The aesthetic nature of recreational waters is such that visible contamination affects the psychological needs of individuals. Chemical and physical agents can enter the surface water and contaminate the beaches from a variety of sources, including runoff from land, contamination from landfill sites and contamination from old mines, working industries and ship disasters at sea.
Swimming Pool Codes and Inspections
Swimming pool codes and inspections vary from community to community and therefore it is difficult to compare problems from one area with those of another one. However, the CDC has compared violation summaries on more than one occasion of thousands of pools from several different states. Approximately 12% of the pools closed immediately because of serious violations, particularly a lack of disinfectant in the water. This has been shown repeatedly through microbiological tests of the water. Tests of the filters used in public pools showed evidence of contamination by many organisms.
Childcare pools had the highest percentage of immediate closures (approximately 17%), followed by hotel/motel and apartment/condominium pools which each had about a 13% immediate closure rate. Interactive fountains had the highest percentage of immediate closures at about 17%. Kiddy/ wading pools had the highest percentage of disinfection level violations.
Best Practices in Preventing and Mitigating Illness and Injury Associated with Recreational
• Use the Model Aquatic Health Code as the basis for the construction and operation of all swimming pools and other water venues to reduce injuries and levels of disease transmission. The most up-to-date science and Best Practices are incorporated throughout the entire guide. The guide covers: facility design standards and construction; facility operation and maintenance; policies and management of the facility; and resources. (See “Resources” section below and endnote 54.)
• All approved swimming areas must be supervised by an individual with credentials similar to American Red Cross swimming instructor certification, plus practical experience. Other individuals involved in water safety must have as a minimum credential training which is similar to American Red Cross senior lifesaver certification.
• To prevent drowning teach individuals swimming skills and life-saving skills including cardiopulmonary resuscitation (CPR).
• Fence off all swimming pools to prevent children from falling into the water and drowning.
• Make the use of lifejackets mandatory for all individuals who cannot swim and where swimming or boating occurs in natural bodies of water. Only US Coast Guard-approved lifejackets are acceptable in natural bodies of water.
• Provide appropriate supervision for all swimming areas.
• Insist on the use of the buddy system or no swimming allowed.
• If caught in a rip current, swim parallel to the shore until free of the current. Watch out for dangerous waves and rip currents by looking for discolored, choppy, foamy water filled with debris and moving away from the shore.
• Do not dive into shallow water or water of unknown depths.
• Obtain information on local weather conditions and leave the area in the event of severe weather including thunderstorms.
• Insist upon no alcohol use or very limited alcohol use by individuals involved in water recreational sports.
• Only trained individuals should operate powerboats and then within safe limits.
• Carbon monoxide poisoning can occur aboard a boat and create headaches, confusion, fatigue, dizziness, or loss of consciousness. The engine exhaust builds up within the boat and the carbon monoxide is colorless and odorless. Immediately ventilate the area and remove the individuals to a fresh air situation. Seek immediate medical help.
• Build spill containment, fire suppression equipment, adequate lighting, alarms, check valves in chemical feed lines, and deactivation devices for the chlorine-pH feed pumps when the recirculation system stops, into pump rooms as well as pool chemical use and storage areas. Include emergency showers and eyewash stations as well as chemical safety equipment. Secure the areas against unauthorized individuals. (See endnote 52.)
• Install separate air handling systems for the chemical storage area, pump room, and pool areas from the rest of the structure.
• Use proper scheduled maintenance by experienced people for all recirculation and filtration systems.
• Individuals adding chemicals to the pool, involved in chemical storage, handling, and maintenance and repair of equipment must be specially trained and certified to do the work. These individuals need to be closely supervised because of the potential hazards to the individuals and the people using the recreational water facility.
• Maintain appropriate levels of chlorine or bromine at appropriate pH levels for an adequate contact time in order to destroy organisms that can cause outbreaks of recreational water disease.
• Test all waters frequently during the course of the day to make sure that all chemical levels are maintained at the appropriate amounts.
• Immediately close swimming pools or other water venues if there is a disinfectant level violation.
• Train all operators of water venues including pools and spas in how best to disinfect the water, how frequently to test it, and when to decide to close the operation voluntarily if problems exist.
• Inform all individuals using water venues that if they are having diarrhea they must not enter the water. This is especially true of individuals who are infected with Cryptosporidium since the organisms are chlorine tolerant and are spread through the oral-fecal route of transmission. Babies in diapers should not be allowed in the water.
• Where an individual defecates into a recreational water source, all other individuals should be removed immediately and the area should be thoroughly cleaned and disinfected. Free chlorine levels need to be at 1-3 mg/L for an extended period of time.
• All individuals must take a shower with soap and water prior to entering any water venue.
• In spas or hot tubs, the higher water temperature makes it hard to maintain proper disinfectant levels. This allows organisms such as Pseudomonas and Legionella to grow and cause outbreaks of disease. Greater care should be taken in the testing and the control of chemicals within these areas.
• Interactive fountains, splash pools, and other water play areas readily become contaminated since the water drains into a water reservoir and may be sprayed back onto the individuals. These venues should be regulated in the same way as pools. (See endnote 55.)
• Avoid swimming in oceans, lakes, and rivers after heavy rainfall and runoff or if health departments determine that the water is unsafe for use.
• In children’s pools, at least once every hour all the kids should come out of the water and take bathroom breaks which are supervised to make sure that they wash their hands properly and clean themselves properly. Sunscreen should be re-applied and the children should be given ample quantities of fluids to prevent dehydration.