All Together Now
New Code Aims at Standards for Nation's Pools
By Wynn St. Clair
When it comes to commercial swimming pools and waterparks, aquatic managers are not all on the same page. And they really never have been.
In the United States, there is no federal regulatory authority responsible for disinfected aquatic facilities. All pool codes are handled at the state and local level, meaning there are no unified standards governing design, construction, operation and maintenance of treated aquatic facilities. What's permissible in Pittsburgh may not play in Peoria. Policies followed in Frisco, Texas, may not be required in Frankfurt, Ky.
While there are benefits to localized power and autonomy, the disparate codes and standards long have been a source of concern for industry advocates and the Atlanta-based Centers for Disease Control and Prevention. The first industry standard was issued in 1958 and in the subsequent 53 years, no two states have had the same code. Many counties have created their own standards because the state codes were perceived as inadequate. As a result, there is extraordinary variability, experts say. Without uniformity, for example, the code requirements for preventing and responding to recreation water illnesses can vary significantly from state to state—and sometimes even city to city.
Even when national laws like the Virginia Graeme Baker Pool & Spa Safety Act or the Americans with Disabilities Act were enacted, state and county agencies were left to evaluate the codes on their own. Having so many codes places an exceptional financial burden on industry and government, experts said. A lack of uniformity also fails to ensure that aquatic managers and public health officials are getting the most up-to-date information about industry data and new scientific studies.
To address the issue, the CDC, the National Swimming Pool Foundation and dozens of volunteers have been working on a Model Aquatic Health Code (MAHC), which is intended "to transform the typical health department pool program into a data-driven, knowledge-based, risk reduction effort to prevent disease and injuries and promote healthy recreational water experiences." The MAHC should ensure that the best available standards and practices for protecting public health are available for adoption by state and local agencies, proponents say. It also will provide local and state agencies with uniform guidelines for the design, construction, operation and maintenance of swimming pools and other disinfected aquatic facilities.
"A national code would provide consistency and the ability to update when new science and technology comes out," sais Tracynda Davis, the director of environmental health programs for the National Swimming Pool Foundation (NSPF). "Consistent standards help uniform data collection, which is necessary for illness and injury investigation and treatment. The MAHC uses evidence-based data to understand waterborne illness and appropriate treatment for prevention and remediation."
The CDC, through an initial grant from the National Swimming Pool Foundation, has been working with public health and industry representatives across the United States to build this effort. Initial work has been focused on reducing the spread of recreational water illnesses and injuries at disinfected aquatic facilities.
The aquatic industry and public-health agencies have a shared responsibility to ensure that facilities provide consumers with safe and healthy recreational water experiences and do not become vehicles for transmission of communicable disease or outbreaks.
According to draft documents, the goal of the initiative is to develop a Model Aquatic Health Code that is "user-friendly, knowledge-based, and scientifically supported in an effort to reduce risk and promote healthy recreational water experiences." The objective is to transform the varied swimming pool regulations used by health departments into a uniform model national code to ensure the health and safety of the swimming public.
With more than 368 million annual visits to swimming pools, beaches and lakes in the United States, the stakes are high. The aquatic industry and public-health agencies have a shared responsibility to ensure that facilities provide consumers with safe and healthy recreational water experiences and do not become vehicles for transmission of communicable disease or outbreaks. A national standard can go a long way to achieving this goal, experts say.
"The aquatic industry, governments and the public all benefit from the MAHC," said Thomas Lachocki, CEO of the NSPF, a nonprofit organization that offers safety and educational training for pool operators. "As more states and counties adopt, there is more consistency in rules, making product development and introduction more efficient. It is always better if the industry knows the rules and the rules are consistent. Government benefits because every jurisdiction will not have to invest so much time trying to develop codes that are likely to comply with the highest scientific standards. People benefit because 72 jurisdictions are not wasting precious tax dollars paying for departments to do the same thing another department is doing across the river or across the country. Then those tax dollars can be used for more valuable services."
The new effort was born after a February 2005 workshop sponsored by the CDC, titled "Recreational Water Illness Prevention at Disinfected Swimming Venues." The seminar drew experts from various disciplines at the local, state and federal level, as well as industry experts, to discuss ways to minimize RWIs.
The workshop evolved into a new health code initiative, prompting the CDC to develop a set of modules on specific topics. As they create the module they send it periodically to the steering committee to ensure that the content and format integrates with the work being done by other committees and addresses the overall MAHC goals. This process, by its very nature, involves many drafts of the modules before completion. Once the technical committee finishes the module and the steering committee approves the product, it is passed to the MAHC editor. The module is then moved into final formatting. Additional annex information may be added by staff if further clarification is needed on the intent or direction. Following completion of this process, the module is put through internal CDC clearance.
Upon CDC clearance, the initiative also calls for multiple opportunities for review and comment by the public and other stakeholders. Under the initiative, each module is developed by the appropriate technical committee, approved by the steering committee and posted for public comment for 60 days. The steering committee and appropriate technical committee then review the input and revise the modules accordingly. Once all the modules have been revised after their respective 60-day reviews, the entire MAHC will be posted for another 60-day public comment period to allow the public to review the new code in its entirety and check it for thoroughness.
Even after the new code is finalized and released, the CDC anticipates that it will be updated on a periodic and systematic basis to reflect additional best practices and the latest science.
Even after the new code is finalized and released, the CDC anticipates that it will be updated on a periodic and systematic basis to reflect additional best practices and the latest science. The current plans call for a new edition of the MAHC every two years, with supplements issued when needed.
Lachocki said there has been great optimism about the new health code throughout the aquatic industry. He understands that some government agencies may initially resist the science-based codes because it represents a change in the way things have been done in the past. The issue could be resolved if and when public health agencies stopped thinking about how "we" do things locally and embraced the idea of how "we" should do things as a country. One of the best ways to do this, he said, is to become involved with the new code's development.
There has been some confusion about the role MAHC will play, with some mistakenly believing that it will be a federal mandate, much like the Virginia Graeme Baker Pool and Spa Safety Act. The new code, however, will not be a federal requirement and could actually help with federal laws because it will be a repository of the latest science on recreational water, while some federal codes clearly are not.
"The Virginia Graeme Baker Act is a law. Once you get a new pool code in a state it can be another 20 years to get it updated," said Dr. Michael Beach, the CDC's associate director for healthy water. "The MAHC is a model. It's a renewable process. Every couple of years, the model can be taken and updated with the latest data."
Given the issue's importance, Beach strongly encourages recreation managers and other aquatic industry workers to become involved in the health code's creation.
"This is going to work for you if you give input. If you don't like something, or you do, get involved in the project," he said. "We read everything. Most of the time we agree with the comments, and if we don't, we'll address why we don't. We want those comments. We want to change things based on the comments."
Indeed, the published public comments show industry experts from across the country have taken a deep interest in the codes. The input has led to rewording of the codes, as well as additional requirements. When suggestions are rejected, the committee explains why it does not agree with the idea. Thus far, the published comments have been notable for their constructive nature, thoughtfulness and support for a national code.
The first of the 12 modules was released in public comment in April 2011. Titled "Operator Training," the initiative seeks to minimize drowning, injuries and accidents by requiring a mandatory instruction period for pool operators. Currently, only 23 states have adopted requirements that public pool operators complete a minimum two-day training program, according to the NSPF. Studies cited in the MAHC reinforce the obvious: Minimum training helps operators prevent violations of health codes.
According to a recent CDC study, pool inspection data from 15 jurisdictions across the country indicated that 12.1 percent of inspections resulted in immediate closure because of the seriousness of identified violations.
In voicing support for the module, the NSPF cited historically poor track records when it comes to complying with public health codes. According to a recent CDC study, pool inspection data from 15 jurisdictions across the country indicated that 12.1 percent of inspections resulted in immediate closure because of the seriousness of identified violations; violations regarding the following issues are frequently identified: free chlorine level (10.7 percent of inspections), pH level (8.9 percent), other water chemistry (12.5 percent), filtration/recirculation system (35.9 percent), water test kit (3.3 percent), record keeping (10.9 percent) and licensure (2.7 percent).
"I am an aquatic engineer in Vermont," Cindy Burdett of Waterbury, Vermont, wrote to the CDC during the comment period. "Here in Vermont we have no swimming pool codes. Commercial pools are not required to have a certified operator overseeing the aquatic environment. I very much agree with the operator training requirements that have been written and encourage a speedy implementation of them."
Other modules are in various stages of development. Some have already gone through the first public comment period, and others are still in the steering committee or awaiting CDC clearance. When completed, the MAHC is expected to address RWI response, ventilation, facility operation, hygiene facilities, regulatory administration, water quality, contamination burden, facility design, recirculating and filtration systems, lifeguarding and monitoring.
"The MAHC is filling a gap," Beach said. "What we saw in the beginning, because all of the legislation and regulation is at a state and local level, and sometimes it wasn't in place at different counties within the state. That was not the best way to promote public health and safety."
The published public comments on the Model Aquatic Health Code show industry experts from across the country have taken a deep interest in the codes.
Beach acknowledged there could be some additional costs incurred by following the new codes, but added that the standards are supported by the data. At the end of the day, experts want to create a code that allows the public to see the benefits of aquatic recreation and that they are protected from the health deficits.
"I'm very passionate about this," he said. "I feel that this can be the most important thing I've ever done in my career. I want to see it grow and live."
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