Potentially Dangerous When Wet
Aquatic risk management red flags
By Stacy St. Clair
When it comes to risk management, pool managers need to dive right in. Pools and waterparks, perhaps more than any type of recreation facility, are particularly susceptible to injuries and subsequent liability claims. The ongoing aquatic safety issues need to be addressed with both frequency and intensity.
But rather than talk about the same tired topics, we're putting a fresh face on five risk management areas.
We'll look at making your ladders as safe as the local playgrounds and the surprisingly few number of drinks it takes to impair diving. We'll also examine quelling the spread of recreational water illnesses and preventing drain entrapment.
And, perhaps most importantly, we'll offer tips at identifying potential sexual predators. Your pool and your patrons are more vulnerable to sexual abuse than you probably realize.
The biggest challenge, however, is addressing the safety issues while keeping the spotlight on aquatic recreation. Swimming, water fitness and other aquatic sports play a vital role in combating heart disease, diabetes and other obesity-related illnesses.
To lose that focus would be as detrimental to the public as ignoring the risk management issues outlined in this article.
"It's imperative to keep in mind that we don't want to scare people away from pools," says Tom Lachocki, director of the National Swimming Pool Foundation. "Pools are helping people exercise. Pools are saving lives."
Imagine a new playground opens in your community.
It has a top-rate slide that the whole town seems to enjoy using. Once you get there, however, you see the playground has been built on hard ground without enough padding and safety surfacing. Falling from the apparatus could guarantee a cracked skull or worse.
You inspect the slide and notice there are no toe enclosures on the ladder. It's obvious a child's foot could slip right through the rungs.
The handrails are also too large for children to fully wrap their hands around. They won't have a secure grip as they climb the 10-foot ladder.
Would you let your child play on the slide? Probably not. It's not safe.
Yet the aquatics industry regularly installs diving boards with the same unsafe conditions. They're mounted on concrete slabs, without toe enclosures and handrails much too large for a child to completely grasp.
If they were playground slides, most diving boards would violate local and national standards. There would probably be a community uproar, as well.
"There's a disparity between what's permitted at playgrounds and what's permitted at pools," aquatic expert Jason Mart says. "The industry has to do something to change this."
There's more than just a moral obligation to keep patrons safe. There's also an important financial aspect to providing user-friendly pool ladders.
Injuries stemming from ladder falls have resulted in multimillion-dollar lawsuits. By providing safe climbs, aquatic managers reduce the risk of both injury and liability.
Until the industry makes ladders with smaller handrails and toe enclosures standard, proactive pools are installing padding under their diving boards to cushion falls. The pads, which cost between $1,000 and $5,000, increase in thickness depending on the ladder's height. The thickness also meets the Consumer Product Safety Commission's guidelines for falls.
The pads are slip-resistant to minimize injuries around the board, as well. They are waterproof, so aquatic managers don't have to worry about mold or mildew.
Safety-conscious pool managers also have begun installing padding around the entire deck area. The move protects patrons—especially overexcited children who forget the rules and run around the deck—from slipping and falling.
It may not be the industry's most important risk-management issue, but pool padding is gaining more interest. It's much-deserved attention, too, given the padding's ability to protect patrons and reduce liability issues.
"Drowning is always going to be the No. 1 risk management issue," Mart says. "But there are other areas that need to be considered, as well."
Perhaps it's no surprise that drinking and diving don't mix.
A recent study, however, shows how dangerous it really is. Research done by the National Institute of Alcohol Abuse and Alcoholism (NIAAA) shows a diver's ability to perform shallow-entry dives is impaired at a blood-alcohol concentration of only 0.04 percent.
That's half the legal limit in most states and the equivalent of a 160-pound man drinking two beers in an hour.
"It increases the risk to the point that the alcohol is a contributor to serious injury," says Dr. Bud Perrine, the scientist who led the study. "We now know what happens even with these fairly low amounts of alcohol."
As part of the study, 13 male subjects were asked to dive into a pool as if it held 3.5 feet of water. The performances were videotaped and rated on the relative risk of injury due to contact with the hypothetical pool bottom. None of the men realized his abilities deteriorated in lock step with his drinking, researchers found.
"As important as impaired performance, the divers show impaired perception of performances," says Enoch Gordis, NIAAA director.
The men were allowed to perform the maneuver sober, and all completed the task like a racing dive in which they hit the water and sprung to the surface. As they consumed alcohol, the dives became deeper, and in some cases, the subjects made little effort to stop their plunge. Roughly 11 percent of the 207 dives probably would have resulted in injury if the pool actually had been 3.5 feet deep.
The subjects also misbehaved on the pool deck, increasing the chances of a water-related injury in an uncontrolled environment.
"Their diving just really deteriorated—just as their behavior did," says Perrine, who also is the director of the Vermont Alcohol Research Center. "They started clowning around on the side of the pool and dancing. It wasn't very safe behavior."
The study is extremely important given the serious nature of diving-related injuries. Nearly 95 percent of diving accidents result in paralysis from the neck down, studies show.
"When we talk about shallow-entry injuries, we aren't talking about minor injuries," Perrine says. "We're talking about injuries that leave them quadriplegic, with no neurological function below the neck."
The data sends a critical risk management message for hotels, country clubs and other aquatic centers that have alcohol served in close proximity to the water.
Perrine has testified as an expert witness in several lawsuits between hotels and patrons who went swimming after drinking alcohol. In some cases, he says, the injuries resulted in upwards of $15 million judgments against the pool operators.
Many times, the hotel placed low priority on the pool after it closed. They wrongly believed the pool only required attention during hours of operation, Perrine says.
"That's a fallacious assumption," he says. "They have to secure the pool at night. Having a night watchman check every half-half hour is not enough. The control point has to be the pool itself."
Perrine recommends operators install motion censors that turn on lights and alert security personnel if the pool area is entered after hours. Other security measures such as higher fencing and constant security checks are additional ways of combating the problem.
"It cannot be a low priority," Perrine says.
Pool entrapment is not new. The warnings have been around for years. Yet it remains a senseless—and wholly preventable—tragedy.
An estimated 126 entrapment cases took place between January 1990 and October 2003, according to the latest figures from the Consumer Product Safety Commission (CPSC). Of those incidents, 25—roughly 20 percent of all entrapments—resulted in death.
Aquatic centers and waterparks have a moral obligation to ensure their drains will not snare patrons. The precautions will not only save lives, they are part of any thorough risk-management plan.
The protections, among other things, include making the right design decisions. Dual drains, if spaced and plumbed a sufficient distance from each other, minimize entrapments because bathers cannot block both drains.
Some pools use so-called anti-entrapment covers that prevent arms and torsos from blocking the cover. Others eliminate direct suction outlets from pools and spas by installing a gutter system or surge tanks.
Aquatic managers also can reduce risk with properly engineered and maintained atmospheric vents, which break the vacuum at the suction outlet once entrapment occurs. Release systems also may provide relief from certain kinds of entrapment.
Once the mechanics are in place, pool operators still have major responsibilities. The National Swimming Pool Foundation (NSPF) advises paying close attention to spas and wading pools, where bathers are at greater risk because they're closer to the suction outlets in shallow water.
Among the top priorities is ensuring the drains don't become clogged and drain covers are properly installed. No pool or spa should ever be opened if the drains are missing, damaged or secured incorrectly.
Drain covers also should display markings for maximum flow rates, model number and proof of third-party testing, according to the NSPF. They also should be installed so that the maximum flow rating is not exceeded, making the drain more susceptible to entrapment and hair entanglement.
Operators also should check frequently with the CPSC for any advances or new recommendations for preventing entrapment. Updates can be found at the CPSC Web site, www.CPSC.gov.
No one goes to the pool to get sick.
But that's exactly what's happening at aquatic facilities all over the country.
Experts link about 10 diarrheal outbreaks to swimming pools each year. While the number may seem small to pool operators, it's probably grossly underestimated because most diarrheal illnesses do not get reported to health-care providers and health officials.
One outbreak, however, can be devastating from both a financial and public-relations standpoint. Just ask the residents of Lawrence, Kan., where last year more than 600 people fell ill from the pool-related parasite cryptosporidium.
"It's a major problem for aquatic facilities," says NSPF's Lachocki. "They're fighting open and invisible pathogens."
Aquatic centers have begun combating the problem by educating the public. They're enforcing strict rules, insisting that patrons shower thoroughly before entering the water and prohibiting parents from changing diapers poolside.
Pool operators have begun hanging posters and distributing pamphlets explaining why bathers should not swallow the water or swim when they have diarrhea. Some facilities also are instituting mandatory break times and encouraging parents to use that time to take their children to the bathroom.
"From a prevention standpoint, it's one of the best things you can do," Lachocki says. "For example, you have to explain to parents why they can't change diapers near the pool or on lounge chair."
The proper design also can help deter recreational water illnesses. The NSPF recommends using separate filtering systems for different areas of the pool. That way, only one section of pool has to be closed in the event of a diarrheal accident.
Experts also recommend bathrooms be located close to the pool, making it easier for patrons to use the facilities. CDC studies show parents want clean, well-stocked bathrooms within a quick walk from the pool.
The bathroom also should have adequate changing stations so moms and dads have a hygienic alternative to changing diapers near the water.
"A lot of these issues can be addressed in the design," Lachocki says.
The most important thing pools can do, however, is make sure their operators are well-trained. Having a pool operator who doesn't understand the job or the chemistry behind it is like hiring a lifeguard that doesn't know how to perform CPR or makes rescues.
A recent NSPF study of six jurisdictions showed nearly one in every five operators had no formal training. Even worse, all six of the jurisdictions required it by law.
Experts estimate nearly half of the pool operators are untrained in states that do not require it.
"It's hard to believe," Lachocki says. "It's extremely important for operators to understand the chemistry behind it."
The precautions will help prevent an outbreak of recreational water illnesses, thus keeping pools from having to close for health reasons. An unscheduled closing means lost revenue and extra expenses.
But should a serious incident arise, Lachocki says operators should not be afraid to close the infected waters.
"As little as people want to pull the cord," Lachocki says. "They don't want make their clients sick."
Every pool seems to have one.
A creepy loner that hangs out near the changing rooms. A childless man who sits near the kiddie pool. A goggle-wearer who constantly swims around children he doesn't know.
Melissa Carrier hears these same stories at every aquatic facility she visits. She goes to the pools and waterparks to teach employees about identifying potential child abusers. Without fail, she listens to the lifeguards and gate monitors describe suspicious patrons and, occasionally, employees.
"Inevitably, when we ask the questions, they all have stories," Carrier says. "One group says, 'We even have a name for him. We call him Chester the Molester because he comes by himself in the middle of the day and plays with children.'"
Carrier works for Praesidium Inc., a Texas-based organization that helps recreation facilities and other kid-centered groups prevent abuse. The effort, which is supported by insurance companies, helps keep patrons safe. The training also serves to protect pools and waterparks from the lawsuits and liability claims that often accompany incidents of abuse.
"Sometimes they don't know what they don't know," Carrier says.
The first step toward preventing abuse at local aquatic centers is acknowledging it exists. In fact, pools and waterparks are havens for pedophiles because they are filled children in various stages of dress.
"It's easy to gain access to kids and gain access without losing anonymity," Carrier says. "They can touch children in the pool and easily explain it away if someone challenges them on it."
Aquatic centers also are susceptible because parents of proficient swimmers often pay little attention to their children. Moms and dads often chat with friends or sunbathe while their kids splash in the pool.
"It shouldn't happen, but a lot of parents use the lifeguards as babysitters," Carrier says. "Children who want attention are more vulnerable. It's easier for [a pedophile] to engage them."
Carrier encourages pool employees to look out for abnormal behavior. Some molesters like to go underwater near the slide, which allows them an unrestricted view of the children as they plunge into their pools and their bathing suits move. Others enjoy bumping and diving into kids at the wave pool.
There are also reports of pedophiles using camera phones in dressing rooms and returning day after day to play with toddlers in the kiddie pool.
Carrier also advises lifeguards to look for childless patrons who bring toys to attract young swimmers. She knows of one pool where a man brought dozens of inflatable toys and passed them out to children.
"They [pool employees] need to recognize that these behaviors have to be addressed," Carrier says.
Confronting suspicious patrons, however, is a delicate subject. Carrier advises facility employees to take a friendly, but pointed, stance. She suggests they approach questionable customers, introduce themselves and ask their names.
"Just going up and introducing yourself is going to make a big difference," Carrier says. "You've taken away their anonymity. If they're there for the right reason, all you've done is made a personal connection without making any accusations."
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