We all know about Recreational Water Illnesses (RWIs).  We know what they are, how harmful they can be to our patrons, and how detrimental they can be to our facilities.  Everyone knows this is an important issue, so why are the cases still increasing?

The number of confirmed RWI cases, especially cryptosporidium, is rising with each passing year.  Giardia, cryptosporidiosis, and scores of other bacteria, viruses and parasites are invading our waters.  Why aren’t they stopping and what can we do to halt the mounting crisis?

Why are the Cases Increasing?

National, state, and local health organizations have investigated and confirmed more cases of recreational water illnesses in 2007 than in previous years.  Aquatic faculties are becoming more popular across the country, fun water features are more prevalent, and bather loads are higher than ever.  But parasites, such as cryptosporidium, are chlorine resistant and traditional means of filtration and disinfection are ineffective against these organisms.

What Can You Do?

Prevention is key in protecting your facility against RWIs, and although there are many different ways to prevent the contamination of your facility, following is a list of the most effective means of risk reduction in both facility design and operation.

Ensure that your systems are operating properly.  It goes without saying that when patrons are in the pool, your first line of defense is effective filtration and disinfection.  It is imperative to perform the routine and seasonal maintenance required on all of your systems to ensure that your equipment is running effectively. 

Don’t abuse your filtration system.  When the filter runs are too long, the system will short circuit and, in effect, the water can bypass filtration altogether.  To avoid lengthy filter runs, use pressure gauges to determine the proper time to backwash your filters.

Exceed the minimum standards while still maintaining safe levels.  This includes the chlorine levels and turnover rates.  For example, the CDC recommends free chlorine residuals between 1 and 3 parts per million (ppm).  If you are currently operating under chlorine levels of 1 ppm, consider taking the levels in your pool to 2 or 3 ppm.

Minimize the use of cyanuric acid.  Cyanuric acid is used a stabilizer to limit the dissipation of chlorine due to sunlight.  However, when using this chemical, it reduces the responsiveness of chlorine and higher chlorine levels are necessary to provide the same amount of disinfectant responsiveness.  For instance, with cyanuric acid consider maintaining a free chlorine residual between 3 and 5 ppm.  Also, higher levels of cyanuric acid may interfere with the chemical controller probes.

Maintain safe water at all times.  Test the water in your pool at least two times per day, if not more, to make sure that you are maintaining the proper chlorine and pH levels.  The CDC recommends maintaining a chlorine level of 1 to 3 ppm and pH levels of 7.8 to 7.2 for optimum patron eye and skin comfort.  Maintaining safe water also means making sure your water is clear.  Cloudy water is not only dangerous for lifeguarding, but can also mean that your filtration and disinfection system may not be operating effectively and efficiently.

Invest in enhancement systems.  Chlorine systems are still the main disinfection system utilized at aquatic facilities, but enhancement systems, such as ultraviolet (UV), are becoming increasingly popular.  These additional systems have been proven to inactivate parasites, such as cryptosporidium, that are chlorine-resistant. 

Maintain honest and accurate logs.  In addition to logs of accidents at your facilities, keep track of system maintenance and replacements, chlorine levels, and other important items.  Some facilities also track patron complaints related to sicknesses to identify water illness related concerns.

Employ a Certified Pool/Spa Operator (CPO) or Aquatics Facility Operator (AFO).  Individuals who have completed the CPO or AFO courses have been exposed to the basic knowledge, skills and techniques necessary to effectively operate an aquatic facility.  Possessing the basic understanding of key operation issues may reduce the risks at your facility and provide a safer environment for patrons.

Train and empower staff members.  Train your staff members to deal with risks at your facility and empower them to make decisions that will benefit the overall health and safety of your facility.  Many facilities utilize several layers of lifeguards, deck attendants, and head guards to watch both the water and the patron activities.  By having several layers of trained and empowered staff members on the deck, these facilities have increased their awareness and reduced the risks at their facility.

Create policies specific to the prevention of RWIs.  Institute specific policies geared towards reducing RWIs in your pool.  Some examples include posting a sign warning patrons with diarrhea not to swim, requiring swim diapers in the facility, and requiring diaper changing in restroom facilities only.  Communicate those policies to patrons with clear signage around the facility, especially at the front entrance, and ensure that your staff enforces those policies. 

Create an emergency RWI outbreak plan.  When you have an outbreak, have a plan in place for your staff to follow.  After a diarrhea incident at your pool, immediately clear the pool, close the facility, and shock the pool under the recommended CDC guidelines.  Practice your emergency plan and make sure your staff members understand the importance of following the guidelines to provide a safe environment for the patrons.

Develop relationships.  Create relationships with your local health department, media, daycares, aquatic facilities, and other entities.  If you have an outbreak, notify these parties, and ask that they work with you to contain the situation.  These relationships can be vital when trying to protect your facility from a potential breakout or when trying to communicate or contain a current breakout. 

Use your resources.  The CDC and NSPF have created an Outbreak Alert system that will automatically send regional notifications to registered users regarding the general location and details of outbreaks.  They have also coordinated an online toolkit of useful information including signs, helpful policies and other tools on the NSPF Web site, www.nspf.org/cryptotoolkit.html.  Also, utilize your network of peers!  They have an immense range of knowledge regarding aquatic safety and best practices, and many areas have aquatic groups that can provide a valuable networking opportunity.  For example, in Kansas, there are two such aquatic groups, Kansas City Metro Aquatics Council (KCMAC) and the Southcentral Kansas Aquatics Council (SKAC).  Search your area for these types of groups and become an active member. 

Manage emotional reactions and community expectations.  Educate the public with informational articles in the media and explain that prevention is the only guarantee.  Unfortunately, no treatment system exists that will prevent contamination, and although pool water treatment reduces the risk, patrons create the hazard.  Encourage common sense behavior by children, parents and caregivers as the best way to prevent RWIs at your facility. 

For additional information on the items covered above, or to register for the Crypto Outbreak Alert System, please visit the RWI download page. 

This article was brought to you by Water's Edge Aquatic Design.  Please contact Heather Jensen, hjensen@wedesignpools.com, if you have any questions related to the content of this article.