It is a favorite summertime activity for all ages. In fact, swimming or relaxing in recreational water, such as swimming pools, water parks, hot tubs, lakes, rivers, or the ocean is one of the most popular activities in the country. However, swimmers can become affected by recreational water illnesses.
In swimming pools, parasites,
excessive chlorine, and indoor air irritants
are the most common causes of recreational water illnesses. These germs enter the water primarily through fecal contamination. Exposure to these contaminants usually results in diarrhea. However, contaminated water may also cause skin rashes, ear infections (swimmer's ear), or respiratory infections.
And while it is true that chlorine does kill these germs, poor maintenance of chlorine levels and filtering systems may impact the effectiveness of chlorination. In addition, chlorine takes time to work, even in the best-maintained swimming facilities. Some parasites are highly resistant to chlorine and may continue to live for several days after a pool has been disinfected.
In lakes, rivers, and oceans, pollution by raw sewage is the largest culprit for water contamination with disease-causing organisms, such as bacteria, viruses, protozoa, and worms. And of course, open water is not chlorinated. This means that you should check with your local public health department or pollution control authorities regarding water quality at your favorite beach before you go. You can also check the US Environmental Protection Agency’s (EPA) beach monitoring and notification website at
In addition to fecal contamination, swimming pools, hot tubs, and water parks may also be contaminated by vomit or blood in the water. The US Centers for Disease Control and Prevention (CDC) publishes guidelines for the maintenance and care of these facilities and recommends procedures to deal with any of the above mentioned types of contamination.
If your favorite spot to relax happens to be a swimming pool, water park, or hot tub, check with the pool’s management and staff to make sure they are aware of these recommendations and have a clear plan for responding to any type of water contamination.
If your favorite water spot is a public beach, here are some questions the EPA suggests you ask your local beach-monitoring official so you can stay safe:
Which beaches do you monitor and how often?Where can I see the test results and who can explain them to me?What are the primary sources of pollution that affect this beach?
If your favorite beach is not monitored regularly, here are some things you can do to protect yourself and your family:
Don't swim after a heavy rainstorm.Avoid swimming near storm drains when you are at the beach.If your beach is a no-discharge zone for vessel sewage, investigate whether pump-out facilities are available for boats. Be aware of trash and signs of pollution, such as oily water. If you think your local beach is contaminated, contact health or environmental protection officials.Work with authorities to create a beach monitoring program.
The CDC has published steps for healthy swimming to help you protect yourself and others against recreational water illnesses. Following these six recommendations will go a long way in ensuring everyone has fun in the water this summer!
Do not swim, or allow your child to swim, if either of you has diarrhea. Contrary to popular belief, diapers—even those designed for swimming—do not prevent fecal matter from leaking into the water. Allowing your kids to swim with diarrhea, or doing so yourself, may easily spread germs that could make you, your children, or others sick.
Do not drink the water, and if possible, try to avoid getting it in your mouth. Children should be instructed that this water is not for drinking.
Bathe with soap before swimming and wash your hands after using the toilet or after changing a baby’s diaper.
Take your children to the bathroom often. “Mommy, I have to…” may come too late to prevent an accident.
Change your children’s diapers in the bathroom or in a designated changing area, not by the side of the pool.
Bathe your children thoroughly before they get in the water. The cleaner your children, the cleaner the water.
Rinse after getting out as well.
Before you go to the beach. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/healthywater/pdf/swimming/resources/epa-before-you-go-to-beach-brochure.pdf. Accessed May 1, 2014.
Healthy swimming/recreational water. United States Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/healthyswimming. Updated Updated April 8, 2014. Accessed May 1, 2014.
Hyperchlorination to kill cryptosporidium. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/healthywater/pdf/swimming/pools/hyperchlorination-to-kill-cryptosporidium.pdf. Accessed May 1, 2014.
Steps of healthy swimming: protection against recreational water illnesses (RWIs). United States Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/healthywater/swimming/protection/steps-healthy-swimming.html. Updated May 16, 2013. Accessed May 1, 2014.
Last reviewed May 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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