Guam, and that the Enterococcus they found on O'ahu and Guam is not really fecal bacteria, but comes from an unidentified non-fecal source. So, while HI DOH neglected, and continues to neglect to put warning signs on beaches during events where Enterococcus USEPA standards were and are exceeded in marine and fresh waters, the potential backlog of illnesses from tourists and residents in Hawaiian Islands remains unknown since USEPA created fecal bacteria water quality standards in 1986. Until a scientific and methodical epidemiological study on tropical islands worldwide occurs that links water quality to illness rates of user groups, concerns remain regarding the effects of animal and human fecal matter to public health on tropical islands worldwide. It is possible that perhaps HI DOH does not realize the large amount of feces in the soil matrix from pigs, birds, rats, cats, cattle, dogs, mongoose, goats, cattle, and humans that overpopulate O'ahu increasingly each year.
So recently, Governor Lingle of Hawai'i signed a bill that forces HI DOH to follow USEPA Enterococcus standards in marine waters. But, HI DOH still does not follow fresh water USEPA Enterococcus standards for stream waters or irrigation waters used to grow crops. Instead, HI DOH uses two fecal indicators for fresh water (Clostridium perfringens and Enterococcus), thereby making it more difficult to warn the public because more than one fecal indicator have to be exceeded before HI DOH posts warnings regarding fecal pollution of fresh waters. Meanwhile, marine water users on Hawaiian islands can only hope that warning signs will go up when USEPA and HI DOH Enterococcus standards are exceeded on places like Waikiki Beach and North Shore O'ahu, suffering from decades of neglect, land abuse, and fecal matters.