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Splash Pads: Understanding Risks and Creating Best Practices

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Splash Pads: Understanding Risks and Creating Best Practices WELCOME TO THE 2020 FRPA CONFERENCE! Splash Pads: Understanding Risks and Creating Best Practices Presenter: Lauren Broom, B.S., R.S. About Your Instructor • Certified instructor through the Pool & Hot Tub Alliance to teach the Certified Pool Operator Course (CPO)® • Attended University of Central Florida • B.S. in Biology • Florida Dept. of Health for 16 ½ years-Dec. 2003 to 08/2020 • Environmental Specialist II—public health inspector • Inspected public swimming pools • Recreational water outbreak investigations as part of the Epidemiology Dept. • Registered Sanitarian(R.S.)—certification in public health • Adjunct Instructor- Apartment Maintenance Technician Program • Valcencia College General The popularity of splash pads have gained traction over the past decade. These facilities have inherent risks since the water is recirculated. The objective of this presentation is to identify the public health risks and create best practices to best manage these risks. LEARNING OBJECTIVES ▪ Recognize public health risks in splash pads. ▪ Identify best practices to control public health risks in splash pads ▪ List examples of recreational water illness outbreaks specific to splash pads ▪ Design & treatment equipment used to minimize the recreational water illness outbreak hazards Overview: Splash Pads • Many names • Spray park, wet deck, splash park,spray-ground • CDC Model Aquatic Health Code categorizes these as “Increased Risk Aquatic Venues” • Water does not accumulate—reduces risk of drowning • Increasing popularity • Little to no supervision compared to wading pool, spa, traditional pool • Cheaper to run for Parks & Rec since no supervision is required Design Re-Circulating System Non-Recirculating System Higher Risk • Design often not indicated to the public Lower Risk • Presentation focuses on re-circulating splash pads • Re-circulating--higher risk of contamination and disease transmission that can be mitigated through proper design and operation Splash Pad Risk Factors: • Behavior of people using it—mostly young and diapered children • Non-hygenic behaviors like exposing buttocks to spray features or drinking the water • One infective bowel movement can release enough oocysts of Crypto to contaminate 100 million gallons of water. • It is an open system outdoors—thus can get contamination from animals, birds, dust • Larger bathing load in relation to volume of water • Increase chance of fecal contamination • Increase turbidity in water—lower usefulness of disinfection • Reduced turnover rates • Areas that are constantly damp for prolonged periods of time—have higher levels of microorganisms compared to those submerged constantly in chlorinated water • Facility may use foggers or misters in the area • Water supply • Improper signage—bad messages or lack thereof • Greater dissipation of chlorine due to water being sprayed • High chlorine stabilizer(Cyanuric acid) levels • Lack of super-chlorination • Lack of properly trained staff that understand how to operate equipment • Irrigation systems that may overspray into the splash pad • Popular to use reclaimed water in Florida that contaminates the splash pad water • Studies performed found that it is often contaminated with crypto oocysts • People like to bring food and drinks into the fenced in area that could potentially contaminate water. • ORP monitoring system inoperable or in lock out • Lock out chlorine feeder and pH adjustment feeder • High pH levels that could lower % activity of chlorine concentration • Need ORP controller and pH adjustment feeder in most set ups • Irrigation systems that may overspray into the splash pad • Popular to use reclaimed water in Florida that contaminates the splash pad water • Studies performed found that it is often contaminated with crypto oocysts • People like to bring food and drinks into the fenced in area that could potentially contaminate water. • ORP monitoring system inoperable or in lock out • Lock out chlorine feeder and pH adjustment feeder • High pH levels that could lower % activity of chlorine concentration • Need ORP controller and pH adjustment feeder in most set ups • High levels of chloramines that cannot be removed by breakpt. Chlorination that can cause: • Pool odor • Eye, nose, throat irritation Public Health Risks • Recreational Water Illness Outbreak Risks • Cryptosporidium—protozoan parasite • Giardia—protozoan parasite • Salmonella-bacteria • Shigella-bacteria • Legionella-bacteria Who is at most risk?? • Young children • Pregnant women • People with weakened immune systems that have the following: • AIDS • Cancer • Other inherited diseases Recreatinal Water Illnesses (RWI) • Can be transmitted in 3 ways: • Ingesting water • Contact with contaminated water • Air- aerosolized water droplets that are contaminated • Where do they come from? • From swimmers!! • Average person swallows 1 ounce of water for every 30 min. of swimming • GI illness is caused by swallowing food or water that is contaminated with feces. • Average person carries about 0.14 grams of feces on their rear end—babies carry more Anyone Here Have Diarrhea? • Where do they come from? • From swimmers!! • Average person swallows 1 ounce of water for every 30 min. of swimming • GI illness is caused by swallowing food or water that is contaminated with feces. • Average person carries about 0.14 grams of feces on their rear end—babies carry more • Add up all the bodies using splash pad and you get fair amount of feces • If a person has an accident(formed or diarrhea) then the amount of feces in water goes way UP! • At some point concentration rises above the minimum for infection—and you get an outbreak! The germs that cause GI RWI have very low infective doses: Organism Dose that will cause disease: E. Coli O0157:H7 10 cells Norovirus 10 particles Giardia 10-100 cysts Cryptosporidium 10 cysts There is enough Cryptosporidium cysts in contaminated water if you lick your lips after going into the splash pad and ingest it to get you sick! Control of GI illness causing pathogens in splash pads: Group Organism Killed by chlorine? Bacteria E. Coli O157:H7 Very quickly—all bacteria killed in Shigella ≤1 min @ 1 ppm FAC Parasites Giardia Quickly- <30 min @ 2 ppm FAC Cryptosporidium Killed by 20 ppm FAC in 12.75 hours in absence of CYA Crypto-800 pound gorilla of RWI’s • Amounts for 75% of recreational water illness outbreaks • Thus well represented in outbreaks • Outbreaks become community wide and can spread through other ways like childcare centers and food establishments • Chlorine resistant • Requires additional(secondary) treatment to kill (use of UV or ozone) • Most common in treated recreational venues • Infective unit (oocyst) is built like a basketball with 2 little larvae inside the ball • Much larger than bacteria, • very difficult to kill with routine disinfectant levels • Effective filtration helps in removal • Best prevention is to discourage swimmers who have been ill • Do not swim until 2 weeks after symptoms have ended. Crypto: • Symptoms: • Diarrhea • Loose or watery stools • Stomach cramps • Upset stomach • Slight fever • Spread by fecal contamination of water from infected person • Factors that contribute to spread: • Inadequate animal waste removal • Inadequate filtration • Inadequate or interrupted disinfection • Contamination for other water source overspray Hyper-chlorination & Crypto • Different from routine super-shocking or breakpoint chlorination • Specific for inactivating Crypto • Must achieve contact time (CT) of 15,300 min The correct use of hyperchlorination for Crypto 25 20 15 correct incorrect 10 5 ppm chlorine of free 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 time in hours Keep the HOCl at 20 ppm for ENTIRE 13 hour period 28 Animals & Aquatic Venues—It does happen! j Crypto Outbreak • Location: • Water Park • Broward County, FL • 22 cases(16 confirmed) • Time period: July – August 1996 • Suspected index case: • 2 yr old child with diarrhea • Problems seen on inspection: • Grossly exceeded permitted bathing load of 118 persons • Water clarity was compromised • Ozonator for secondary disinfection not operational Crypto Outbreak/ Shigella RWI Outbreak • Location: Volusia County,Florida– Splash Pad • Volume of water: 3380 gallons • When: August 1999 • Number affected: 38 Environmental Assessment • Contributing Factors to Outbreak: • No filtration system installed • Inadequate chlorine residual • Fountain water ingestion • Consumption of food/ water at splash pad • Many young children in swim diapers and they were standing over the spray nozzles • Chlorine levels not monitored • Results after closure of splash pad: • Cartridge filtration system installed • Chlorine monitor(ORP) installed to halt fountain operation automatically when chlorine residual levels fell below 3 ppm. • Signage advising: • Showering before entering fountain • Do not drink the water since it is recirculated • Change swim diapers in appropriate areas in bathrooms Crypto/ Giardia RWI Outbreak • Where: Florida—Splash Pad • When: 2006 • Number Affected: 49 • Contributing Factors to outbreak: • Inadequate chlorination • Other operational deficiencies Cryptosporidiosis Outbreak Florida, 2007 • Context • Child played in 2 interactive fountains while ill with diarrhea • Magnitude • 33 cases • 1 child care center • Multiple interactive fountains potentially contaminated Source: C Dunn and G Schuessler, Indian River County Department of Health Inspection during Outbreak Investigation — Florida, 2007 • ~6,000 gallons • No lifeguards or attendants • Children drinking water,
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