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Poison Control
The Bottom Line
Pool chlorinating
products are generally safe when handled properly. The key to avoiding injury
at the pool is prevention!
Make sure to follow
all the safety rules at the pool and follow the instructions for handling all
pool chemicals.
The Full Story
Summer is here,
which means backyard barbecues, fireworks, and trips to the swimming pool!
Whether it's in
your backyard or at a local community center, keeping a swimming pool clean and
properly maintained is important to limit people's exposure to recreational
water illnesses (RWIs).
According to the
Centers for Disease Control and Prevention (CDC), RWIs are caused by bacteria
and other germs that spread by swallowing, inhaling, or making skin contact
with contaminated water.
The most common RWI
is diarrhea, which can be caused by organisms such as Cryptosporidium, E.
coli, and norovirus.
In the last two
decades, there has been an increase in the number of RWI outbreaks associated
with swimming pools.
According to the
CDC, reported RWI Cryptosporidium cases increased by over 200%
from 2004 to 2008.
Chlorine and
chlorine derivatives are the most commonly used disinfectants to treat swimming
pools.
Pool chlorinating
agents are either inorganic (ex. calcium hypochlorite) or organic (ex.
chlorinated isocyanurates like trichloroisocyanuric acid or potassium
dichloroisocyanurate).
Pool owners and
maintenance teams must keep the chlorine concentration within a range that is
high enough to effectively kill germs yet low enough to avoid injury to
swimmers.
The CDC recommends
keeping a free chlorine concentration of at least 1 ppm in pools and 3 ppm in
hot tubs.
Maintaining an
optimal pH also contributes to protecting swimmers from the spread of germs in
pool water.
If the pH or
chlorine concentration is out of the recommended range, it can sometimes cause
mild irritation to the skin and eyes of swimmers.
Now you might be
thinking, "What about the strong chemical odor that I smell when I'm at
the pool? Is that safe?"
The strong odor is
not actually from the chlorine alone.
When chlorine is
added to a pool, it mixes with other things in the water, particularly from
swimmers themselves (think sweat, dirt, and yes, even urine and feces).
The mixing of
chlorine and these compounds creates chloramines.
Chloramines are
irritants that are formed from the reaction of mixing the free chlorine (hence
"chlor") and amine groups (hence "amine") from organic
matter.
These are what
cause extreme irritation to the skin and eyes after prolonged exposure.
Additionally, the
fumes induce irritation of the respiratory tract causing coughing and breathing
trouble.
Because chloramine
gas is heavier than air, it settles on top of the water, making it problematic
for both swimmers and those nearby.
It can be
especially troublesome for people who spend many hours in a pool (e.g.,
competitive swimmers) or those with pre-existing health problems (e.g., asthma
or COPD).
Indoor pools
increase the risk of experiencing irritation from the accumulation of these
fumes because of limited ventilation.
As pool-goers and
owners, there are some preventative measures that can be taken to help keep the
experience safe.
For swimmers,
consider wearing swim goggles and practice sanitary swimming pool etiquette:
·
Do not go into the water if you have diarrhea.
·
Do not urinate or defecate in the pool.
·
Rinse off in a shower before you enter the pool.
·
Do not drink the water.
For pool
owners/operators:
·
Use chlorinating agents according to the product instructions.
·
Ensure adequate ventilation for indoor pools and hot tubs.
·
Use test kits frequently to keep chlorine and pH levels within
recommended ranges.
·
Store all pool chemicals in temperature-controlled environments
and away from public access, direct sunlight, and water.
·
Always wear personal protective equipment (e.g., gloves,
goggles) when handling pool chemicals.
For pool staff and
maintenance teams, proper training on the handling and storage of chemicals is
key.
All aquatic
facilities should have specific rules and procedures in place to ensure
everyone's safety.
Most brief
exposures result only in mild irritation, but if left unaddressed or from
larger scale exposures, chemical burns, burns to the surface of the eye, and
serious respiratory illness have occurred.
If someone has been
exposed to a pool chemical, it's important to immediately move them from the
area to fresh air.
Most often, skin
and eye exposures will respond to immediate irrigation of the affected area.
As a pool-goer,
it's important to be aware of the potential health effects from exposure to
excess amounts of chloramine.
If you or someone
you know starts feeling irritation from the fumes, immediately move away from
the water and into fresh air.
If there is
irritation to the skin, rinsing off in a shower should help reduce discomfort.
If the eyes are red
and burning from direct exposure, irrigation with water in a shower or at an
eye station for 15 minutes is recommended.
If anyone starts
experiencing difficulty breathing, shortness of breath, wheezing, chest
tightness, or any persistent pain or discomfort of the skin or eyes, then seek
medical attention immediately.
These symptoms can
be addressed at an urgent care center or an emergency room with a breathing
treatment and further eye irrigation.
There is nothing
more refreshing than cooling off on a hot summer day with a dip in the pool.
By knowing the
potential risks and best preventative practices, we can all do our part to keep
this fun activity safe and enjoyable for everyone.
And remember…Don't
pee in the pool!
If you are worried
about exposure to a pool chlorinating agent, check the webPOISONCONTROL® online
tool for guidance or call Poison Control at 1-800-222-1222. Whether you log on
or call, expert assistance is available 24 hours a day.
Kristina Yee,
PharmD, BS
Certified Specialist in Poison Information
Prevention Tips
Do not go into the water if you have
diarrhea.
Do not urinate or defecate in the pool.
Rinse off in a shower before you enter the
pool.
Do not drink the water.
This Really Happened
A 46-year-old man came to an emergency room
after unintentionally inhaling dust from pool chlorinating tablets he was using
for his own pool.
He had a history of asthma and was
experiencing difficulty breathing and shortness of breath.
The ER called Poison Control for
recommendations. Poison Control recommended oxygen, bronchodilators, and
respiratory support as needed until the patient returned to his baseline.
The man's symptoms resolved after a couple of nebulizer treatments and he was discharged home within a few hours.
https://www.poison.org/articles/pool-chemical-safety-192
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