April 24, 2009 Presenters: Laura Hunter, EPHS Thomas Bixler, EPHS Bob Reynolds, EPHS Brent Brockmeyer, NSPF Certified Pool Operator Instructor

Agenda Sign In and Introduction Pool Ordinance Information Break Sessions Inspection Chemical Storage Safety with Brent Testing Procedures Break Troubleshooting with Brent Recreational Water Diseases Collect Surveys!!! Virginia Graeme Baker Act Questions

Inspection of Indoor and Outdoor Pools and Spas City of Branson Municipal Code Chapter 46 HEALTH AND SANITATION Division 3. Swimming Pools Sec through Definition: Public Swimming Pool- means any place open to the public for swimming or recreative bathing whether or not a fee is charged for use thereof, and shall be classified as pools, outdoor or indoor, which are entirely of artificial construction Health Permit displayed in a conspicuous place

Frequency of Inspection Indoor Facilities: Inspected 4 times a year, approximately every 3 months (not including complaints or revisits) Outdoor Facilities: Inspected 3 times a year Usually open in May and close in September Approximately every 5 or 6 weeks

Safety: Lifeguard Chairs/Stations At least one lifeguard shall be provided for swimming pools, spas, and recreational water attractions equal to or greater than 3400 square feet of pool surface area. One additional lifeguard shall be provided for each additional 2000 square feet of pool surface area thereafter.

Safety Requirements: Safety Unit One unit = Conspicuous location of a throwable device and a reaching device. One unit shall be provided for each 2,000 square feet of water surface area or major fraction thereof.

Safety Unit Definitions Throwable Device: A U.S. Coast Guard Approved Ring, 18 inches in diameter, or throwing buoy fitted with a one-fourth-inch diameter line with a length of 1 ½ times the maximum width of the pool or 50 feet, whichever is less. Reaching Device: A life pole, or shepherd’s crook type of pole, having blunted ends with a minimum length of 12 ft and able to reach the center of the bottom of the pool at the deep end.

First Aid Equipment Every swimming pool shall be equipped with a minimum of a Red Cross standard 16-unit first aid kit, or its equivalent. A spine board should be provided at each pool.

Attendant Alarm Any swimming pool, spa, or recreational water attraction which is located such that it is not at all times in direct view of the attendant shall have, in the immediate vicinity of the pool, a clearly labeled alarm device that can be activated when a bather is in trouble and is easily heard throughout the area or building. Or the facility shall have a non-pay telephone permanently installed at pool side which is readily accessible and conspicuously located. The telephone shall have signage stating call 911 in case of emergency or contact directly with an attendant.

Attendant Alarm 1. Attendant who has direct line of sight of pool at all times 2. Alarm that rings to an attendant or front desk or be heard throughout facility. There must be someone available to respond to alarm 3. Emergency Phone: Ring to front desk or 911. Clearly mark phone with a sign and dialing directions!!!

Safety Requirements: Depth Markings Plainly marked at or above the water surface on the pool wall and on the edge of the pool deck, at maximum and minimum points points of break between the deep and shallow portions, and at intervals of not more than 25-feet, intervals measured peripherally. Numerals 4 inches minimum height and a contrasting color with the background.

Decks Entirely surround pool Not less than 5 feet Easily cleaned Slip resistant No carpeting Hose bib required

Fencing and Gates Completely surrounded Not less than 4 feet high Self-closing and positive self-latching closure mechanism The latch shall be installed as high as possible, but at least 4 feet high

Safety Requirements: Rules and Signs Located in a conspicuous place Letters at least 4 inches in high Letters contrasting color from background WARNING SIGNS Whenever the pool area is opened for use and no lifeguard service is required or provided, warning signs shall be placed in plain view to the entrances and inside the pool area which state “WARNING--NO LIFEGUARD ON DUTY ” legible letters at least 4 inches tall.

Pool Rules Children shall not use pool/spa without an adult in attendance. Persons with infections not permitted. No food, drink, gum or tobacco permitted in pool or on deck. No containers made of glass or shatterable plastic. Shower before entering and after use of toilet facilities. No running or rough play. No pets allowed. Do not leave small our young children unattended. Management shall post additional rules as needed

Spa Signage Caution signs. A legible sign visible from the spa shall be provided. It shall state: “Caution. Any person having an acute or chronic disease such that use of the spa might adversely affect their health should consult a physician before using the spa. Do not use the spa immediately following exercise or while under the influence of alcohol. Do not use the spa longer than ten minutes. Children shall be accompanied by an adult.”

Disinfection Swimming pools shall be designed to provide for continuous disinfection of the pool water with a chemical which is an effective disinfectant and which is easily measured, active residual.

Test Kits Colormetric, DPD test kit (Diethyl-P-Phenylene Diamine) pH test kit with a range from , accurate to the nearest 0.2 Appropriate reagents Reagents replaced annually Demonstrate working knowledge of proper use

Maintenance Pool Cleaning System A pool cleaning shall be provided to remove dirt from the bottom of the pool. Manual For Operations Instructions for each filter, pump, or other equipment, drawings, illustrations, chart operating instructions, and parts list to permit to permit proper installation, operation, winterization and maintenance.

Log Sheets Pool water quality should be checked AT LEAST 2 times a day and logged Chlorine: combined, total, and free pH Any chemicals added should also be written down in the log sheets along with the amounts added Routine maintenance or repairs need to be logged as well

Safety Requirements: Chemical Storage Rule of Thumb: Store like chemicals with like chemicals Store acids separate and away from bases Never re-use chemical containers, especially to store other chemicals Never use the same scoop or utensil for different chemicals Never use the same cloth to clean up spills Store on a non-absorbent surface STORE IN ACCORDANCE TO MANUFACTURER’S LABEL

Water Quality Standards

Chlorine, Free and Combined Free chlorine residual of at least 1.5 mg/l for a pH of 7.2 to 7.5 shall be maintained throughout the pool. For higher pH values, higher free chlorine residuals of at least 0.2 mg/l for each 0.2 pH unit increase shall be maintained. Total at least 1.5 ppm and not more than 5 ppm 1 ppm = 1 mg/l pH Maintained between 7.2 and 8.2

Combined Chlorine If the concentration of combined chlorine greater than 0.2 ppm, than the pool should be super chlorinated to reduce the concentration of combined chlorine Superchlorination ( f.1): free chlorine raised between 5 to 10 ppm. Swimmers are not allowed back in until residual below 5 ppm

Bromine When Bromine is used as a disinfectant, a residual of 1 ppm shall be maintained for a pool with a pH below ppm for pH 7.8 or higher

Water Clarity Swimming pool water shall have sufficient clarity that the main drain cover is readily visible at the deepest point of the pool when viewed from the side of the pool. A black drain cover or two-inch circle around the drain cover. Transparency Disk Must be readily visible

Clarity

Algae Control An algaecide may be used as long as it is in accordance with the label.

Temperature Pool water should be between 72 F and 85 F Air temperature for an indoor swimming pool should be maintained from two to five degrees F above the pool temp. This helps with the humidity and also comfort of swimmers Spa temperature not over 102 F

Pool Cleaning Recommended pool and deck be cleaned, the pool water surface skimmed, and the pool walls and bottom vacuumed or brushed, all on a daily basis and while the pool is closed for use.

Turnover Pool water turnover at least every 6 hours (4 times a day) Wading pools must turnover a minimum of every 2 hours A flow meter shall be provided to determine flow rates and turnover rates

Code Compliance: What Fails and Inspection Any critical violation! Criticals: Chemicals out of compliance Chlorine (free or combined) or pH too high or low Clarity: Cannot clearly see black drain No continuous disinfection Inoperable pumps Entrances not closed Unsanitary conditions, including saunas and showers Any electrical deficiencies Ex. Bare wires

Code Compliance: What Fails and Inspection Immediate Danger-Any threat to safety of life Ex. No lifeguard, as required by code Ex. No attendant, emergency phone, or alarm Overhead lights not shatterproof or properly shielded Backflow prevention device on hose bib Cross connection of potable water to sewage Any repairs to walls, ceilings or floors Absence of anti-entrapment system and standards (includes lack of proof or documentation)

3 GROUPS AND ROTATE EVERY 10 MINUTES Pool Inspection: 10 minutes Water Testing: 10 minutes Chemical Safety: BRENT 10 minutes

Troubleshooting Brent will discuss common problems with pools and how to bring your pool into compliance

Recreational Water Illnesses (RWI’s) Diseases that are transmitted through recreational use of water including waterslides, swimming pools and lakes. Some infect the gastro intestinal and respiratory tracts while others infect skin, ears, and eyes

9 Steps to Prevention of RWI’s Leadership Education Communication Water Quality Disinfection Facility Design Planning Prevention Healthy Swimming

Lead Your Staff Making a choice to integrate an RWI protection plan into an existing facility risk management plan is the single greatest decision you can make to protect swimmers from RWI’S

Educate Pool staff Ensure that all staff know the critical role of water testing, proper testing methods, and how to respond if disinfectant levels are not adequate.

Develop Partnerships Building a communication bridge to your health department and other aquatic facilities is a great way to get information about other outbreaks occurring in your community.

Educate Swimmers and Parents Remember that people care about their health, so a lead- in might be: “To ensure the health and safety of all our visitors, we ask that you remember to follow these easy “ P-L-E-As” for Healthy Swimming.” Please don’t swim when you have diarrhea. Please don’t swallow the pool water Please practice good hygiene Please take your kids on bathroom breaks often Please change diapers in a bathroom, not at poolside Please wash your child thoroughly (especially the rear end) with soap and water before swimming

Maintain Water Quality Equipment Keep the chemical feed equipment and chemicals at optimal levels. Poor pH control can compromise chlorine’s effectiveness as a disinfectant. Ensure regular and thorough maintenance of the recirculation and filtration equipment to provide maximum filtration.

Institute Disinfection Guidelines Have a written fecal accident response policy and keep records of all fecal accidents, chlorine and pH level measurements, and any major equipment repairs or changes.

Evaluate Hygiene Facilities In CDC’s parent interviews, parents uniformly said they changed diapers at poolside because changing rooms were unclean, poorly maintained, and/or had inadequate diaper-changing facilities.

Create a Special Policy for Large Groups of Young Children If you allow large groups of diaper/toddler-aged children in the pool consider: Requiring RWI orientation training for the care providers and make sure they understand that your pool, like most daycare centers, also excludes children ill with diarrhea. Keeping diaper/toddler-aged children in the pools specifically designated for them.

Post and Distribute Health Information Encourage swimmers to shower with soap and water before entering the pool. Post the six “P-L-E-As” that promote Healthy Swimming.

Develop an Outbreak/Emergency Response Plan The best advise is to be prepared. If an outbreak does occur, are you ready? Do you have a plan? Collaborate with your local health department. Support the investigation, it can lead to better illness prevention strategies that can help everyone.

Cryptosporidiosis “Crypto” During the past two decades, Crypto has become recognized as the most common cause of RWI’s in the United States. Causes diarrhea and respiratory infections Protozoa found in infected people’s stool Cannot be seen by the naked eye Survives for a long period of time Resistant to chlorine disinfection Takes approximately 6.7 days to kill in chlorinated swimming pool

Cryptosporidium Parvum

Escherichia Coli 0157:H7 Bacteria Causes severe diarrhea and abdominal cramps Can lead to hemolytic uremic syndrome the principal cause of acute kidney failure in children Chlorine is very affective in killing E. coli 0157:H7, < 1 minute

E.Coli 0157:H7

Giardia (gee-ARE-dee-uh) A protozoan infection principally of the upper small intestine Found in infected peoples stool Cannot be seen by the naked eye Takes approximately 45 minutes for properly chlorinated water to kill

Giardia

Norovirus Noroviruses are a group of viruses that cause the “stomach flu,” or gastroenteritis (GAS-tro-en-ter-I- tes), in people. Found in the stool or vomit of infected people Very contagious and can spread easily from person to person

Norovirus

Shigellosis Disease caused by a group of bacteria called Shigella Infects the GI tract Characterized by diarrhea accompanied by fever and nausea, vomiting and cramps Present in infected individuals stools while they are sick and for a week or two afterwards

Shigella

Pseudomonas aeruginosa Dermatitis/Folliculitis Pathogenic Bacteria Hot Tub Rash Be aware that hot tubs and spas have warmer water than pools, so chlorine or other disinfectants break down faster

Pseudomonas aeruginosa

Legionellosis Legionnaires’ disease and Pontiac fever are caused by Legionellae bacterium. Symptoms include anorexia, malaise, myalgia, headaches, rapidly rising fever and chills. Temperatures commonly reach 102° F - 105° F.

Legionella bacterium

Other Infections Swimmer’s ear (ear ache) is an infection caused by Pseudomonas aeruginosa. Swimmer’s itch, also called cercarial dermatitis, appears as a skin rash caused by an allergic reaction to certain parasites

Swimmer’s itch

Questions??? Questions for Inspectors Questions For Brent Troubleshooting for pool problems Pumps, filters, etc. New Rules based on Virginia Graeme Baker Act is next. If you are not staying please fill out a survey and pass it in now. If you are staying, please fill out survey now or make sure it gets turned in after the VGB section: Surveys are important because it helps us have a better Pool School for you next year!!!

Thanks Center for Disease Control Many images found through Brent Brockmeyer: Vaughn Pools Roark Health Club: for use of Facilities!

Thank You For taking time out to be dedicated to Public Health Taney County Health Department Environmental Section

New City Ordinances: VGB The Virginia Graeme Baker Act went into enforcement action December 19, 2009 The City of Branson also adopted provisions from the Virginia Graeme Baker Act into the current municipal pool ordinance. All pools in operation at this time (indoor pools) must be in compliance at this time or will be closed. All pools who haven’t opened (outdoor pools) must come into compliance before opening

Resources US!!!! Contact your inspector for questions or set up a consult of your pool and/or spa. Your pool supply company

Plan Submittal Please consult your inspector before making changes to your pool! Please submit your plans of action for coming into compliance and have your inspector approve it before making big purchases or changes to your pool! Please keep all information, documentation, and certificates of compliance on hand at the facility.

How do I know my pool or spa is in Compliance??? Step 1: Does my drain comply with the VGB Act? They must be marked with VGB 2008 ASME/ANSI A or logo Flow Rate Life Span

Drain Covers If field fabricated, must by certified by a Registered Design Professional (Professional Engineer) who provides a copy of a certificate saying it meets the VGB Act Standards, including flow rates, UV exposure, and durability Is it secure and installed according to manufacturer’s instructions?

Is my pool in compliance? Step 2: Do you have secondary back up options? Do you have more than 1 main drain going to single pump? (MUST BE 3 FT DISTANCE FROM CENTERS) If you have a single main drain? Did you get an SVRS (Safety Vacuum Release System) Do you have and automatic shut off? Do you have a suction-limiting vent system? Is your drain unblockable? Is your drain gravity fed? Did you disable your main drain? (if you did, did you provide flow rates or turnover rates to show you meet local code?)

Secondary Systems SVRS: A safety Vacuum release system which ceases operation of the pump, reverses the circulation flow, or otherwise provides a vacuum release at the suction outlet when a blockage is detected, that has been tested standard by an independent third party and found to conform to ASME?ANSI standard A or ASTM F2387 Automatic Pump Shut Off System: An automatic pump shut-off system

Secondary Systems Suction-limiting Vent System: A suction-limiting vent system with a tamper-resistant atmospheric opening. Unblockable: means a drain of any size and shape that a human body cannot sufficiently block to create a suction entrapment hazard. (from CPSC interpretation) ASME/ANSI A standard of unblockable- Dimensions of 18’’ x 23”, which represents shoulder to waist measurements of the 99 th percentile of adult males.

Secondary Systems Gravity Drainage System: A gravity drainage system that utilizes a collector tank. Drain Disablement: A device or system that disables the drain ONLY IF YOUR INSPECTOR APPROVES IT!!!!! YOU MUST MEET LOCAL CODE TURNOVER AND FLOW RATES!!!! Turnover Rates Every 6 hours (4x a day) for pools Every 2 hours for wading pools and spas

Secondary Systems Other Systems can be used but must be determined by the CPSC as equally effective or better than the ones outlined in the VGB Act. NO DRAIN REVERSALS! (These are not permanent and the department is not approving them)

If you answered no… Than grab a card of your inspector and call and set up a consult. YOU MUST MEET ALL REQUIREMENTS OF THE VGB ACT AND LOCAL CODE TO OPEN YOUR POOL.

Questions? Thank you for attending. Please turn in surveys now if you haven’t already. Make a consult with your inspector if you have specific or detailed questions about your specific pool. Have a Great Day!!!!