Swimming Pool Disease Management

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Nationwide concerns over potential outbreaks of E. coli have had swimmers and pool operators alike asking questions. The strain of E. coli historically associated with contaminated food products, particularly beef, has been documented to have been transmitted in the swimming pool environment. This serves as a reminder that many diseases area capable of being transmitted in the swimming pool environment.

Although swimmers do no intentionally drink swimming pool water, accidental ingestion of pool water must be assumed when dealing with disease prevention. It is for this reason that the required disinfection of pool water through chlorination or bromination has been aimed at achieving drinking water quality at swimming pools. In cases where an individual with diarrhea goes swimming in a pool, fecal matter containing harmful organisms may be introduced into the pool water. This water may be swallowed by other bathers before contact with the chlorinated water. The contact time necessary to kill such organisms in a properly sanitized pool is normally less than one minute. It is important to stress to parents that children who are ill in any way, particularly if they have diarrhea, must not be allowed to go swimming. This greatly minimizes the potential disease exposure to others in a pool.

Swimmers may ask "How safe is it, then, to go swimming?" The requirements for pool operators in Ohio are quite stringent. Operators are required to regularly test and record various water quality parameters. The most important parameter is the disinfection level. Sanitarians from the Cuyahoga County Board of Health routinely inspect all public pools and spas to assure proper disinfection levels, record-keeping, availability of safety equipment, and operational procedures.

Concerned pool operators may ask "What do I do if a child has a fecal accident in my pool?" This can be a difficult problem to deal with, and responses are sometimes based more on emotion than fact. The action taken should be a measured response based on the facts at hand. Nearly all disease organisms will be killed in less than a minute if the proper levels of disinfectant are present and if the disinfectant has sufficient contact time with the organisms. With these facts in mind, the Cuyahoga County Board of Health suggests the following steps be taken if it is discovered that a fecal accident has occurred in a pool or spa:

1. Have all swimmers exit the pool or spa.
2. Use a net to remove all visible fecal material and properly dispose of it.
3. Measure the disinfectant and pH levels.
4. Add a sufficient amount of disinfectant to raise the level to 2 to 3 parts per million (ppm), making sure that a portion of the disinfectant is applied to the area where the fecal matter was discovered.
5. Allow swimmers to reenter the pool after approximately 30 minutes.
   

More information on swimming pool diseases as well as other topics related to swimming safety may be found on the Centers for Disease Control web site at www.cdc.gov.