Prevent Recreational Water Illness and Injury

Having fun while you swim this summer means knowing how to prevent recreational water illnesses (RWIs) and injuries. Learn how to stay healthy and safe while enjoying the water!

Swimming is one of the most popular sports activities in the United States1. Although swimming is a physical activity that offers many health benefits, pools and other recreational water venues are also places where germs can be spread and injuries can happen.

Prevent Illnesses

Recreational water illnesses (RWIs) are caused by germs spread by swallowing, breathing in mists or aerosols of, or having contact with contaminated water in swimming pools, hot tubs/spas, interactive fountains, lakes, rivers, or oceans.

Contrary to popular belief, chlorine and other disinfectants do not kill germs instantly. While most germs are killed within minutes, Crypto (short for Cryptosporidium) can live for days. Before they are killed, these germs can cause RWIs, such as gastrointestinal, skin, ear, respiratory, eye, neurologic, and wound infections. The most commonly reported RWI is diarrhea caused by germs such as Crypto, Giardia, Shigella, norovirus and E. coli O157:H7. Swallowing just a mouthful of water that contains these germs can make you sick.

We all share the water we swim in, and we each need to do our part to keep ourselves, our families, and our friends healthy. To help protect yourself and loved ones from germs, here are a few simple and effective steps all swimmers can take each time we swim:

Keep the poop, germs, and pee out of the water.

• Don't swim when you have diarrhea.
• Shower with soap before you start swimming.
• Take a rinse shower before you get back into the water.
• Take bathroom breaks every 60 minutes.
• Wash your hands after using the toilet or changing diapers.

Check the free chlorine level and pH before getting into the water.

• Pools: Proper chlorine (1–3 mg/L or parts per million [ppm]) and pH (7.2–7.8) levels maximize germ-killing power.
• Hot tubs/spas: Proper disinfectant level (chlorine [2–4 parts per million or ppm]) or bromine [4–6 ppm]) and pH (7.2–7.8) maximize germ-killing power.
• Most superstores, hardware stores, and pool-supply stores sell pool test strips.
• Free pool test strips: Go to the Water Quality & Health Council (WQHC)'s Healthy Pools page to order and receive free test strips. (Please note that any questions regarding your order or the availability of test strips should be addressed to the WQHC,
• Don't swallow the water you swim in.

Parents of young children should take a few extra steps:

• Take children on bathroom breaks every 60 minutes or check diapers every 30–60 minutes.
• Change diapers in the bathroom or diaper-changing area and not at poolside where germs can rinse into the water.

Visit CDC's Healthy Swimming website for more information. A variety of materials for the public, including infographics, brochures, posters, videos, podcasts, and fact sheets are available in the Health Promotion Materials section.

Prevent Drowning

Drowning is the leading cause of injury death among children 1–4 years old. Every day, 10 people die from drowning, and 2 of those 10 are children under the age of 15 years. Of drowning victims who survive and are treated in emergency rooms, more than half are hospitalized or transferred for further care. These individuals often experience brain damage, which can cause memory problems, learning disabilities, or permanent loss of basic functioning (or permanent vegetative state).

Keep swimmers safe in the water.

• Make sure everyone knows how to swim.
• Use life jackets appropriately.
• Provide continuous, attentive supervision close to swimmers.
• Know CPR (for older children and adults).

Prevent access to water when pool is not in use.

• Install and maintain barriers like 4-sided fencing and weight-bearing pool covers.
• Use locks/alarms for windows and doors.

Visit the Water-Related Injuries webpage for more information.

Prevent Pool Chemical Injuries

Pool chemicals are added to the water to kill germs and maximize disinfection. However, the same pool chemicals can also injure us if they're not handled and stored safely. Preventable injuries from pool chemicals led to nearly 5,000 emergency room visits in 2012. Nearly half of these preventable injuries were in children and teenagers and more than a third of these preventable injuries occurred at a home rather than a community pool.

Residential pool owners and public pool operators can follow these simple and effective steps to prevent pool chemical injuries:

• Read and follow directions on product labels.
• Wear appropriate safety equipment, such as goggles and masks, as directed, when handling pool chemicals.
• Secure pool chemicals to protect people and animals.
• Keep young children away when handling chemicals.
• NEVER mix different pool chemicals with each other, especially chlorine products with acid.
• Pre-dissolve pool chemicals ONLY when directed by product label.
• Add pool chemical to water, NEVER water to any pool chemical.

Visit the Pool Chemical Safety page for more information, including free posters and a video on pool chemical safety.

Remember: Think Healthy. Swim Healthy. Be Healthy!