Public and private swimming pools have long been a source of recreational fun for patrons of all ages, but are they safe?  In a time of increasing risk, both in and out of the pool, who oversees the safety of these recreational outlets?  Does anyone?

If you have been anywhere around aquatic headlines in the last year, you probably noticed two big issues at the forefront; cryptosporidiosis and suction entrapment.

According to the Centers for Disease Control (CDC), the total number of reported cases of cryptosporidiosis, the leading cause of recreational water illnesses (RWIs), increased from 3,505 in 2003 to 3,911 in 2004, and continued to climb to 8,269 reported cases in 2005.¹  At the end of the 2007 summer swim season, in an unprecedented case, the metro area of Salt Lake City, Utah, reported over 1,300 confirmed cases of cryptosporidiosis; previously, confirmed cases in their state averaged 30 incidents per year. ²  In an attempt to reign in the situation, in August the Utah Department of Health banned toddlers 5 and under from all public swimming pools for the remainder of the 2007 swim season, a preventative measure they may enact again in 2008. 

Also a frequent hot topic, drowning continues to be one of the top five leading causes of unintentional death in the United States, and the second leading cause of injury-related deaths worldwide for children 14 years old and under. ³  A lesser known hazard and cause of drowning, suction entrapment became infamous on June 15, 2002, when Virginia Graeme Baker drowned in a residential swimming pool after being held underwater by a powerful suction force from a drain. ⁶   Her tragic death spurred her grandfather, a United States Senator, to bring the issue to the United States Congress for increased regulations regarding child drowning prevention.

Why does it seem that there is a lack of standards and regulations governing these types of facilities until it’s too late? 

Across the United States, codes governing public pool design, construction, and operation are reviewed and approved by different state and local public health officials.  Of the 50 states, 48 possess some type of pool regulation or guideline, and 2 states, Kansas and Mississippi, possess none.  Unfortunately, many of the 48 states with codes and guidelines have outdated or complex and hard to understand text, and many do not fully address the current identified risks.  For example, in the Salt Lake Valley where the RWI incidents have spiked, their codes and regulations have not been updated since September 6, 1984.  And for those codes that are updated regularly, the requirements run the gamut from generic to specific; in the state of Missouri, to control communicable diseases, they specifically prohibit spitting in one section of their code, and in the city of Wichita, Kansas, codes go so far as to detail the amount of free chlorine residual required in swimming pools, spas, and wading pools. ⁴

In addition to non-relevant and often lacking aquatic regulations, state and county health departments are continually asked to cut budgets and decrease staff.  With so many current aquatic facilities, and more being added each year, the limited staff and department budgets restrict many health professionals, and make them unable to complete the necessary tasks to ensure public safety in aquatic environments. 

What is the government doing to make sure we are swimming in safe environments?

Currently, government agencies are racing to catch up in a race against time.  Two notable improvements in the efforts to regulate aquatic environments have come from the Centers for Disease Control and Congress.

In the first-ever response to the lack of nationwide regulations and standards and an increasing awareness of the dangers associated with aquatic environments, the CDC is sponsoring a project to develop a national code and risk reduction plan, called the Model Aquatic Health Code.  The project is “intended to transform the typical health department program and aquatic facility design, construction, alteration, replacement, and operation efforts into a data-driven, knowledge-based, risk reduction effort to prevent disease and injuries and promote healthy recreational water experiences.” ⁵

In addition to the CDC’s effort to establish a national aquatic code, President Bush and Congress signed the “Virginia Graeme Baker Pool and Spa Safety Act” into law on December 19, 2007. ⁶  The law promotes the safety of young children around swimming pools, hot tubs, and spas, specifically addressing anti-entrapment prevention and increased barriers for residential pools and spas.

What can we do?

No matter what is happening at the governmental level, facilities looking for the best defense against these identified risks and others should look no farther than great design and facility training. 

Although everyone would like top-notch equipment and facility designs to ward off potential problems, properly maintaining your current facility and equipment is just as important.  Maintaining excellent water quality at all times is also important, and simple additions may also benefit your facility, such as equipping your facility with enhanced treatment technology, for example UV, to decrease the risk of your water to harbor crypto spores. 

Reduce the risk of entrapment by ensuring drain covers and outlets are secure and intact.  Replace any broken grates immediately and if there is any question regarding the safety of your facility consult a professional to evaluate your compliance with the new anti-entrapment regulations. 

Also equally important, your staff should be thoroughly trained to handle any type of health incident at your aquatic facility.  Although all lifeguards are trained to minimize the risk of drowning, they should also be trained to minimize the risk of spreading RWIs and in other health concerns.  If your facility does not have a process for addressing health incidents such as these, talk to your peers and utilize resources such as the Centers for Disease Control to create your plan.

Above all, know the risks, know the regulations, and make a plan for your facility to stay safe at all times; because if you don’t, no one else will!

¹ Centers for Disease Control (CDC), Morbidity and Mortality Weekly Report, Cryptosporidiosis Surveillance - United States, 2003-2005

² Utah Health News, Swimming Restrictions Extended for Kids Under Age Five

³ Centers for Disease Control (CDC), 10 Leading Causes of Injury Death: Highlight Unintentional Injury, 2004

⁴ Association of Pool and Spa Professionals, State Pool and Spa Codes

⁵ Centers for Disease Control (CDC), Model Health Aquatic Code

⁶ Pool and Spa News, Troubled Waters

This article was brought to you by Water's Edge Aquatic Design.  For more information, please visit the above source links or contact Heather Jensen, hjensen@wedesignpools.com.