The summer months present a unique set of environmental health challenges for practitioners to consider. Climbing temperatures awaken a host of public health vectors (animals and insects that can transmit diseases to humans). Public pools reopen, with children flocking to splash around in—and, most likely, swallow—water that local health departments must ensure is adequately chlorinated. Warm weather overworks refrigeration systems and quickens spoilage when food is left out, making food safety a concern. And of course, the heat itself is a hazard, especially for vulnerable populations. A changing global climate is likely to alter regions that experience high temperatures, bringing new challenges to local health departments.
To address these summer environmental health risks, NACCHO will release a series of blog posts over the coming months on some of the topics mentioned above.
The series begins, as summer does, with the opening of public swimming pools for Memorial Day Weekend.
“Swim Healthy. Stay Healthy.”
These words summarize the theme for this year’s Healthy and Safe Swimming Week (May 21 – 27), an initiative of the Centers for Disease Control and Prevention (CDC) to bend the public’s ear toward preventing injury and illness around recreational water activities.
This is an excellent time for local health departments to communicate key recreational water health and safety recommendations. Community engagement is essential for public health campaigns, and local health departments should consider partnering with the following organizations to spread messaging for Healthy and Safe Swimming Week:
- Healthcare providers
- Park and recreation departments
- Community organizations
- Summer camps, school programs, and day care centers
- Pool maintenance companies
- Home owner’s associations and apartment complexes
- Public beaches
Pools, Hot Tubs, and Water Playgrounds
- Check inspection scores. Local health departments regularly inspect public swimming pools and hot tubs, and the results of these inspections are publicly available. While an inspection is one snapshot of an establishment at a given moment in time, patterns of violations can indicate problems with the pool’s management or construction.
- Check the water. Pools need enough free chlorine or other disinfectant in the water to kill any harmful bacteria. In addition, the pH of the water should be balanced so as not to irritate users’ skin or reduce the effectiveness of disinfectants. Pool test kits are available at hardware or pool supply stores.
CDC Recommended Measures
|Chlorine*||≥ 1 ppm||≥ 3 ppm|
|Bromine*||≥ 3 ppm||≥ 4 ppm|
|pH||7.2 – 7.8||7.2 – 7.8|
*Swimming pools and hot tubs utilize either chlorine or bromine as a disinfectant, but not both.
- Check yourself. Don’t swim if you have diarrhea, and apply the same rule with your children. Whatever is causing your watery stools can easily be passed on to your fellow recreational swimmers if they accidentally swallow even a mouthful of water. Some parasites, like the diarrhea-causing Cryptosporidium, can survive in properly treated pools. To be extra safe, wait at least few days to get in the water after you’ve had diarrhea.
- Know your limits. Hot tub users should follow all the same rules as pool-goers, with some additional considerations. Legionnaires’ disease can be transmitted through the inhalation of water vapor, which may occur when relaxing in a hot tub. Certain individuals are at higher risk of contracting Legionnaires’ disease from hot tubs. These at-risk populations include people 50 years or older, current or former smokers, and individuals with chronic diseases or otherwise weakened immune systems. Individuals who meet these criteria may choose to skip the hot tub this summer.
- Come clean. When you first arrive at a pool, take a rinse in the shower, and then dry off and apply sunscreen. Wait a few minutes for the sunscreen to set in before jumping in the pool. This is an important step to reduce the amount of dirt and oil on your skin, which can throw off the balance of chemicals in the water keeping you safe. Don’t pee or poop in the pool, and try not to swallow any water. Take kids on hourly bathroom or diaper-check breaks, and take that opportunity use the bathroom yourself.
Healthy and safe swimming doesn’t just happen in pools—every year, millions of Americans enjoy trips to the beach. For many of us, the beach calls to mind images of sand castles and crashing ocean waves. The Environmental Protection Agency has a broader definition that includes any strip of land along a natural body of water, including lakes, rivers, and streams.
People who swim in fresh or marine water may find the health and safety tips below useful:
- Check the water. Naturally occurring bodies of water do not have treatment systems to kill bacteria. However, most beaches are monitored to ensure the water quality is safe for swimming. You can find information about your beach through the EPA’s website.
- Avoid algae. Seeing algae in the water makes swimming unappealing, and you should heed this natural deterrent, as some types of algae can make you sick.
- Prevent water from getting up your nose. Naegleria fowleri is a pathogen that can be found in warm bodies of fresh water. Very rarely, this amoeba can cause a serious brain infection when it enters through the nose.
- Swim safe. Ocean currents present an added threat to safe swimming. Learn about rip currents and other ocean safety tips from the American Red Cross.
Read the CDC’s new Healthy and Safe Swimming Week Toolkit for environmental health practitioners.
Join the Model Aquatic Health Code (MAHC) Network to learn more about health and safety around recreational water. This online community hosts bi-monthly webinars on the MAHC, a voluntary guidance document for state and local governments charged with regulating swimming pools.
- View the slides from the latest MACH Network webinar, featuring the CDC’s Michele Hlavsa and CDR Joe Laco. Michele shared highlights from a new report on outbreaks associated with treated recreational water venues, and Joe gave a preview of upcoming “mini MAHCs” – topic-specific packages of MAHC resources.
- Save the date for the next MAHC Network webinar, to be held July 24. Michael Beach, PhD, Associate Director for Healthy Water at the CDC, will give an overview of the third edition of the Model Aquatic Health Code. The third edition will be released this summer in June or July. For updates on this webinar, email your name and affiliation to firstname.lastname@example.org