Objective vs perceived bathing water quality assessments and associations with wellbeing outcomes
Abstract
Background: The global burden of mental health disorders is increasing, highlighting the need for accessible preventive approaches. Aquatic (“bluespace”) environments are associated with improved wellbeing, and environmental quality may influence these benefits. However, it remains unclear whether perceived or objectively measured water quality is more relevant to wellbeing outcomes. This study examined associations between perceived and objective water quality and visit-related happiness, worthwhileness and satisfaction.
Methods: A cross-sectional study analysed geolocated visit data from the BlueHealth International Survey (n = 572) across 14 European countries (2017–2018). Participants reported perceived water quality and visit-related wellbeing. Data were linked with bathing water quality classifications from the European Environment Agency under the EU Bathing Water Directive. Linear regression models examined associations between perceived and objective water quality and wellbeing outcomes, adjusting for age, gender, visit duration and environment type.
Results: In fully adjusted models, perceived water quality was significantly associated with wellbeing outcomes. Compared with sites perceived as poor, sites perceived as excellent were associated with higher happiness (β = 0.63, 95% CI 0.24–1.02), worthwhileness (β = 0.66, 95% CI 0.28–1.05) and satisfaction (β = 0.80, 95% CI 0.44–1.16). No significant associations were observed for objective classifications. Perceived and objective water quality were weakly correlated.
Conclusions: Perceived environmental quality was more strongly associated with wellbeing than objective classifications, suggesting current frameworks may not capture factors relevant to mental wellbeing. Incorporating perceptual indicators into monitoring under the EU Bathing Water Directive could complement existing systems and support prevention-focused strategies that maximise wellbeing benefits from recreational water use.
Key messages: • Perceived water quality, rather than objective ratings, was associated with higher visit-related wellbeing at European bathing sites.
• Incorporating perceived environmental quality into water assessments could improve strategies that use recreational waters to support population wellbeing.
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BibTeX
@article{graves2026objective,
title = {{Objective vs perceived bathing water quality assessments and associations with wellbeing outcomes}},
author = {HV Graves},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1249},
url = {https://doi.org/10.1093/eurpub/ckag169.1249},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Objective vs perceived bathing water quality assessments and associations with wellbeing outcomes
AU - HV Graves
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1249
UR - https://doi.org/10.1093/eurpub/ckag169.1249
AB - Background: The global burden of mental health disorders is increasing, highlighting the need for accessible preventive approaches. Aquatic (“bluespace”) environments are associated with improved wellbeing, and environmental quality may influence these benefits. However, it remains unclear whether perceived or objectively measured water quality is more relevant to wellbeing outcomes. This study examined associations between perceived and objective water quality and visit-related happiness, worthwhileness and satisfaction. Methods: A cross-sectional study analysed geolocated visit data from the BlueHealth International Survey (n = 572) across 14 European countries (2017–2018). Participants reported perceived water quality and visit-related wellbeing. Data were linked with bathing water quality classifications from the European Environment Agency under the EU Bathing Water Directive. Linear regression models examined associations between perceived and objective water quality and wellbeing outcomes, adjusting for age, gender, visit duration and environment type. Results: In fully adjusted models, perceived water quality was significantly associated with wellbeing outcomes. Compared with sites perceived as poor, sites perceived as excellent were associated with higher happiness (β = 0.63, 95% CI 0.24–1.02), worthwhileness (β = 0.66, 95% CI 0.28–1.05) and satisfaction (β = 0.80, 95% CI 0.44–1.16). No significant associations were observed for objective classifications. Perceived and objective water quality were weakly correlated. Conclusions: Perceived environmental quality was more strongly associated with wellbeing than objective classifications, suggesting current frameworks may not capture factors relevant to mental wellbeing. Incorporating perceptual indicators into monitoring under the EU Bathing Water Directive could complement existing systems and support prevention-focused strategies that maximise wellbeing benefits from recreational water use. Key messages: • Perceived water quality, rather than objective ratings, was associated with higher visit-related wellbeing at European bathing sites. • Incorporating perceived environmental quality into water assessments could improve strategies that use recreational waters to support population wellbeing.
SN - 1101-1262
SN - 1464-360X
ER -