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RUNNING CASE STUDY: DIRTY POOLS In August 2011, the Toronto Star conducted an investigation of pools and hot tubs at con- dominiums, health clubs, and swimming pools across the city of Toronto. They discovered that many pools and hot tubs in Toronto have repeatedly violated public health and safety rules. This means that bathers are potentially being exposed to injury and discase. Public health inspectors conduct inspections of the approximately 1600 recreational water facilities in the City of Toronto. Every recreational water facility in the city is inspected at least two times a year and no less than once every three months while oper- ating. Those facilities that operate year-round might receive up to four inspections per year. These inspections are unannounced and based on mandated inspection frequen- cies. Owners receive an inspection report and written instructions that outline the cor- rective actions they must take to correct any identified deficiencies. When an imminent health and safety hazard is identified a facility can be closed. A closed facility is allowed to reopen once it has met certain conditions as determined by a re-inspection. There are no set fines, and public health inspectors cannot issue tickets. The data obtained by the Toronto Star indicates more than 10 000 violations by pools and spas over the past two years at luxury condominiums, private schools, spas, hotels, and fitness clubs. Many have repeatedly failed to meet health and safety standards set by the city with little penalty or public knowledge, thereby putting unwitting swimmers at risk of disease and injury, Health infractions include things such as failure to maintain safe and sanitary con ditions and equipment in sanitary and working order, poor water clarity, unsafe storage of chemicals, failing to keep proper records, improper chemical balance such as pH levels, and a hot tub's vacuum release system not working properly (a safety device that prevents the pool's suction mechanism from trapping bathers to the whirlpool floor). Inspectors reported 635 incidents of improper pH levels in two years. Health inspectors can close a pool for a variety of violations, such as cloudy water, missing emergency equipment such as a spine board or two buoyant safety rings, or loose or missing pool outlet covers. Since 2009, more than 300 pools have been closed for various violations, including faulty mechanics, missing emergency equipment, and dirty water. Poorly maintained pools can be breeding grounds for bacteria that can cause serious gastrointestinal illnesses. Recreational water illnesses are caused by germs spread by swal- lowing or having contact with contaminated water. Swallowing a small amount of pool water with cryptosporidium can make a person sick and has become a leading cause of swimming pool-related outbreaks of diarrheal illness. Tiinesses include gastrointestinal, skin, car, respiratory, eye, and neurologic infections. The most common symptom is diarrhea, which is caused by germs such as cryptosporidium, giardia, shigella, norovirus, and E. coli. Other symptoms include rashes and burning eyes. The root of pool problems and infractions is poor training, In Ontario, how ever, there are no standardized training requirements. In 2009 and 2010, inspectors reported 114 cases of staff who were not adequately trained to run a hot tub or pool safely. City officials cited 23 facilities multiple times for this infraction, suggesting that they failed to get the necessary training despite the inspector's warning. Although health officials can order an operator be retrained as part of their inspections, there is no standardized training. As a result, a retraining order just means that when the inspector returns the operator must show that he/she can perform the procedure in question. In response to the Toronto Star investigation, safety experts called for the province of Ontario to enforce standardized training for swimming pool operators Toronto's Board of Health has also asked the province to require standardized training for operator. Ontario's health minister said the province may consider introducing a certification program for pool operators. At a meeting on September 13, 2011, the Board of Health requested that the med ical officer amend the current regulations and require standardized training for public pool and public spa operators with respect to water chemistry analysis and promoting health and safety and injury prevention. Ontario health regulations require training for pool and hot tub operators but it does not indicate to what extent. As a result, some operators receive rigorous two-day courses while others receive brief instructions on how to check chemical levels. Purthermore, while regular training is mandatory for operators at municipal pools in Toronto, this is not the case for operators of facilities at condos or hotels Government sanctioned training for pool operators is enforced in the province of Alberta, where two-day training programs are offered by public and private government- approved agencies across the province. Operators are certified if they receive 70 petcent or higher on a final exam. On April 28, 2014, the Toronto Board of Health adopted a proposal from the med ical officer of health that the city should draft a bylaw that requires all recreational water facilities including public swimming pools, public spas (hot tubs), and wading pools to post a sign or document on site showing notices disclosing inspection results to inform the public of whether any health and safety violations have taken place. The final deci sion must still be made by Toronto City Council. Toronto City Councillor John Filion, who has been a strong advocate for facilities to display evidence that they have met city standards, said he expects the recommended bylaw will ensure that standards are being adhered to boost public confidence, and improve conditions at pools and spas. He also believes that inspectors should have the power to issue fines, something that requires provincial approval. Source: Mathie, bol operators could be forced to post their inspection mult, The Star, p. 1 14. April 18, 2014; Dominic & McLean, Board of health wow caddown on badpool Time Aug 20, 2011, www.th.com/a/2011/08/20board of health vows endedownload J. McD. Zlomislic, "Toronto pool' dirty secret. Ster, p. A1, A20 Aug 20, 2011: Mclan D. Zlomilk, "Training standards unged to clean up diny pools, Sr, Al. A20. Aug 27, 2011 J. McLean, Toronto Crada down on badpool, The Step A3, Sept. 14. 2011: Onte posting of inapee tonreales for recreational water facilities, City of Toronto, Strupert 1. State any assumptions you have made as you consider the instructional methods to leverage? RUNNING CASE STUDY: DIRTY POOLS In August 2011, the Toronto Star conducted an investigation of pools and hot tubs at con- dominiums, health clubs, and swimming pools across the city of Toronto. They discovered that many pools and hot tubs in Toronto have repeatedly violated public health and safety rules. This means that bathers are potentially being exposed to injury and discase. Public health inspectors conduct inspections of the approximately 1600 recreational water facilities in the City of Toronto. Every recreational water facility in the city is inspected at least two times a year and no less than once every three months while oper- ating. Those facilities that operate year-round might receive up to four inspections per year. These inspections are unannounced and based on mandated inspection frequen- cies. Owners receive an inspection report and written instructions that outline the cor- rective actions they must take to correct any identified deficiencies. When an imminent health and safety hazard is identified a facility can be closed. A closed facility is allowed to reopen once it has met certain conditions as determined by a re-inspection. There are no set fines, and public health inspectors cannot issue tickets. The data obtained by the Toronto Star indicates more than 10 000 violations by pools and spas over the past two years at luxury condominiums, private schools, spas, hotels, and fitness clubs. Many have repeatedly failed to meet health and safety standards set by the city with little penalty or public knowledge, thereby putting unwitting swimmers at risk of disease and injury, Health infractions include things such as failure to maintain safe and sanitary con ditions and equipment in sanitary and working order, poor water clarity, unsafe storage of chemicals, failing to keep proper records, improper chemical balance such as pH levels, and a hot tub's vacuum release system not working properly (a safety device that prevents the pool's suction mechanism from trapping bathers to the whirlpool floor). Inspectors reported 635 incidents of improper pH levels in two years. Health inspectors can close a pool for a variety of violations, such as cloudy water, missing emergency equipment such as a spine board or two buoyant safety rings, or loose or missing pool outlet covers. Since 2009, more than 300 pools have been closed for various violations, including faulty mechanics, missing emergency equipment, and dirty water. Poorly maintained pools can be breeding grounds for bacteria that can cause serious gastrointestinal illnesses. Recreational water illnesses are caused by germs spread by swal- lowing or having contact with contaminated water. Swallowing a small amount of pool water with cryptosporidium can make a person sick and has become a leading cause of swimming pool-related outbreaks of diarrheal illness. Tiinesses include gastrointestinal, skin, car, respiratory, eye, and neurologic infections. The most common symptom is diarrhea, which is caused by germs such as cryptosporidium, giardia, shigella, norovirus, and E. coli. Other symptoms include rashes and burning eyes. The root of pool problems and infractions is poor training, In Ontario, how ever, there are no standardized training requirements. In 2009 and 2010, inspectors reported 114 cases of staff who were not adequately trained to run a hot tub or pool safely. City officials cited 23 facilities multiple times for this infraction, suggesting that they failed to get the necessary training despite the inspector's warning. Although health officials can order an operator be retrained as part of their inspections, there is no standardized training. As a result, a retraining order just means that when the inspector returns the operator must show that he/she can perform the procedure in question. In response to the Toronto Star investigation, safety experts called for the province of Ontario to enforce standardized training for swimming pool operators Toronto's Board of Health has also asked the province to require standardized training for operator. Ontario's health minister said the province may consider introducing a certification program for pool operators. At a meeting on September 13, 2011, the Board of Health requested that the med ical officer amend the current regulations and require standardized training for public pool and public spa operators with respect to water chemistry analysis and promoting health and safety and injury prevention. Ontario health regulations require training for pool and hot tub operators but it does not indicate to what extent. As a result, some operators receive rigorous two-day courses while others receive brief instructions on how to check chemical levels. Purthermore, while regular training is mandatory for operators at municipal pools in Toronto, this is not the case for operators of facilities at condos or hotels Government sanctioned training for pool operators is enforced in the province of Alberta, where two-day training programs are offered by public and private government- approved agencies across the province. Operators are certified if they receive 70 petcent or higher on a final exam. On April 28, 2014, the Toronto Board of Health adopted a proposal from the med ical officer of health that the city should draft a bylaw that requires all recreational water facilities including public swimming pools, public spas (hot tubs), and wading pools to post a sign or document on site showing notices disclosing inspection results to inform the public of whether any health and safety violations have taken place. The final deci sion must still be made by Toronto City Council. Toronto City Councillor John Filion, who has been a strong advocate for facilities to display evidence that they have met city standards, said he expects the recommended bylaw will ensure that standards are being adhered to boost public confidence, and improve conditions at pools and spas. He also believes that inspectors should have the power to issue fines, something that requires provincial approval. Source: Mathie, bol operators could be forced to post their inspection mult, The Star, p. 1 14. April 18, 2014; Dominic & McLean, Board of health wow caddown on badpool Time Aug 20, 2011, www.th.com/a/2011/08/20board of health vows endedownload J. McD. Zlomislic, "Toronto pool' dirty secret. Ster, p. A1, A20 Aug 20, 2011: Mclan D. Zlomilk, "Training standards unged to clean up diny pools, Sr, Al. A20. Aug 27, 2011 J. McLean, Toronto Crada down on badpool, The Step A3, Sept. 14. 2011: Onte posting of inapee tonreales for recreational water facilities, City of Toronto, Strupert 1. State any assumptions you have made as you consider the instructional methods to leverage