Pool testers take a dip for safety
By JIM NESBITT, Staff Writer
The News-Observer
Jul 31, 2005
http://newsobserver.com/news/story/2643643p-9080452c.html
Tyler Threewitts is a Wolfpack student with a summer job that puts him on the front line of protecting the public’s health and safety. A $9-an-hour pool technician, he is one of six temporary employees Wake County brings aboard each summer to help with the seasonlong crunch of checking the water quality and safety of the almost 900 pools and spas in the county.
Every day, Threewitts patrols a swath of eastern Wake County that includes three zip codes and the towns of Garner, Zebulon, Knightdale and Wendell, pacing his Jeep to hit 10 to 15 pools and spas a day at apartment complexes, subdivisions, hotels and swim clubs.
As part of one of North Carolina’s most aggressive inspection programs, Threewitts makes sure pools and spas maintain mandated levels of chlorine and bromine — the primary and secondary water disinfectants — and stay within the narrow range of pH balance these chemicals need for maximum effectiveness.

Working with a plastic test kit the size of a recipe box, he helps ensure that swimmers have a margin of chemical protection from outbreaks of waterborne diseases that federal health officials say are on the rise in recreational waters nationwide.
These illnesses range from the relatively minor “swimmer’s ear” to more deadly contagions such as the hepatitis A virus and legionella, the bacterium that causes Legionnaires’ disease. There’s also the threat of cryptosporidium, a tough-skinned protozoan that is resistant to chlorine and bromine and causes abdominal cramps, fever and diarrhea.
“If we can’t see the bottom of the pool, we shut it down,” said Threewitts, 21, a business management junior at N.C. State University. “We stay busy — definitely.”
In the face of escalated outbreaks of disease traced to recreational waters, federal and state health officials say Threewitts’ work has heightened importance.
They also warn that people have a false sense of security about a treated pool or hot tub. That overpowering chemical stench? That’s not the smell of chlorine; it’s the whiff of chlorinates — chlorine combining with organics like body oils, urine and fecal matter.
“People need to understand this is a communal bath,” said Dr. Michael J. Beach, a Centers for Disease Control and Prevention medical epidemiologist. “The public tends to think that a chlorinated pool is sterile water. That’s not the case.”
Beach is a co-author of an October 2004 CDC study, which said 65 outbreaks in 23 states were reported in 2001-02 in lakes, rivers, swimming pools, wading pools and hot tubs — the largest number to occur since reporting began in 1978. More than 2,536 people became ill, the study said. Eight people died — all of them after swimming in rivers and lakes, not pools.
None of the cases covered in the CDC study occurred in North Carolina.
The state’s top epidemiologist, Dr. Jeffrey Engel, said outbreaks of waterborne diseases in public pools in the state are rare. In fact, he said, he wasn’t aware of any outbreaks in large community pools.
Risks of smaller pools
Wading pools and spas, which include hot tubs and whirlpools, are a different matter. Because they’re shallow and cater to toddlers and small children, it’s tough to keep wading pools clean and maintain an effective chlorine level, health officials said.
Because of high heat, hot tubs easily burn off chlorine and can be ready incubators for bacteria. In May, a Virginia vacationer died after contracting Legionnaires’ disease, probably from an unregulated hot tub at a Nags Head rental house he shared with other family members.
Engel and other health officials are also quick to warn that the absence of reported outbreaks from North Carolina’s public pools and hot tubs doesn’t necessarily mean they’re safe.
“There’s a whole lot of illnesses that go unreported because we don’t recognize the source,” said Jim Hayes, an environmental health supervisor with the state Department of Environment and Natural Resources. “We’re more likely to say, ‘I got it from something I ate,’ rather than water swallowed from a swimming pool.”
Thin public health resources and a surveillance system canted toward detecting more deadly diseases in food and drinking water may also mask the problem, said Beach of the CDC.
“Recreational water is the last thing on the list,” he said.
All of this places a premium on pool and hot tub inspections and mandated training for pool operators, Beach said, noting that up to a third of the pool-related outbreaks in his study were caused by poor maintenance.
State lawmakers and health officials agree.
Since 1989, state law has required county health officials to issue state operating permits for public pools and hot tubs and inspect seasonal pools at least once a year and year-round pools twice a year. The law also requires pool operators to show proof of training — a mandate usually met by a certificate from the National Swimming Pool Foundation or the Red Cross.
Wake’s pool standards
Wake County takes a tougher regulatory stance. The county has its own pool ordinance that sets more exacting parameters for chlorine use. It also mandates pool operators to test chlorine and pH levels three times a day and log the results.
The county ordinance requires pool operators to take a two-day course on the county ordinance and pass an exam, said Bobby Fulcher, the Wake County Department of Environmental Services section chief who oversees pool inspections. State environmental health officials say Wake is the only county in North Carolina to hire extra pool inspection help.
At the current pace of inspection, pool operators can expect a visit every two or three weeks, said Terry Chappell, a full-time Wake County team leader who heads the pool technicians.
Other Triangle counties aren’t as aggressive, don’t have their own pool ordinances and don’t hire summer help. Durham County has only one pool inspector checking 253 permitted pools and spas. In Orange and Johnston counties, pool inspections are handled by full-time employees who are also responsible for food and lodging oversight.
“We don’t have the staff to do routine inspections,” said Rod Holdway, Orange County’s environmental health director. “I wish we did.”
WATER PATROLS
Triangle pool inspections as of June 30:
WAKE COUNTY: 900 pools, 2,040 inspections, 127 total closures for safety and water quality violations, 101 substandard chlorine and bromine levels or improper pH balance, 46 safety violations ranging from broken phones and unsecured gates to cloudy water and missing or broken drain covers.
DURHAM COUNTY: 253 pools and spas, 298 inspections, 17 closures for water quality and safety violations.
ORANGE COUNTY: 120 pools and spas, 150 to 175 estimated inspections, no closures. Breakdown of safety and water quality violations was unavailable because records aren’t electronically compiled.
JOHNSTON COUNTY: Less than 100 pools and spas; number of inspections, closures or violations not available.
ENVIRONMENTAL HEALTH OFFICIALS IN ORANGE, DURHAM, WAKE AND JOHNSTON COUNTIES
WATER WORRIES
Along with safety equipment, pool and spa inspectors check water quality, including levels of chlorine and bromine, disinfectants that provide a chemical margin of protection against a variety of waterborne viruses, bacteria and organisms. These include:
ESCHERICHIA COLI: A bacteria found in animal feces that can contaminate food or water and cause abdominal cramps, nausea, vomiting and diarrhea that could be bloody.
SHIGELLA: A bacteria, usually food-borne, that causes diarrhea, fever, nausea, abdominal cramps and feeling the constant need to empty the bowels. Frequently transmitted through dirty diapers.
HEPATITIS A: A viral infection of the liver accompanied by abrupt onset of fever, malaise, anorexia, nausea and abdominal discomfort, along with a yellowing of the skin.
LEGIONELLA: A bacteria that causes the deadly Legionnaires’ disease, which is characterized by flulike symptoms, fever and pneumonia; and the less virulent Pontiac fever. Heated spas, including hot tubs, can be a breeding ground for this bacteria.
CRYPTOSPORIDIUM PARVUM: A tough-skinned protozoan parasite resistant to chlorine that causes diarrhea, abdominal cramps, low-grade fever and vomiting.
PSEUDOMONAS AERUGINOSA: A common human intestinal bacteria most often encountered as “swimmer’s ear.” Can also cause eye infections, particularly for those wearing contact lenses, and an infection of hair follicles known as folliculitis.
GIARDIA: Another protozoan parasite that is the most frequent cause of nonbacterial diarrhea in North America, commonly encountered by backpackers who drink untreated water from streams and lakes.
NOROVIRUS: Commonly found in humans and can cause a mild to moderate illness with nausea, vomiting, diarrhea, abdominal pain and low-grade fever. Usually transmitted by food, but can be passed by fecal matter in recreational waters.
N.C. COMMUNICABLE DISEASE CONTROL MANUAL; DIVISION OF ENVIRONMENTAL HEALTH, N.C. DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
(Staff writer Ryan Teague Beckwith and news researcher Susan Ebbs contributed to this report.)
Staff writer Jim Nesbitt can be reached at 829-8955 or jim.nesbitt@newsobserver.com.
Staff writer Ryan Teague Beckwith and news researcher Susan Ebbs contributed to this report.