The document discusses a study analyzing the recreational water illness (RWI) prevention protocols of the City of Mesa Aquatics Division. It examines the division's administration, aquatic staff, and maintenance entities to evaluate if their prevention and sanitation measures meet CDC guidelines. Through interviews and reviewing documentation from each entity, it was found that while administration and maintenance meet standards, aquatic staff inconsistently complete required daily logs. The study concludes by recommending streamlining the staff documentation process and increasing education on its importance to improve compliance with RWI prevention protocols.

1. How Clean Is Your Public Pool?-Recreational
Water Illness Protocol in Mesa
Andrew D. Scott
Research Question:
Do the City of Mesa Aquatics Division's
prevention and sanitation measures to combat
Recreational Water Illnesses (RWI's) meet
industry standards and CDC guidelines for
healthy swimming habits?
If not, how can Mesa's Aquatics Division
streamline, standardize, or improve their
methods to better prevent outbreaks?
Methods:
Literature Review:
• Background information on RWI's
like
• 1) Cryptosporidium
• 2) E. Coli
• 3) Giardia
• Prevention and sanitation
techniques currently being used
in the industry
• Research current "Healthy
Swimming" Steps proposed by
the CDC
Administration
• Interviews with Aimee Manis
(Aquatics Coordinator) and Dalra
Armfiled (Aquatics Supervisor
Aquatics
Staff
• Data Analysis of Staff's
Daily Pool Logs and
Chemical Check Logs
Maintenance
• Interview Tyler Dees,
Maintenance
Foreman Mesa Pools
The diagram above displays the three entities
that make up the Mesa Aquatics Program and
explains the steps taken to gather information
fro each of the three entities.
Administration
BACKGROUND: “REDUCING
GERM CONTAMINATION OF
SWIMMING POOLS”
STEP 1 “LEAD YOUR STAFF”
STEP 2 “DEVELOP
PARTNERSHIPS”
STEP 3 “EDUCATE POOL STAFF”
STEP 4 “EDUCATE SWIMMERS
AND PARENTS”
And
STEP 9 “DEVELOP A BATHROOM
BREAK POLICY”
STEP 10 “CREATE A SPEICAL
POLICY FOR LARGE GROUPS OF
YOUNG CHILDREN”
STEP 11 “POST AND
DISTRIBUTE HEALTH
INFORMATION”
STEP 12 “DEVELOP AN
OUTBREAK, EMERGENCY
RESPONSE PLAN”
0%
20%
40%
60%
80%
100%
Brimh
all
Carso
n
Fremo
nt
Kino Rhode
s
Sheph
erd
Skylin
e
Staple
y
Taylor
Missing 3 16 0 1 0 0 0 4 2
Incomplete 2 22 1 9 0 4 0 5 5
Filled Out 65 32 69 60 0 66 0 61 63
PercentageofChecklist
2009 Daily Checklists by Pool
0%
20%
40%
60%
80%
100%
Brimh
all
Carso
n
Fremo
nt
Kino Rhode
s
Sheph
erd
Skylin
e
Staple
y
Taylor
Missing 0 1 1 1 3 3 1 21 5
Incomplete 3 22 0 3 11 19 6 15 11
Filled out 60 40 62 59 49 41 56 27 47
PercentageofChecklist
2012 Daily Checklists by Pool
85%
10%
5%
2009 Daily
Checklist Totals
Filled Out
Incomplete
Missing
78%
16%
6%
2012 Daily
Checklist Totals
Filled out
Incomplete
Missing
Not Recorded Not Recorded
0
1
2
3
4
5
6
ChlorineLevel(ppm)
2009 Chlorine Levels at Time of Fecal
Release
0
1
2
3
4
5
6
7
ClorineLevels(ppm)
2012 Chlorine Levels at Time of Fecal
Release
Not Recorded
14%
7%
10%
69%
2009 Fecal Releases
No Chem Log
Not Recorded
Incomplete
Documented
2% 12%
42%
44%
2012 Fecal Releases
No Chem Log
Not Recorded
Incomplete
Documented
Study 3 Entities of Mesa Aquatics
Program:
Reports at Time of Incident
The graphs to the right categorize what
documentation was found for Chemical
readings at the time of each recorded
fecal release.
Documented: the Chlorine readings were recorded properly
Incomplete: the Chemical Log for that day was not entirely filled
out
Not Recorded: the Chlorine level at the time of incident was not
recorded on the Daily Log sheet
No Chem Log: the entire Chemical Log for that day was missing
Introduction, Background:
Within the United Sates, there are a reported 360 million annual visits
to more than 7.4 million public swimming venues, either public pools,
water parks, or splash pads. (Otto 54). In recent years, the outbreaks of
recreational water illnesses for public swimming areas have increased
significantly. In particular, cryptosporidisis and Escherichia coli (E. coli)
have been major concerns for Parks and Recreation entities across the
United States.
Initially, freshwater areas become contaminated through sewage and
animal defecation into public watersheds (Weber 249). Then, since so
much of our recreational activity in the summer months comes from
freshwater sources, humans come into contact with various RWI's in the
water. From there, humans can contract a variety of complications.
Without proper attention to healthy swimming practices, the recreational
water illnesses can become widely distributed very quickly. Accidental
fecal releases, or AFR’s, are the main mode of transmission from one
body of water to another of these recreational water illnesses. When one
person who has contracted a RWI visits a public swimming area, the
oocytes and viruses transfer into the water itself through either AFR's or
even just recreational swimming. The swallowing of contaminated
material while swimming induces transmission of oocytes, viruses, and
bacteria (Weber 249). While many people think that the proper
maintenance of facilities, checking of pool chemistry, and routine super-
chlorination kill these recreational water illnesses, outbreaks of
Cryptosporidium have proved that these measures alone are not enough.
The series of outbreaks nationally led me to consider what controllable
aspects of recreational water illnesses are either effective or ineffective.
Having been an aquatics employee for ten years, I have been subject to
stringent requirements for pool sanitation and chemistry. However, one of
the largest components that Parks and Recreation entities control is the
educational aspect: education of aquatics administration, maintenance
teams, seasonal staff, and the public itself. While researching, I found
that the CDC has made very clear suggestions to pool operators and
municipalities in how to deal with RWI control and sanitation. After
reading these I found my research question
Maintenance
BACKGROUND: “REDUCING
GERM CONTAMINATION OF
SWIMMING POOLS”
And
STEP 5 “MAINTAIN WATER
QUALITY & EQUIPMENT”
STEP 6 “EVALUATE AQUATIC
FACILITY DESIGN”
STEP 7 “INSTITUTE
DISINFECTION GUIDELINES”
STEP 8 “EVALUATE HYGIENE
FACILITIES”
And
STEP 12 “DEVELOP AN
OUTBREAK, EMERGENCY
RESPONSE PLAN
Twelve Steps for Prevention of Recreational Water
Illnesses
Center for Disease Control.
Discussion, Conclusion
Of the three parts of the Aquatics Program in Mesa, two
fulfill all duties as provided by the CDC with documentation.
Administration and Maintenance accurately, quickly, and
efficiently fill out their paperwork and follow through with
their responsibilities. However, the seasonal aquatics staff
does not consistently follow instructions and responsibly finish
their daily pool logs in time.
This does NOT mean that the aquatics staff is not
compliant with the daily tasks assigned for prevention and
sanitation. It does mean, however, that documentation
procedures performed by the aquatics staff can be
streamlined and improved to meet standards.
Throughout this summer (starting next week) the
administration staff and myself will begin making alterations
to the daily pool logs to highlight the more pertinent sections
and to ensure it is completed accurately. We have also
structured part of the pre-season management trainings to go
over the importance, legally speaking, of accurately
completing documentation. Also, we have discussed incentive
programs that reward the pools that most accurately
complete their daily pool logs and chemical check sheets
References:
Arko T. Kick the sick: Clear your waters of organisms that cause recreational water
illnesses. Parks& Recreation. 2008;43(2):52.
Beach MJ. Recreational water illness prevention and swimming pool operation:
Moving beyond the basics. J Environ Health. 2007;69(9):82.
Hlavsa MC, Beach MJ. The three es of healthy swimming. J Environ Health.
2011;73(9):26.
Manheimer WA. Studies on the sanitation of swimming pools. J Infect Dis.
1914;15(1):159-186.
Meyer KJ, Appletoft CM, Schwemm AK, Uzoigwe JC, Brown EJ. Determining the
source of fecal contamination in recreational waters. J Environ Health.
2005;68(1):25.
NB Alden, TS Ghosh, RL Vogt, et al. Cryptosporidiosis outbreaks associated with
recreational water use five states, 2006. JAMA: The Journal of the American Medical
Association. 2007;298(13):1507-1509.
Otto C, Joe PS. Recreational water illness prevention, 2008. J Environ Health.
2008;70(9):57.
Otto 3, Charles. Recreational water-illness-prevention = healthy swimming. J
Environ Health. 2006;68(9):54.
"Twelve (12) Steps for Prevention of Recreational Water Illnesses (RWIs) (for Pool
and Aquatics Staff)." Center for Disease Control. April 10 2010 2010.Web.
<http://www.cdc.gov/healthywater/swimming/pools/twelve-steps-for-prevention-
rwi.html>.
Weber CJ. Update on recreational water illnesses. Urologic nursing. 2005;25(4):289
Acknowledgements:
City of Mesa Aquatics
Professional Contact- Aimee Manis
Darla Armfield
Tyler Dees
Arizona State University
Faculty Mentor- Jane Maienschein
Ann Kinzig
Catherine May
Fellow Students
From Multiple
Years...
Administration
Aquatics
Staff
Maintenance