Not at My Pool – Avoiding Illness and Infection Poolside

Recreational Water Illnesses (RWI’s) are bacteria, viruses and protozoa that can spread through swimming pool environments. This happens when contaminated water is swallowed, contaminated water droplets are inhaled, or through contact between skin and an aquatic surface at a pool. Well-trained swimming pool operators are the first line of defense in the battle against illness transmission poolside.

Standard setting organizations such as the Centers for Disease Control and Prevention equip swimming pool operators with data, knowledge and standard operating protocols to reduce the risk of disease transmission poolside.

The Issue with Recreational Water Illness

In the United State between the years 2000 and 2014 nearly 500 outbreaks associated with swimming pools were logged by the CDC. Those outbreaks impacted over 27,000 individuals and lead to at least 8 deaths. With chlorine and bromine as the primary barrier between pathogens and the public, pool operators must remain hypervigilant in the sanitation of their swimming pool. [1]

Unfortunately, the CDC also reports major issues associated with sanitizer level compliance. Using datasets gathered from health departments inspecting public swimming pools, the CDC reported that 12.3% of pool inspections resulted an immediate closure of a pool for a serious violation. The principal violation was a lack of appropriate disinfectant level (10.1% of the total sample set was closed for this reason). [2]

Furthermore, many recreational water illnesses are transmitted through fecal matter and accidental fecal releases in swimming pools. These incidents require special consideration and protocol. The CDC recommends strict guidelines for hyperchlorination to inactivate fecal related pathogens. Operators must make themselves well aware of the CDC’s Fecal Incident Response Recommendations and follow this protocol closely when dealing with a fecal incident at their pool.

According to the CDC, vomit and blood are unlikely to spread illness through pool water. In many scenarios, vomiting in the pool is caused by symptoms similar to motion sickness or by a swimmer swallowing too much water. Vomited pool water is relatively sanitary, however in the event that the contents of the stomach are vomited, the CDC notes that operators should act quickly and follow formed stool protocol to treat the water.[3]

Familiarizing operators with the industry specified standards regarding recreational water illness is essential in the prevention of disease transmission poolside.


Good Pool Operating Practices

Know the Codes – Operators must always maintain an appropriate disinfectant level in their pool. State and county codes vary, but reflect the minimum disinfectant residual, as well as the minimum number of daily tests required by an operator.

The state required standards represent the lowest acceptable amount of sanitizer allowed, and the lowest frequency of chemical testing at a pool per day. Well trained operators may determine greater quantities of sanitizer and frequency of testing are more appropriate at their facility.

Know the Standards – Operators must be well-versed in the CDC’s Fecal Accident Response Protocol.[4] If an accident happens at their pool, they must act quickly to clear the pool and chemically treat per the appropriate recommended standards. The prescribed hyperchlorination protocol recommends usage of high levels of chlorine for an extended period of time. Operators must plan in advance to have enough chlorine available and a professional grade chemical test kit capable of documenting levels of chlorine in excess of 20 parts per million.

Advanced Training – The risk associated with a RWI’s is both severe and likely. Aquatic teams should be trained in appropriate operational procedures through certification courses, continuing education workshops and in-service training. Staff required to perform pool operation tasks such as chemical testing and chemical dosage should receive significant training. These tasks are not appropriate for staff who are untrained in pool operations. Currently 24 states mandate that aquatic personnel are trained and certified in pool operations.

Health Department Partnership – Public health officials share a common goal with pool operators. They are both working to protect the health of swimmers at public aquatic facilities. Detailed reporting of chemical compliance and poolside incidents serves as a layer of documented legal protection and keeps the health department informed of best practices at aquatic facilities.


Aquatic Risk, Chemical Dosing and Poolside Standards and Regulations are discussed in detail at all of our Certified Pool / Spa Operator Training programs. Please click here for the full schedule of courses available in your area. 


[1]Morbidity and Mortality Weekly Report (MMWR) May 18, 2018 / 67 (19); 547-551

[2]Morbidity and Mortality Weekly Report (MMWR) May 21, 2010 / 59(19);582-587

[3]Centers for Disease Control and Prevention – Vomit & Blood Contamination from Pool Water

[4]Centers for Disease Control and Prevention – Fecal Incident Response Protocol for Aquatic Staff