By Rudy Stankowitz & Ileah Bradshaw with Aquatic Facility Training & Consultants
The free standing outdoor shower, required to be installed on the pool deck of every single public pool in the country, is perhaps the least voluntarily used piece of equipment at any swimming pool anywhere. Standing off to the side, alone and unnoticed, this 7 foot tall monument to hygiene (whose presence is required to meet Health Department code) does indeed offer a layer of protection against harmful recreational water illnesses – when it is used.
“While 64 percent of parents feel it is very important for children to not swallow water at a water park, only 26 percent of parents think it is very important to shower before getting into the water,” Dr. Matthew Davis, University of Michigan C.S. Mott Children’s Hospital.
Watching bathers arrive at an aquatic facility day in and day out, place down there bag and head directly for the pool (seemingly unaware that the shower even exists), one can estimate the number of individuals who voluntarily follow the Shower Before Bathing Rule falls somewhere between 15 to 20%. Sadly, the individuals who are following the rule and showering, our 15 to 20%, are being punished by those who do not. The non-showerers are exposing those who shower to a multitude of harmful diseases, pathogens, and disinfection by products unseen to the naked eye.
Pee in the Pool?!?!
We all know who you are – the bather that suddenly and slowly swims off by themselves lingering at the wall of the pool and waving their hand in the water to disperse the yellow cloud. On multiple occasions we have even heard parents tell their children “As long as you don’t have to poop you can pee in the pool.”(One in five Americans admits to peeing in the pool, according to a 2012 survey by the Water Quality and Health Council).
The reality of it is that yellow is not mellow!!! Urine does present a possible disease threat: If a person who is infected with Leptospirosis was to pee in the pool, they would shed this harmful bacteria in their urine. Once present in the pool water, even insuring that one does not get water in his/her mouth will not protect them from this zoonotic illness: The Leptospirosis bacteria enters a host through the skin (if in the water long enough), mucus membrane, or even directly through the eye. Luckily, the lepto bacteria is destroyed quickly in a properly maintained swimming pool. Person to person transmission of Leptospirosis is rare, but does occur.
When a person urinates in a swimming pool, or when they bring in perspiration on their skin, they introduce urea to the water: Urea is a nitrogen containing substance that forms during the breakdown of protein metabolism. When this nitrogen rich protein byproduct is introduced into chlorinated water, organic chloramines are formed. Chloramines, often called combined chlorine, are a weak and ineffective sanitizer; they are also a powerful irritant typically responsible for the red itchy eyes often wrongly blamed upon high concentrations of chlorine and/or pH imbalance. Organic chloramines differ from ammonia based inorganic chloramines not only in that they have much lower disinfecting efficiencies, but in that they are impossible to remove from water using a breakpoint chlorination process (“Shocking”), in fact additional chlorine may just make matters worse. To remove organic chloramines from a swimming pool, water replacement is often the best option.
According to research
Research conducted by Jing Li and Ernest R. Blatchley III of Purdue University, titled Formation Resulting from Chlorination of Organic-Nitrogen Precursors in Swimming Pools, Trihalomethanes (THMs) have been reported to be formed by chlorination of materials of human origin (hair, lotion, saliva, skin, sweat and urine). According to the EPA people who drink (or swallow) water containing THMs can experience liver, kidney, or central nervous system problems and an increased risk of cancer. Jing and Blatchley’s research goes on to document that in the chlorination of proteins found in urea (creatinine and L-histidine) volatile DPBs (Disinfection By Products) Dichloromethylamine, monochloromethylamine, Trichloramine (Often associated with the development of asthma in children and professional swimmers) are also formed.
As much as we would like to think that toilet paper cleans our bottoms to perfection, the truth is that no matter how well you wipe you won’t get it all. Microbiologist Charles P. Gerba’s research, which can be found in his publication titled “Assessment of Enteric Pathogen Shedding by Bathers during Recreational Activity and Its Impact on Water Quality”, explains that the amount of fecal material a bather naturally carries on their person and introduces to a swimming pool upon entry is about 0.14 grams. That means that for every 3,243 people that enter a body of water – 1 full pound of poop has been introduced to the pool just from what they carry on their buttocks. Gerba, currently a professor at the University of Arizona, goes on to explain that the concentration of Giardia or Cryptosporidium an infected person can shed into a swimming pool, just by entering the water, can range from 100,000 to 10,000,000 protozoan parasites per gram of feces. Enteric viruses (enterovirus, adenovirus, and rotovirus) shed into a pool from the feces naturally present on a person’s bottom of an infected person can actually number as high as 1,000,000,000,000 per gram. So, a person doesn’t actually have to poop in the pool to spread a fecal related illness at a recreational water venue – they simply just need to get in.
Does the average swimmer understand the reasoning behind the Shower Before Bathing Rule? To find out, we conducted a survey of 100 random people, here are our results:
The reality of it is that most bathers are not typically aware of any hidden or possible dangers when they visit a swimming pool (or any other type of recreational aquatic venue) whether it be in the water, on the deck, or something that they may bring in themselves. Increased education and a change in culture may prove to be a huge part of the solution. The CDC has created a series of posters for aquatic facilities that encourage proper pool hygiene, with a bit more blunt of a message, that both grabs attention and educates the bather: http://www.cdc.gov/healthywater/swimming/resources/posters.html