Feature Article - April 2007
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Risky Business

Critical Safety Issues for Aquatic Facilities

By Joseph Ryan

Getting ill at the pool

As managers focus on preventing drowning and other injuries and incidents at their aquatic facilities, sometimes the prospect of a massive illness outbreak can lose its priority. But Dr. Michael Beach, a CDC epidemiologist, said that this is dangerous thinking.

Preventing illness outbreaks can take as much continual supervision and prevention measures as stopping a child from diving into the shallow end of the pool.

Between 2003 and 2004, 62 water-borne illness outbreaks were reported in 26 states, infecting 2,698 people and causing 58 hospitalizations and one death, according to the latest CDC data. About half of the outbreaks were intestinal, 13 involved skin infections and seven were respiratory. Twelve others were either mixed illnesses or types of meningitis.

Intestinal illnesses were involved with 72 percent of the infected swimmers, and more than 90 percent of those infections either involved or were caused by Cryptosporidium, commonly called "crypto." Most of those infections occurred at treated pool facilities.

Crypto should be the number-one concern for pool facilities when it comes to a potential illness outbreak, Beach said, because even proper chlorination and common sand filtration can't stop it.

The bug is caused by microscopic parasites that live in the intestines and cause vomiting, fever and diarrhea.

Even though the illness is hard to kill, experts contend that there are measures on the market that have proven effective. Moreover, good pool maintenance and a quality patron and staff education program can significantly lessen the chances of an outbreak.

"We believe most outbreaks are prevented by good pool maintenance," Beach said. "But even the best-maintained pool can have an outbreak."

The parasite is passed on by patrons experiencing diarrhea. Therefore, kiddy pools and wade pools frequented by children are the most at risk.

Beach said that managers should institute a bathroom break policy at those pools every 30 minutes to help parents manage multiple children at once and decrease the chances of the pool becoming a toilet.

"The kids aren't being changed enough or using the bathroom," Beach said. "We would like to see all of that waste deposited in the bathroom, not the pool."

Brochures for guests and regular patrons as well as signs that warn about swimming while ill can also be helpful, Beach said.

"A lot of patrons just aren't knowledgeable about the issue," he said. "There is a resistance to talk about it, but there really shouldn't be."

Unfortunately, he also said many outbreaks appear to be caused by sick staff members, so reminders to lifeguards and pool employees also are critical.

"If (the staff) isn't feeling well, they will still get in the water," Beach said. "They don't want to lose that paycheck."

On the equipment front, Beach said that ozone or ultraviolet light disinfectors along with diatomaceous earth (DE) filters have proven very effective at eliminating crypto from the water.

Fijas of Raging Waves said UV filters have worked well in his experience. "From a standpoint of a pool, that is a great additional safety measure to kill all the bugs," he explained.

Overall, Beach said that as with all of the other safety issues at a pool facility, managers need to take the lead and assume responsibility for creating the safest environment possible for guests and staff.

"Swimming is a great physical activity. There are so many health benefits," he said. "But there are public health concerns too, and while we need to swim responsibly, managers need to realize they are the front line."