Children and Sand Play: Screening of Potential Harmful Microorganisms in Sandboxes, Parks, and Beaches

Sand serves as a reservoir for potentially pathogenic microorganisms. Children, a high risk group, can acquire infections from sand in sandboxes, recreational areas, and beaches. This paper reviews the microbes in sands, with an emphasis on fungi. Currently monitoring in sandboxes is limited to measurements of Toxocara eggs, although other microbes have been documented. Recreational areas and beach sands have also been found to harbour many types of fungi and microbes. A newly emerging group of fungi of concern include the black yeast-like fungi. After establishing that sand is a reservoir for fungi, clinical manifestations of fungal infections are described with an emphasis on ocular and ear infections. Overall, we recommend environmental studies to develop monitoring strategies for sand and studies to evaluate the link between fungi exposure in sand and human health impacts.