Recreational Water Illness Prevention Week

The week of May 19–25, 2008, marks the fourth annual National Recreational Water Illness Prevention Week. This yearly observance is an opportunity for swimmers to learn more about recreational water illnesses (RWIs) and the steps they can take to protect themselves. To learn more about Recreational Water Illness Prevention Week, visit the Healthy Swimming site.

What are RWIs?

RWIs are illnesses that are spread by swallowing, breathing, or having contact with contaminated water from swimming pools, water parks, spas, interactive fountains, lakes, rivers, or oceans. Diarrhea is the most common RWI, and it is often caused by germs like Cryptosporidium ("Crypto"), Giardia, Norovirus, Shigella, and E. coli O157:H7. Other common RWIs include skin, ear, respiratory, eye, neurologic, and wound infections. Children, pregnant women, and people with weakened immune systems are most at risk for RWIs.

How Can I Help Prevent RWIs?

Recreational water illnesses are preventable, and there are a number of simple steps the public, aquatics staff, and public health officials can take to help keep germs out of recreational water. Most importantly, public health officials and aquatics staff should work together to dispel the myths about recreational water and educate the public about the basics of healthy swimming. For example, some people mistakenly believe that chlorine immediately kills germs in pools. This might lead people to do things that put everyone at risk for RWIs, like swimming while ill with diarrhea and not showering before swimming. Chlorine does kill germs, but it doesn't work right away. It takes time to kill germs, especially chlorine-resistant germs like Crypto. Crypto is the leading cause of RWI outbreaks of diarrhea linked to pools. That is because it can survive for days in a pool if someone has an "accident" and contaminates the water.

The general public, aquatics staff, and public health officials can also take the additional steps listed below to prevent RWIs.

General Public

Follow the 'Six PLEAs' for Healthy Swimming to stop germs from getting in recreational water and causing illness:

• Please don't swim while ill with diarrhea.

• Please don't swallow the water.

• Please shower before you swim (children too!).

• Please wash your hands after using the toilet or changing diapers.

• Please take your kids on bathroom breaks or check diapers often.

• Please change diapers in the bathroom or diaper-changing area and not at the poolside.

Pool users can also take additional steps ( 1 page, 281KB), which include checking chlorine and pH levels of the water themselves, before getting in. Adequate chlorine (1–3 parts per million) and pH (7.2–7.8) levels are important, because they are the first defense against most germs that cause RWIs. If the pool does not have adequate chlorine or pH levels, tell the pool operator.

Remember, without your help even well maintained pools can spread RWIs.

Aquatics Operators

Approximately one fourth of RWI outbreaks of diarrhea linked to pools are caused by chlorine-sensitive germs like Giardia, Norovirus, Shigella, and E. coli O157:H7. These outbreaks can be prevented by good operation and maintenance.( 1 page, 81KB)

Aquatic operators and staff are also encouraged to engage swimmers and the media in efforts to stop germs from entering the water and to join the effort to develop a national model aquatic health code, which was made possible by a start-up grant from the National Swimming Pool Foundation. The Healthy Swimming site offers many prevention resources, including:

• Educational materials - brochures, posters, fact sheets, and podcasts

• Additional operation recommendations

• Prevention recommendations

Public Health Professionals

Public health agencies and staff members are encouraged to become involved in Recreational Water Illness Prevention Week by engaging the public, local aquatics operators, and the media in prevention efforts. Check out the Health Promotion Tool Kit ( 1 page, 91KB) for ways to promote healthy swimming in your community.

Special Tips for Swimmers in Natural Waters

If you swim in natural waters such as lakes, rivers, and oceans, consider the following recommendations from the Environmental Protection Agency (EPA):

• Ask if the beach water quality is monitored. If so, check out the latest results to see if the water is safe to swim in. The Beach Water Quality Program* provides information about water quality found at natural water venues in many states.

• Avoid swimming after a heavy rain.

• Look for storm drains (pipes that drain polluted water from streets) along the beach. Don't swim near them.

• Look for trash and other signs of pollution such as oil slicks in the water. These kinds of pollutants may indicate the presence of disease causing bacteria that may also have been washed into the water.

Check out EPA's brochure, 'Before You Go to the Beach' ( 2 pages, 75KB) for more information about beach safety.