Archive for the ‘Health’ Category

Green Hair Caused by Copper, Not Chlorine — Myth Busted

Friday, May 17th, 2013

Swimmer wearing a swim capSwimmers, especially blondes, may be surprised – and even horrified – to discover that frequent pool use imparts a greenish hue to their hair. Typically chlorine in pool water is named as the culprit, sending the green-haired swimmer in search of products to remove the unwanted color or at least in search of a swim cap.

The green hair-chlorine connection is a firmly embedded myth: Almost half of respondents to our 2012 swimmer survey agreed that chlorine in the pool can turn hair green. We would like to expose this urban legend at its roots and offer an explanation of how it might have grown.

Copper, Not Chlorine, is Responsible for Green Hair

Green hair is caused by the presence of copper, not chlorine, in swimming pool water. Copper sulfate, for example, is added to pools to help control algae. Tiny particles of this greenish-blue compound can turn blonde or white hair green. Copper may also be leached into pool water from metal plumbing or from copper ionizer equipment and form copper sulfate in the water. One research study titled “The Green Hair Problem1” concluded that hair that had been extensively damaged–either by harsh cosmetic treatment or by exposure to sun and weathering–showed the highest degree of green coloration from absorbed copper.

To avoid an unwanted green tint:

  • Wear a swim cap, or
  • Use a shampoo formulated to help remove copper (yes, they exist) after swimming.

We suggest there could be a semantic reason for the chlorine/green hair linkage. The root “chloro” is Greek for “green.” Chlorophyll, for example, is the organic compound in plants that absorbs sunlight and lends a green color to leaves. In 1810 the chemical element chlorine was named for the greenish color of its gas. Nevertheless, chlorine does not impart a green color to pool water.

Chlorine is added to pool water to destroy bacteria, viruses and parasites in water that would otherwise put swimmers at risk for disease. Most chlorine is added to pool water in the form of compounds of chlorine that are either white solids or colorless liquids. Although some pools are designed to bubble chlorine gas into the water, the greenish chlorine gas reacts quickly with pool water to produce dissolved “free chlorine,” which is colorless.

Chlorine is a well-known pool chemical and its name implies the color “green.” We think it is conceivable that those two factors together helped shape a myth linking chlorine and green hair. Hopefully we have helped expose the roots of this myth and untangled the truth. Happy swimming!

1Bhat, G.R., Lukenbach, E.R., Kennedy, R.R. and Parreira, R.M. (1978). The green hair problem: A preliminary investigation, J. Soc. Cosmet. Chem., 30, 1-8.

The Chlorine Residual: A Public Health Safeguard

Friday, April 5th, 2013

Chlorine and chlorine-based disinfectants are used worldwide to destroy germs in drinking water and swimming pools. One of the reasons for the widespread use of chlorine disinfectants is that they provide a “residual” level of protection against waterborne pathogens. A chlorine residual is a low level of chlorine remaining in water after its initial application. It constitutes an important safeguard against the risk of subsequent microbial contamination after treatment—a unique and significant benefit for public healthi.

What happens to chlorine when it is added to drinking water or swimming pools? According to the US Centers for Disease Control & Prevention’s Chlorine Residual Testing Fact Sheet, chlorine proceeds through a series of reactions:

  1. The Chlorine Demand is Satisfied: Upon initial dosing, chlorine reacts with any organic matter in water. The amount of chlorine used in these reactions is known as the “chlorine demand” of the water. Raw water taken from lakes and streams for drinking water treatment is likely to have a high chlorine demand based on the presence of natural organic material, e.g., decaying plant and animal matter. Groundwater, which normally contains far lower levels of organic matter, has a low chlorine demand.
  2. Combined Chlorine Forms: When the chlorine demand of the water is satisfied, some portion of the remaining chlorine reacts with nitrogen in the water to form compounds known as chloramines. Nitrogen-containing compounds may result from decaying organic matter in raw water secured for drinking water treatment. In swimming pools, swimmers add nitrogen-containing compounds to the water in the form of substances such as urine and perspiration. Chloramines may impart a chemical odor to water, which is sometimes inaccurately described as a “chlorine” odor. The chlorine that combines chemically with nitrogen and nitrogen-containing compounds is known as “combined chlorine.”
  3. Free Chlorine Destroys Germs: Chlorine remaining in water after the chlorine demand is satisfied and combined chlorine is formed is known as “free chlorine.” This is the chlorine portion available for disinfection. Many waterborne germs are either killed or rendered incapable of reproducing, helping to prevent waterborne disease outbreaks. The time required to destroy viruses, bacteria and parasites present in raw water at a given chlorine concentration varies with the organism and is known as the “contact time.”
  4. A Chlorine Residual Remains: Following a given contact time during which chlorine destroys germs, some chlorine remains in the water. This remaining, or residual level, acts as a safeguard against additional microbial contamination that, in the case of swimming pools, for example, could be introduced as more swimmers enter the pool. Chlorine and bromine are unique in their ability to impart this kind of protection. EPA requires all US facilities that treat water to maintain a chlorine residual of no more than 4 parts per million, whether chlorine is used as a primary disinfectant or not. Swimming pool operators generally maintain a chlorine residual of 1 to 3 parts per million. Swimming pools that are treated primarily with metal ions, such as copper, require a low level of chlorine to provide residual protection.

A Safety Marker Too

By monitoring the chlorine residual throughout a drinking water distribution system, water treatment operators can quickly identify points at which the residual declines or disappears. A sudden decline in the chlorine residual could indicate a leak in the drinking water distribution system. Swimming pool operators monitor the chlorine residual regularly. As the number of swimmers and conditions in the pool varies, the disinfectant level can be adjusted to maintain the chlorine residual.

In both drinking water and swimming pools, the chlorine residual represents a smart use of chemistry and provides a remarkable public health safeguard!

Chris Wiant, M.P.H., Ph.D., is president and CEO of the Caring for Colorado Foundation. He is also chair of the Water Quality & Health Council.

iOne other disinfectant—bromine–provides a residual level of protection in water. Bromine is used in swimming pools, but more frequently in spas. It is not used in drinking water disinfection.

Great Water Quality: Gold for Olympian Swimmers

Friday, August 3rd, 2012

Olympic Screenshot
Watch the full video here.

Swimming is one of the most refreshingly beautiful Olympic events to watch. Thanks to modern communications technology, this summer we are treated to crystal-clear underwater images of the world’s elite swimmers as they vie for the Olympic gold.

Water plays a First Place role in the lives of professional swimmers: There is the water through which they swim and the water they must ingest to remain properly hydrated.

Swimming Pool Water Quality

The London Aquatics Centre houses two 50-meter swimming pools and a 25-meter diving pool. Altogether, the pools hold 2.6 million gallons of water (10 million liters). What technology is responsible for the sparkling water through which the athletes glide to glory or defeat? For one thing, pool water is circulated through efficient filtration systems. Additionally, water is treated with chemicals, including chlorine-based disinfectants to prevent swimmers becoming ill with diarrhea, swimmer’s ear and various skin infections that untreated water can transmit.

Chlorine-based disinfectants serve two purposes: They destroy algae and most waterborne germs, and they react with—oxidize—small bits of organic debris and impurities introduced into pool water by swimmers. Chlorine levels (usually 1 – 3 parts per million) are maintained in part by adjusting the pH, or acidity level of pool water. Pool operators maintain pool water pH in the slightly basic range of 7.2 to 7.8 in order to ensure good germ destruction by chlorine while keeping the water comfortable for swimmers.

Pool operators must carefully monitor pool water chemistry, as chlorine may be depleted by substances inadvertently added to the pool, including swimmer perspiration, body oils and urine (see Understanding Pool Chemistry).

Hydrating the Olympians

The athlete’s high daily intake of 4-6 liters of water per day makes safe drinking water an extremely important commodity for the professional swimmer. Water makes up over 50 percent of the weight of the human body. It lubricates and cushions the joints, serves as a “shock absorber” inside the eyes and spinal cord and regulates body temperature and blood volume. No athlete could reasonably compete without access to safe, life-sustaining water.

Before drinking water protections were perfected over a century ago, the population of London was regularly devastated by cholera outbreaks spread by contaminated water. Today, in that same city, thanks to appropriate watershed protection, water filtration and disinfection, Olympian swimmers soar through huge pools of clean municipal water. At the same time, athletes, visitors and residents of London alike enjoy the health-giving benefits of safe drinking water.

Kudos to the amazing swimming Olympians…and the abiding water quality technologies by which they, and we, thrive.

Busting a Chlorine Swimming Pool Urban Myth

Friday, July 27th, 2012

The Water Quality and Health Council would like to thank John Tesh for tweeting the results of our swimmer hygiene survey and for giving us an opportunity to address a very common urban myth.

John Tesh Tweet

Last week, musician, composer and radio talk show host John Tesh tweeted the finding from a recent Water Quality & Health Council survey that one in five swimmers admit to “peeing in the pool”. Tesh warns, “If you smell chlorine, stay out”. I appreciate the fact that Tesh raised this subject and respectfully submit that his tweet needs a tiny tweak.

A healthy chlorinated pool can emit a light chemical odor, especially if it is an indoor pool and one with less than ideal ventilation. It is good advice, however, to stay out of the water when a strong chemical smell pervades the air around any type of pool, indoor or outdoor. On this point John Tesh is absolutely correct.

What actually causes the distinctive, irritating smell around swimming pools is not chlorine–that’s an urban myth–but volatile substances known as chloramines. Chloramines form in pool water when chlorine combines with contaminants brought into the pool by swimmers. Think urine, perspiration, body oils and cosmetics. The truth is that cleaner swimming, not less chlorine, can help reduce the chloramine irritants that cause “swimmer red eye” and itchy skin. The Centers for Disease Control and Prevention’s swimmer hygiene tips recommend swimmers shower with soap before entering the pool (almost 70% of the survey respondents said they don’t do this routinely) and stop peeing in the pool.

The next sentence of Tesh’s tweet requires no tweaking at all: The smell gets stronger if there’s urine in the water. It is true that the more urine there is to combine with chlorine, the higher the level of unwanted, smelly chloramines in the pool. Following that thread, if chlorine is combining chemically with contaminants like urine, then it is not available to destroy germs in the pool that can make swimmers sick with diarrhea, swimmer’s ear and various skin infections.

Eighty-seven percent of respondents to the survey agreed with the urban myth that it is chlorine in pool water that makes swimmers’ eyes red and irritated. Ironically, the irritants actually responsible, chloramines, may be produced when there is not enough chlorine in the pool. The bottom line: Pool operators need to keep pool chemicals in appropriate ranges. Swimmers need to clean up their act. The proof will be in the air around the pool.

Swimmers can order free pool test kits from the Water Quality & Health Council to see if their pool pH and free chlorine levels are in the proper range.

Chris Wiant, M.P.H., Ph.D., is president and CEO of the Caring for Colorado Foundation. He is also chair of the Water Quality & Health Council.

Color Me Safe at the Pool

Friday, May 25th, 2012
One of 12 coloring images in CDC’s free, downloadable  “Color Me Safe” coloring book, designed to raise awareness of safety issues.

This is one of 12 coloring images in CDC’s free, downloadable “Color Me Safe” coloring book, designed to raise awareness of safety issues.
Spanish version

It’s time to dig out the swim suits, sunscreen and beach towels and head to the pool. Swimming lessons, swim team, frolicking in the pool with friends, lap swimming and leisurely poolside chats are hallmarks of summer for families all over the country. As this fun season begins, we have some safety tips to offer.

Make sure your children have adult supervision while they are in the water.

Children ages one to four have the highest drowning rates of all age groups, according to a May 17 report by the Centers for Disease Control and Prevention (CDC). For every child who drowns, another four received emergency care for injuries.

In addition to supervision, adults should learn Cardiopulmonary Resuscitation (CPR) and avoid drinking alcohol while supervising children.

Most drowning of young children occur in backyard pools. To help prevent accidental drowning in these settings, install a four-sided pool fence of at least four feet in height to completely separate the pool area of the backyard. Don’t leave toys in or around the pool. Also, formal swimming lessons can help keep children safe in the water. The CDC website has more information on drowning prevention.

Use sunscreen at the pool.

CDC recommends sunscreen with sun protective factor (SPF) 15 or higher, and both UVA and UVB protection. Reapply sunscreen every two hours, and after you swim or sweat. Finally, check the expiration date on your sunscreen and keep in mind that high temperatures can degrade sunscreen before its expiration date.

Use pool test strips to check for adequate pool chemistry.

A 2008 CDC pool inspection survey conducted in 13 states found about one in eight public pools were closed immediately after inspection due to serious code violations (reported in 2010). Disinfection violations were most common in kiddie and wading pools and water play areas. Improperly maintained pools put swimmers at risk for diarrhea, swimmer’s ear and skin infections. CDC encourages families to take matters into their own hands and pack easy-to-use pool test strips when they take off for the pool. The strips can be used to check that pH and chlorine levels are in the appropriate range. This summer the Water Quality & Health Council is offering free pool test strips online at If levels are unsatisfactory, CDC recommends notifying the pool manager; if readings remain unsatisfactory, consult your local health department.

Here’s to a safe and healthy summer swim season!

Joan Rose, PhD, is the Homer Nowlin Chair in Water Research at Michigan State University and a member of the Water Quality and Health Council.

Pool Chlorine Hypothesis Remains Unproven

Friday, March 2nd, 2012

Swimming researcher Dr. Joel Stager says swimming is “the only activity we know of where you can say that if that’s all you do for exercise, you can be almost perfectly fit.”
Swimming researcher Dr. Joel Stager says swimming is “the only activity we know of where you can say that if that’s all you do for exercise, you can be almost perfectly fit.”

Can pool swimming promote the development of asthma in children or help alleviate its symptoms? This question has been debated among researchers ever since Belgian Professor Alfred Bernard published a 2006 study supporting the “pool chlorine hypothesis”. That hypothesis suggests that the increasing exposure of children to pool chlorine could be contributing to the rise of childhood asthma in the developed world. Other studies have found swimming improves asthma symptoms; Welsh et al., for example, reviewed the relevant scientific literature and found “positive effects of swim training on fitness as measured by improved aerobic efficiency, physical working performance, and recovery heart rates.”

Since the Bernard study appeared, there has been much discussion of the pool chlorine hypothesis in the popular and scientific press. No research has confirmed Bernard’s findings. An extensive review of the literature conducted by Goodman and Hays in 2008 found asthma to be more likely among elite swimmers than among similar high-level participants in other competitive sports. Interestingly, it is unclear whether asthma in high-performance swimmers developed as a result of swimming or whether many high-performance swimmers are asthmatics who took up the sport when encouraged by their doctors to swim for therapeutic exercise (a true chicken and egg question–which came first?). That question aside, researchers could find no consistent association between asthma development and swimming pool use during childhood.

The Belgian Minister of Public Health in 2009 requested detailed scientific advice on this matter from her advisory body, the Superior Health Council. The Council responded in February, 2011 with a report stating that although a relationship between swimming pool attendance and childhood asthma has not been confirmed, it cannot yet be excluded. The Council concluded that, for now, the available evidence does not support advising children against swimming in chlorinated pools. That’s important because there are significant benefits to swimming.

How is a child’s life improved by learning to swim?

  • According to the Centers for Disease Control and Prevention (CDC) participation in formal swimming lessons can reduce the risk of drowning by 88 percent among children aged one to four years old.
  • Swimming can yield a broad range of benefits throughout a person’s lifetime. According to a 2006 article, swimming provides even resistance and a full-body workout, improving cardiovascular health, muscle tone and overall flexibility.
  • As many children and adults would agree, swimming is fun!

Keeping Swimming Healthy

A well-maintained pool is critical to healthy swimming, according to CDC. Proper pool chemistry, including adequate chlorine and pH, helps destroy waterborne pathogens that can cause everything from swimmer’s ear to gastrointestinal illness. Swimmers must also play a role in keeping swimming healthy by showering before swimming and not peeing in the pool. When pool operators and swimmers do their part to maintain healthy pools, there are fewer irritating disinfection byproducts generated in pools.

As with a lot of issues in life, everyone needs to balance known and suspected risks with known and suspected benefits. Early in my career as a physician, I was interested to learn that even bed rest has known risks. If swimming is important to your family, it’s important to stay informed on the latest health research. For now, the conclusion of the Belgian Superior Health Council is positive for parents who want their children to reap the considerable benefits of pool swimming.

Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health off

“Doggy”- Paddle to Health

Monday, August 15th, 2011

Aquatic rehab: Not just for the dogs

Jake in the Under Water TreadmillHow cute is that? Little Jake over there is undergoing aquatic rehabilitation in an underwater treadmill after paralyzing his rear limbs in an unfortunate accident. One veterinarian’s initial prognosis was that Jake would not be able to walk again. But after physical therapy and the underwater treadmill, Jake is back on his feet and happier than ever.

Canines are not the only species that can benefit from aquatic therapy. Whether it is used to help people recover from acute injuries or to maintain health in the face of chronic disease, hydrotherapy is regarded as having “broad rehabilitative potential” that is relatively underused (Becker, 2009).

Water: An ideal medium for exercise.

Swimming is widely recommended by medical experts for its healthful benefits*. According to the American Red Cross, the buoyancy of water results in less stress on the joints, helping to reduce swelling and tissue damage. Warm water can increase circulation, decrease pain, and increase muscle relaxation and soft tissue flexibility.

Patients (and puppies) looking to strengthen muscles should exercise in pools with some turbulence.
Aquatic exercise: Benefits galore

  • Lower risk of death In a 2009 Washington State University study of over 40,000 men, exercise swimmers had less than half the mortality risk of sedentary men, and exercise swimmers had half the mortality risk of exercise walkers and runners.
  • Aids patients with COPD A 2009 study of patients with chronic obstructive pulmonary disease (COPD) found the swimming pool a “feasible and positive alternative venue for pulmonary rehabilitation”.
  • Asthma Many studies have found swimming improves asthma symptoms; LaKind et al. cite Welsh et al. 1, who reviewed the relevant scientific literature. According to LaKind et al., Welsh et al. note that most studies find “positive effects of swim training on fitness as measured by improved aerobic efficiency, physical working performance, and recovery heart rates.”
  • Heart healthy Aquatic exercise strengthens the heart muscle and improves oxygen delivery to the muscles.
  • Reduces water and sodium retention Animal data collected in Brazil 2 indicate exercise in water might be prescriptive for patients with hypertension, obesity and/or mild renal disease as it reduces water and sodium retention.
  • Hand eye coordination and balance According to a study done in Taiwan, swimming can improve hand eye coordination and balance in the elderly, which could lower a senior’s risk of a falling-related injury.
  • Bone health Aquatic exercise can maintain or improve bone health in post-menopausal women.
  • Better flexibility and range of motion According to the American Red Cross, when accompanied by good stretching habits, aquatic exercise can greatly improve flexibility and aid range of motion.
  • Improved mood Swimming can improve the mental state of both men and women, the elderly and women with fibromyalgia, mothers, and parents of children with developmental disabilities.

Swimming may be the BEST and most enjoyable form of exercise, so give it a try!

*The American Red Cross recommends a health assessment from your health care provider before you begin an exercise program.

Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN.

1. Welsh, L.; Kemp, J. G.; Roberts, R. G. Effects of physical conditioning on children and adolescents with asthma Sports Med. 2005, 35 ( 2) 127– 141

2. Fabri et al.,(2010). Aquatic and Land Exercise Training Affects Renal Function in Rats Under Isosmotic Volume Expansion, Journal of Exercise Physiology, vol. 13, no. 2.

Swimming in the News

Monday, August 1st, 2011

by the Water Quality & Health Council

With high temperatures plaguing much of the country, the pool seems like the best bet to beat the heat. This blog highlights two interesting and entertaining resources recently found in the media that can help keep swimming healthy and enjoyable.

1. CDC’s Healthy Swimming 2011 Video Contest Winner’s Video!

This summer, the Centers for Disease Control and Prevention (CDC) challenged the public to create a short video to help educate swimmers about pool safety.  The winners, David and Aaron Mathews, worked with friends and family to develop “Recreational Water Illness Police,” a clip that uses humor to inform viewers about the most common recreational water illness—diarrhea. Roger that.

2. Quiz:  Is It Safe To Pee In The Pool … And Other Water Safety Questions

Want to test your water safety knowledge? A Huffington Post online quiz emphasizes key swimming safety issues, some of which are often overlooked, such as showering before entering the pool.  It is important that swimmers shower with soap (especially swimmer “bottoms”) before swimming so they do not introduce harmful bacteria into the pool.  This fact is lost on all but 25 percent of parents according to a recent report.  And no, it is not safe to pee in the pool.


Understanding Swimming Pool Chemistry

Monday, July 25th, 2011

By Fred Reiff, P.E.

It’s no secret that swimming pools, although fun and refreshing, are essentially communal bath tubs. To help keep water clean and safe, pool operators must adjust pool chemical levels. Maintaining proper pool chemistry can be a challenging task, especially in community pools where the number of swimmers fluctuates wildly from hour to hour.  Add to that the fact that many swimmers are unaware of the role of personal hygiene in keeping waters safe, and one begins to understand the magnitude of the pool operator’s responsibilities.

Chlorine and pH Get it Done

Chlorine is strongly associated with swimming in popular culture.  Although there are persistent myths about chlorine in swimming pools, chlorine is used as a disinfectant in the majority of pools to help prevent waterborne illnesses such as diarrhea, swimmer’s ear and skin infections.  Alternative sanitizers have been introduced in the marketplace over the last several years, but chlorine continues to offer the most effective and economical option to helping maintain safe pools.

Chlorine actually serves two purposes: it destroys algae and most waterborne germs, and it reacts with—oxidizes—small bits of organic debris and impurities introduced into pool water by swimmers.  Chlorine does this work in the form known as free chlorine, a combination of hypochlorous acid and hypochlorite ion.  Free chlorine is produced in pool water when chlorine disinfectant is added.  When free chlorine reacts with nitrogen-bearing or organic substances, the product is known as combined chlorine, a much weaker disinfectant and oxidant. The World Health Organization recommends free chlorine levels up to 3 mg/l be maintained in swimming pools.

As pool operators know, hypochlorous acid1 is a more effective disinfectant and oxidant than the hypochlorite ion 2, and their relative proportions fluctuate with the pH (acidity) of the water in the pool (low pH is more acidic and high pH is more basic).   To maintain optimal levels of hypochlorous acid for germ and algae destruction while at the same time keeping the water comfortable for swimmers, pool operators should maintain pH in the slightly basic range of 7.2 to 7.8.

Monitoring, Monitoring, Monitoring

One of the most important tasks of the swimming pool operator is vigilantly monitoring the pH and free chlorine level of pool water to ensure germs are being destroyed.  This is critical because chlorine may be depleted, for example, by a heavy “bather load”.  A crowded swimming pool adds more organic debris (e.g., perspiration, body oils, trace urine and fecal matter), which can lower the chlorine level or even deplete it, leaving little or no protection against waterborne germs.

A 2010 report from the Centers for Disease Control and Prevention (CDC) found one in eight public pool inspections conducted in 13 states in 2008 resulted in pools being closed immediately due to serious code violations, including insufficient disinfectant.  That is why CDC encourages swimmers to take matters into their own hands and (1) shower and thoroughly wash their bottoms before entering the pool and (2) use portable pool test strips to monitor for adequate free chlorine and pH.  As a public service, the Water Quality and Health Council is making these strips available free to the public this summer at  Swimmers will have to wash their own bottoms.

Fred Reiff, P.E., is a retired official of the Pan American Health Organization.

1Hypochlorous acid is HClO.

2An ion is an atom or molecule with a net electric charge due to the loss or gain of one or more electrons. Hypochlorite ion is OCl-.

Teach Your Children Well: Shower before Swimming

Friday, July 1st, 2011

By Joan Rose, Ph.D.

You are heading off to your community pool. The mental check list goes…

Sunscreen?  Yes.

Bathing suit?  Of course.

Shower?  Probably not.

Although the “shower before you swim” rule is consistently posted at community pools, a new University of Michigan report shows parents of young children do not appreciate the role showering plays in keeping swimming pools safe for the community (see video).  Whereas 64 percent of parents understand it is very important for children to avoid swallowing pool water, only 26 percent believe it very important to shower before swimming.  This study highlights the need to educate parents on swimmer hygiene.

The researchers polled 865 parents of elementary school children, aged 5 to 12 years old.  More than twice as many parents surveyed believe drowning at a water park is a significant risk compared to those who perceive a high potential risk of getting sick from the water in these settings.

Showering before swimming or visiting a water park is a must because it helps remove trace levels of fecal matter and associated pathogens on human skin.  Put bluntly, the most critical area of the body to wash is your bottom. Not surprisingly, young children and babies in diapers are very likely to contribute fecal matter to pools.  An ongoing shigellosis outbreak in northern Kentucky pools has caused the local health department to prohibit children who are not yet potty-trained from accessing pools (see blog).  Shigellosis causes diarrhea and is transmitted through inadvertent contact with fecal matter of infected individuals.

According to the Centers for Disease Control and Prevention (CDC), recreational water illnesses (RWIs) are on the rise. RWIs are caused by germs spread by swallowing, breathing in mists or aerosols or having contact with contaminated water in swimming pools, hot tubs, water parks, water play areas, interactive fountains, lakes, rivers, or oceans. More than 10,000 Americans are sickened annually by RWIs, which can cause diarrhea, vomiting, abdominal cramps and fever or skin, ear, respiratory and eye infections.

Sixty-five percent of parents polled agree that preventing RWIs is a shared responsibility between parents and pool staff; 28 percent believe that preventing infections is the sole responsibility of the water park staff. Chlorine and proper pool chemistry kill most of the germs that cause recreational water illnesses within an hour, and are essential to good pool management, but Cryptosporidium, a parasite that causes abdominal cramping, diarrhea and nausea, can survive for days even in properly disinfected pool.

The solution to preventing RWIs is a collaborative effort between park and pool operators and swimmers. The following simple preventive measures require the cooperation of informed parents:

  • Shower or wash all parts of your body thoroughly with soap and water before swimming, paying special attention to the diaper areas of young children.
  • Take children on bathroom breaks and check infant diapers often.
  • Remind children to avoid swallowing water or getting water in their mouths.
  • Do not swim if ill with diarrhea.

Healthy pools are a shared responsibility.  Parents, teach your children well:  Shower before swimming!

Joan Rose, PhD, is the Homer Nowlin Chair in Water Research at Michigan State University and a member of the Water Quality and Health Council.