Guest Column - November 2007
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The War Against RWIs

Letters From the Front

By Louis "Sam" Fruia, M.Ed.

ighting continues to rage in the aquatic war. We are vastly outnumbered. Our enemy is quick to exploit any weakness. They are sneaky. So sneaky that many of us did not see the war coming. We were, and many still are, unprepared. The war with recreational water illnesses (RWIs) continues, and the battlefront keeps expanding. The outcome is uncertain.

After two years, the ranks at the front are filling. The recruits are veterans of aquatics and captains of the industry. These recruits include the Association of Pool and Spa Professionals (APSP) and the National Swimming Pool Foundation (NSPF). Each has moved up to the line with the Centers for Disease Control and Prevention (CDC) and have troops in combat. But the ranks lack sufficient numbers, so the enemy continues to gain ground. We need more recruits if the tide is to be turned.

There has been a stream of news articles from around the world and industry monitoring the latest developments created to battle RWIs. This news has painted a vivid picture reflecting the true state of the battlefront. It is not pretty.

Published since 1983, the CDC's Morbidity and Mortality Weekly Report (MMWR) focuses on public health surveillance, reporting a broad range of risk factors and health conditions. The report revealed that 60 percent of all RWI outbreaks occur in treated water facilities. The 2001-2002 report revealed an astonishing 11 percent of spas and 8.3 percent of pools required immediate closure. The 2003-2004 report documented 62 waterborne disease outbreaks (WBDOs) in recreational water occurring in 26 states and Guam that affected 2,698 people, and resulted in 58 hospitalizations and one death.

These reports document the severity of RWI outbreaks and have indicated that they continue to rise year after year. The situation is so serious that the CDC recommended that people check pool and spa water with test strips before entering public venues. On the bright side, during this same two-year period, several improvements have made their way into the limelight, including the support for UV treatment and the development of PRS, an EPA-approved, patented, two-stage system that effectively traps Cryptosporidium in the filter. At Brownsville ISD, we have incorporated these methods into our layers of protection for our aquatic facilities.

After all this, why is the enemy gaining ground? The answer is quite simple: Aquatic professionals still do not have the proper information to fight RWIs. The industry must expand the current certification processes for aquatic professionals, including operators, lifeguards, service technicians, coaches and swim teachers to include RWI awareness and prevention. Every aquatic professional must have a practical understanding of waterborne pathogens.

Even the present best practices approach should include a low-tech solution broad enough for the masses to adopt and still afford to keep the pools and spas open. Breaking the material into modules is best. The key elements of the RWI training module could be injected into every training program. The idea is to include RWI training in the curriculum before a candidate is certified as an aquatic specialist by any professional organization.

This idea was presented to the organizations, and seminars were presented at conferences in 2006 and 2007. The Association of Pool and Spa Professionals (APSP) Recreational Water Quality Committee (RWQ) accepted the challenge and made the development of an RWI module one of its key goals.

The RWQ Committee sponsored the premier of the RWI module at the National Environmental Health Association's (NEHA) 71st annual Educational Conference and Exhibition and the 2007 International Pool and Spa Exposition. The information in the RWI module was included in the APSP's new Hot Tub Technician Manual. The APSP also has taken significant strides by providing this valuable information to public health officials (PHOs) in a new newsletter.

The American Swimming Coaches Association, with the largest competitive aquatic coaches' membership in the world, stepped up by publishing an Internet link to an abstract and main article on RWIs.