Illnesses from pool use

Water recreation facilities need to assure the following to help reduce the spread of waterborne illnesses such as E. coli, cryptosporidium and legionella

• Maintain minimum disinfectant levels at all pool facilities.
• The public needs to be cognizant of the potential risk for infecting other individuals if they have suffered a communicable illness, even though they no longer have symptoms. (In general, it is recommended that persons that have been ill not use a public pool within two weeks of suffering an illness. Symptoms of concern include fever, diarrhea, vomiting, nausea, abdominal cramps, upper respiratory infections, staphylococcal or pseudomonas skin infections, and conjunctivitis.)
• Infants, small children and other incontinent users need to wear tight-fitting, waterproof liners around diapers. Some facilities are now providing such plastic, rubber or vinyl pants at their facility.
• Schedule special sessions for pool use by incontinent pool users (e.g. infant swim classes) to reduce the number of people who may be potentially exposed. Avoid scheduling high use activities immediately after incontinent people use the pool.
• Operators should increase disinfectant levels during the time period the incontinent persons use the pool, e.g. during infant swim periods (the maximum allowed is 6 ppm for a swimming pool and 10 ppm for a spa pool.)
• Immediately use procedures outlined in pool contamination guidance documents if visible contamination has occurred in the pool water.
• Encourage people to take hot soapy showers in the nude prior to entering the pool.
• Assure proper operation of the recirculation treatment system for the facility.
• Provide safe and accessible diaper-changing areas. Do not allow diaper changing at poolside.
• Provide training for staff on potential illness issues to increase their awareness and ability to provide better information to the users on potential risks and the need to provide good hygiene.
• Reinforce to users not to purposely drink pool water to help reduce the risk of contracting gastrointestinal illnesses.
• If problems are noted with visible body contaminants in the pool, notify the pool operator immediately and follow the instructions in the pool contamination guidance document for cleaning the pool.

Pool facility owners and operators can provide additional protection by controlling use of pools by incontinent users. Some may prefer exclusion while others may want incontinent users to provide additional protection to the pool by requiring tight-fitting waterproof pants. Realistically, all bathers will add some level of contamination to the pool and good hygienic practices need to be followed by all.