Dirty Pools $$ Final Exam Case Study $(2024)$

In August $2011,$ the Toronto Star conducted an investigation of pools and hot tubs at condominiums, 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 disease.

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 operating. Those facilities that operate year$-$round might receive up to four inspections per year. These inspections are unannounced and based on mandated inspection frequencies. Owners receive an inspection report and written instructions that outline the corrective 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 $10000$ 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 conditions 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 swallowing 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. Illnesses include gastrointestinal, skin, ear, 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, however, 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 re$-$training 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$$s Board of Health has also asked the province to require standardized training for operators. Ontario$$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 medical 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. Furthermore, 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