Going for a swim? Learn tips for healthy swimming.


Welcome everyone and thanks for joining
to help us kick start Healthy and Safe Swimming Week we are alive for the next
15 to 20 minutes to answer your questions I’m Brittany Behm your
moderator for today and I’m joined by CDC expert Michele Hlavsa. She is chief
of our Healthy Swimming Program here at CDC. Last week CDC released new data that showed mixed progress in preventing outbreaks linked to pools hot tubs and
water playgrounds. Today we’re going to talk about some of these findings and
also provide tips to avoid getting sick from swimming this summer. Michelle can
you first tell us about some of the key findings from this report? So, big
picture, there were almost 500 outbreaks linked to pools hot tubs or spas or
water playgrounds that were reported to CDC for the years 2000 to 2014. When we
looked at outbreaks by individual causes we saw some outbreaks went up in numbers over the years, some went down and some stabilized or stayed level. Hmm so what
were some of the germs that were causing illness? Well the top three causes were
germs. There’s Cryptosporidium a parasite that
causes diarrhea, there’s Legionella the bacteria that can
cause a severe pneumonia known as “legionnaires disease” and pseudomonas the
bacteria that causes skin infections or a rash and outer ear infection commonly
known as swimmers ear. So how do people get those germs from the pool? So there
are different ways to get these germs when swimming in a pool. for example,
cryptosporidium you get when someone who’s infected with crypto– “crypto” for
short you know going into the pool, having diarrhea in the
pool and then other swimmers unfortunately drinking that contaminated
water what about those other bacteria. So for legionella,
it’s about inhaling vapors, or mists, or aerosols that contain the bacterium. For
pseudomonas it’s about your skin coming in contact
with contaminated water. What we see often times with hot tub rash is the
rash will look like the shape of the bathing suit because the bathing suit is
holding the contaminated water against the skin. With swimmers ear, it’s just
water– being you know, staying in the ear. Right.
Are some people more likely to get these type of diseases than other people? So
young children who haven’t been exposed to certain germs before, pregnant women
who have an altered immune system, and older people who have an aging immune
system, once they get infected might have more severe symptoms. People with a
weakened immune system if they get crypto, they could have life-threatening
symptoms and people who are fifty years of age are older people who are cancer
patients, people who have chronic diseases, particularly chronic lung
diseases or people who have a weakened immune system they’re more likely to get
sick when infected with legionella. So does chlorine not kill these types of
germs in the pool? Well levels that CDC recommends at
levels at most state and local health departments recommend most germs are
killed within minutes. Crypto is a big exception to this. Crypto can survive for
days in a well maintained pool. Wow what about the other ones?
In and of themselves legionella and pseudomonas are killed within minutes
with chlorine just like most germs but Legionella and Pseudomonas are really
good about creating a biofilm around themselves, or slimy layer that protects
them for chlorine. So if the chlorine level drops they build this biofilm they
grow in the– they grow on surfaces, and then when the chlorine level comes back
up, they’re able to– they’re protected from the chlorine. Is there any way for
us to know whether there’s biofilm in a pool? Well the best way to check it out
is to check the wall of the hot tub or the spa where at the top of the water
meets the wall if it’s slimy there’s a biofilm there and then the pool hasn’t
or the hot tub has not been cleaned or scrubbed recently enough. Mmm gross. I
know my family and I are probably going to go swimming a lot this summer; are
there some benefits of swimming that you can talk about? Well you just mentioned
one, it’s a great way to have fun with family and friends but there’s also the
opportunity to get some physical activity in we recommend two and a half
hours at least of physical activity a week. And why not make it water-based and fun? So let’s get practical. What is something we should all be doing
before we get into the water? Before you get into the water you can, well before
you even consider getting in the water, don’t swim or get into the water or
don’t let your kids swim if sick with diarrhea. We don’t want to share that
with anyone. Check your inspection score before going to a public pool or hot tub
or water playground by a “public pool”. I mean a pool that’s not in someone’s
backyard where multiple families would go kind of at a hotel, or water park, or
your town pool. Your state or local health department might post the
inspection results on their website or might require the pool or hot tub to
post it at the waterside. We check inspection scores before we go out to
eat. We should be checking inspection scores before we jump in the water. Right.
What about those little test strips that you can find some places? Well that’s
another step you can do before you get and do your own mini inspection and you
take the test strips and you check the chlorine or bromine level before you get
in and the pH. The pH is going to be important because it’s going to
determine how effective the chlorine or bromine are at killing germs in the
water. Where can you get those strips? You can go to a pool supply store or
hardware store a big-box store. About a hundred of them go for ten dollars.
interesting. And, oh, sorry go ahead. Oh, and I was gonna I was just gonna add,
to let everyone know, what you can do is you dip the strip in the water, and then
compare the colors on the pads of the strip to the colors on the bottle, and
depending upon where the color is, that’s what chlorine level or bromine level you
have and that’s the pH you have in the water. Interesting; seems easy.
What about once we’re in the pool, in the water, what do we do? Well once you’re in
the water don’t swallow the water you’re swimming in. If we have to tell people
not to swim with diarrhea, we shouldn’t be drinking the water. And as far as
parents of young swimmers, they should remember not to put toys in the water
that encouraged drinking that water. Also, they should be taking their children on
bathroom breaks every hour. And if they have a little one that’s still in
diapers, check that diaper every 30 or 60 minutes
and change the diaper away from the water. Good advice. I have a five-year-old
daughter and we’re going to be doing water playgrounds this summer. Is there
any specific advice for water playgrounds? The most important piece of
advice specific to water playgrounds is don’t sit on the jets. That is recycled
water in many water playgrounds. So what we’re basically doing when we sit on
jets is we’re rinsing off our bottoms. We’re rinsing out that diaper and then
sharing that water. So stay off the jets. Okay. Good advice. So we’re going to take
some questions from live from Facebook right now. Be sure to ask a question
online. Our first question comes from Louise, “I swim year-round in a public
pool. I wear goggles. What other personal protective equipment
is there?” I think the most important thing you can do is to do your own
inspection before getting in the water. Using those pool test strips to make
sure the chlorine is where it needs to be, or bromine, and make sure the pH
is where it needs to be. That’s the most important step you can take before
getting in. Okay, great. And another question from Mary do we
have any recommendation on the best type of test strips to use? My number one
recommendation with test strips is to follow the manufacturers directions. Make
sure that you hold the test strip the way you’re supposed to. O,kay
got it. And we have another one that asks about clothes or bracelets that change
color or indicate somehow that the water has been contaminated. Do we have
any technology that– do we know of anything like that that has clothing or
bracelets that change color based on water contamination? I wish we did. Yeah.
But unfortunately, no. I mean, even there’s that urban legend that there’s a special
chemical in the pool that changes color when someone pees in the pool,
unfortunately that doesn’t exist. Gotcha; okay. What about like free-living amoeba,
is that ever an issue in in swimming pools?
Naegleria fowleri or –which is commonly known as a brain-eating ameba
should not be an issue in a well-maintained pool. Okay great.
And what about this something I always think about the red eye we get in the
pool what’s that from? A lot of people think that’s chlorine, but actually,
that’s chlorine mixed with what we swimmers bring into the water so if we
pee in the water, if we don’t shower before we get in the water, we bring
stuff into the pool that mixes with chlorine
forms an irritant, and that’s actually what’s making our eyes red, not the
chlorine in and of itself. Interesting. We have a question from Andrea Nicole, “is
it worthwhile to use a test strip in a spray park?” Definitely. Spray parks are
where the jets are shooting water up out of the concrete basically. And when you
shoot that water up you’re introducing air into the water and
you’re depleting the chlorine or the bromine in the water. So it’s harder to
maintain the disinfectant level in the water. So I would be especially careful
to change –to check the water in there; that and you also have little kids in
the water, and those kids are, you know, bringing their germs into the water, and
they’re drinking the water, so– Well, speaking of kids, what do you think about
swim diapers? Do they work to prevent some of this illness? Not exactly. Germs
can be slowed down in terms of what swim diapers are able to do. They’re
able to contain solid poop, you know, within the diaper first a set amount of
time. Right. But when they’ve conducted studies looking at swim diapers, within
minutes, germs are getting out of those swim diapers. If water’s getting in it’s
getting out unfortunately. Right. Well what about pee? Is pee just as bad as poop in the water? Pee brings its own problems, different problems into the pool. So I
mentioned earlier when pee mixes with chlorine it forms an irritant and makes
your eyes red. What it’s also doing is that it’s using up the chlorine that
would otherwise kill germs. Gotcha; okay. What about if there’s like leaves and
bugs in the pool, does that mean that it’s not a well-maintained pool and
should we be concerned about that? My concern with with stuff in the water
like leaves and bugs would be that the chlorine is being used up. The chlorine
is interacting with the leaves and with the bugs and there’s less chlorine to
kill germs in the pool. Right. We have a question from Louise about parts per
million of chlorine and pools what’s the safe level for chlorine? So we at CDC
recommend at least one part per million of free available chlorine in water and
that’s the form of the chlorine that kills germs. And we recommend that for
pools and for water playgrounds. For hot tubs we recommend at least
three parts per million. Gotcha; thanks. So what is CDC doing in general to help
prevent some of these water related outbreaks? So what we’ve done is we’ve
done studies looking at how we get– how we kill cryptosporidium. If the levels
that we normally keep chlorine at aren’t working how are we going to prevent
crypto from spreading and causing infections and outbreaks? And so we did a
study to look at how best to kill chlorine– to kill crypto. And we found that you
know raising the chlorine level to a much higher level for a really long
period of time when there’s no swimmers in the water is a is the best way to
deal with it once it’s in the water. But of course, the main message is, “Don’t swim with diarrhea. Keep it out of the water in the first place.”
Gotcha. I know we’re talking about disease today but what about drowning
and other injuries? Are there things we should be on the lookout lookout at the
pool for preventing drowning? The best way to prevent drowning is to learn how
to swim. And if you’re a parent of a young swimmer, stay close to the young
swimmer and pay close attention to that young swimmer. Put that phone down.
You know the smartphone can wait till later, the texting and all that, because
people drown and they drown quietly and quickly. Right. What about athletes foot? Is
that ever a problem in pools? With athlete’s foot I’d be more worried about
keeping the flip-flops on in the locker room and while showering. Got it.
How about are there any ways, tips to not be distracted around the pool? Like if
you’re watching your kids–ya know. Get rid of that put that smartphone down. I
think that’s the number one way make sure you’re paying close attention to
your little one you’re close by. Gotcha. We have another question from Alexander.
“Do you know how dirty our local ocean beach is,” so any way to determine if your
beach is– kind of has dirty contaminants in it? So our ocean beaches should be
monitored for their water quality. And some beaches have chosen to post their
scores online, much like we post inspections online. If there is something
wrong with the water quality, there should be a sign posted on the beach
saying, you know, “The beach is closed to swimmers due to water quality,” or something to that extent. Gotcha. Are there any policies about, you know, laws
or ordinances, and where places have– where people have to shower before going
into the pool; like are they required to do, or is it just a recommendation? It
depends on what what your community requires. Some communities require signs
to be posted. I know at my gym there’s a big sign before you you exit the door to
the pool area saying you need to shower. And the lifeguards actually sends you
back into the back into the locker room if you’re not wet. Interesting, okay. Well I
think we are about done for today. Michelle I really appreciate you being
here. Is there anything else you’d like to tell everyone? I encourage everyone to
go swimming this year and especially this summer but just do it in a
healthier and safer way. Thank you so much. Well thank you all for joining us
today, and for your great questions. If we didn’t get to any of your questions
we’ll respond as soon as possible today. Have a healthy and safe summer everyone.

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