Just more than 20 years ago, 26 children were sickened by a strain of E. coli bacteria after playing in the kiddie pool at White Water Park in Marietta. Seven of the children were hospitalized; one died.
A state investigation determined the chlorine level was too low in the pool, a finding that raised awareness about the importance of proper monitoring and ushered in a new era of vigilant oversight in Georgia.
Nationally, from 2000 to 2014, close to 500 outbreaks of waterborne illnesses were reported in recreational venues in 46 states and Puerto Rico, causing 27,219 cases of sickness and eight deaths, according to the CDC. Georgia fared relatively well over the same period of time, with eight reported outbreaks and a total of 120 illnesses.
Pool chemicals can take care of many problems, but not always. Getting optimal results for safety comes down to having the right balance. And, to be frank, it comes down to having the right users — those who adhere to, let’s just say, proper pool etiquette.
"We want people to go to pools and have a happy, good time," said Michele Hlavsa, chief of the CDC's Healthy Swimming Program. "We just want to make sure people are doing it in a safe, healthy way."
To get down to the nitty gritty, most of the illnesses in pools, hot tubs and water playgrounds are caused by Cryptosporidium — that's Crypto, for short. Crypto is a parasite that causes Cryptosporidiosis, which leads to diarrhea.
Crypto — brace yourself — is spread by swallowing water that has been contaminated with fecal matter. Most germs are killed within minutes by common pool disinfectants like chlorine or bromine, but Crypto is a germ that can survive in properly chlorinated water for more than seven days.
The diarrhea it causes can last for up to three weeks. And the number of Crypto cases have been steadily rising, with twice as many in 2016 as in 2014.
Hlavsa said even a single mouthful of contaminated water can lead to a Crypto illness. She recommends parents encourage their children to not swallow water when swimming.
And there are other steps you should take for healthy swimming. Hlavsa recommends that families check a pool's inspections online or on site. In Georgia, public and semi-public pools (such as pools at apartment complexes), as well as hot tubs and water parks, are inspected by local health departments. Backyard pools are not.
She also recommends that families check to make sure the drain at the bottom of the deep end of a pool is clearly visible – a sign that the water is crystal clear. Other safety measures should include making sure drain covers at the bottom of the pool appear to be secured and in good shape.
Even if you’re not spreading Crypto, people need to consider everything on their bodies — sweat and dirt, dust, deodorant and hair spray — before jumping into communal waters, Hlavsa said.
A recent survey found that more than half of Americans (51 percent) use a swimming pool as a bathtub — either swimming as a substitute for showering or using the pool to rinse off after exercise or yard work. It’s a habit that’s taken hold, even though nearly two-thirds of Americans report they know chemicals do not eliminate the need to shower before swimming.
And that’s not all. The survey — commissioned by the Water Quality & Health Council, a group of advisers to the chlorine industry trade association — found 40 percent of Americans readily admitted they’ve peed in a pool as adult. While it may seem obvious that this is not a good idea, Hlavsa explained the science of why it’s not: Urine reacts with chlorine, reducing the amount of chlorine available to kill germs. That bodily fluid, along with dirt and sweat, mixed with chlorine creates chemicals called chloramines, which causes red and itchy eyes.
Bottom line: It’s not the chlorine alone causing eyes to redden and sting.
Regular maintenance helps eliminate the chance of cryptosporidium, a microscopic parasite can make otherwise healthy adults and children feel sick for up to three weeks. MICHAEL D. PITMAN/STAFF
And speaking of chlorine, people can check water quality themselves by purchasing pool test strips at hardware stores that measure the level of the chemical and the pH level, Hlavsa said. She uses a test strip to check on water quality before swimming with her young children, who are 2 and 4.
Chlorine levels should be at least 1 part per million for pools and at least 3 parts per million in hot tubs, according to the CDC.
Getting the mix right isn’t always easy.
An Atlanta Journal-Constitution analysis of inspections of public-serving pools, spas, hot tubs and splash pads found several in the metro Atlanta area were cited for having either too little or too much chlorine.
Too little means germs can grow and spread. Too much chlorine can irritate the skin and eyes.
Included in the analysis were pools located in subdivisions, apartment complexes, hotels and recreation centers. The Pointe at Colliers Hills on Collier Road had no chlorine detected in the water during an inspection on June 7 of last year, according to records from the Fulton County Health Department. Calls to the apartment complex were not immediately returned.
One of the facilities with too much chlorine was The St. Regis Hotel and residences spa on West Paces Ferry. The spa registered 22 parts per million during a re-inspection on Sept. 5, according to health department records. The hotel decided to close the spa for the rest of the season, which was coming to a close in three days, the records said. Calls to the St. Regis were not immediately returned.
Hlavsa said she is more concerned about too little chlorine in the water than too much, especially in pools where small children will be swimming. They’re more likely to swallow water while swimming.
In Georgia, virtually all public and semi-public pools — which include those located in subdivisions or facilities that require membership — are inspected multiple times a year. Inspections include not just a check for water quality, but safety measures — such as making sure drain covers are secured and are in good shape, that pools have proper fencing and that there’s a land-line telephone that can be used to call 911.
Nationwide, about two-thirds of local health departments inspect public pools, according to the CDC.
The Centers for Disease Control and Prevention said more people are reporting problems linked to a parasite called cryptosporidium, which can linger in pools or water playgrounds.
Pools in Georgia weren’t always this well monitored. Dr. Chris Rustin, interim director of the Division of Health Protection at the Georgia Department of Public Health, said the White Water incident and other tragedies led to better oversight and regulations.
Michelle’s Law — mandating that local and state public health officials regulate and inspect public swimming pools, hot tubs and water parks — was passed in 1999 after a young girl died after being trapped underwater by a faulty pool drain in an unregulated pool.
Experts emphasized that online inspection reports performed last season may not reflect current conditions. So, it's wise to check online and on site for the most up to date inspection reports. (http://ga.healthinspections.us/stateofgeorgia).
AJC data specialist Jennifer Peebles contributed to this article.
Tips for keeping you and your family healthy and safe when swimming
- Before going to a pool, check the pool's inspections online or on site. Public pools in Georgia are inspected by local health departments (backyard pools are not). Most counties are included in this database and more are being added. DeKalb and Gwinnett County are currently not part of the database system. Residents can call their county board of healths directly to ask about pools in their county. http://ga.healthinspections.us/stateofgeorgia/
- You can check water quality yourself by purchasing pool test strips at a hardware store that measure the water's chlorine or bromine level and pH.
- Discourage your children from swallowing the water.
- Take kids on hourly bathroom breaks, and check diapers every hour.
- Shower for at least one minute before you get into the water. This will remove most of the dirt and sweat on your body.
- Never pee or poop in the water.
- If you've had diarrhea, don't swim for at least two weeks.
Source: Michele Hlavsa, , chief of the CDC’s Healthy Swimming Program
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