Posted By Thuy Kim, MPH,
Friday, May 26, 2017
Updated: Friday, May 26, 2017
As summer approaches, many Americans will be searching for solace from the heat in recreational water. Each year, the week before Memorial Day is designated as Healthy and Safe Swimming Week (May 22-28). This year’s observance marks its 13th anniversary of promoting healthy and safe swimming practices for both swimmers and pool operators.
Whether it be in lakes, rivers, water parks, splash pads or neighborhood swimming pools – epidemiologists know that it is no coincidence there is an uptick of waterborne disease outbreaks during the hot summer months. The last major outbreak I investigated before I left the Alabama Department of Public Health (ADPH) in late 2016 to join the CSTE team happened to be a Cryptosporidum outbreak at a local water park. We were happy to have had cooperation from the water park owners and staff who voluntarily closed their facility for treatment. Unfortunately, we were not able to recover organisms from the water. That summer, other states also experienced waterborne disease outbreaks and our collective stories were published in a recently released MMWR.
Pictured: CSTE staff member Thuy Kim, MPH contributed to a CDC MMWR focused on a Crypto outbreak in Alabama, Arizona and Ohio in 2016.
In the spirit of this week, a few CSTE members have also written and created an educational music video on water safety. The video was written by Taishayla Mckitt and stars Miranda Daniels and Allison Roebling – all from ADPH. Please enjoy, like, comment, share and take some notes!
Thuy Kim, MPH is an Associate Research Analyst II at CSTE with a focus on Enteric Diseases.
Posted By Douglas Sackett,
Friday, October 24, 2014
What began with strong surveillance and epidemiologic data supporting a CSTE position statement has spurred a national, multidisciplinary model pool code development process, a multi-thousand-person public dialogue, and the creation of a new non-profit organization to ensure the model code remains up to date. Learn how you can improve health and safety at public pools while saving staff time and resources by adopting this exciting, new model health code in your state or local health department.
In 2004, CSTE issued a position statement, citing the increasing trend in reporting of waterborne outbreaks at swimming pools across the country. It called for Centers for Disease Control and Prevention (CDC) to lead a national workshop to develop a unified strategy to reduce future occurrence of waterborne outbreaks at public swimming venues. The following year, over 100 individuals from public health, academia, and the aquatics industry met to develop this strategy; the major recommendation was an open-access, national model code that would help local and state agencies incorporate science-based practices without having to reinvent the wheel each time they create or revise pool codes.
What our subsequent efforts produced became the Model Aquatic Health Code (MAHC), 1st Edition, released by CDC in August 2014. The scope of the MAHC reflects its multidisciplinary approach. We expanded the prevention guidance beyond just infectious disease prevention to make the MAHC an all-inclusive guidance document covering prevention of infectious diseases, drowning, and injuries through a data and best practices-driven approach to design and construction, operation and maintenance as well as policies and management.
The steering committee set to work in 2007 with a development working plan followed by the recruitment of technical committee volunteers. As an all-volunteer effort, we took time to discuss and incorporate the multifaceted perspectives and evidence from both public health and industry participants. We opened the MAHC to two rounds of public comment. After receiving more than 4400 comments, we incorporated 72 percent of comments—over 3,000 citizen suggestions made a substantive impact. The depth, quality, and practicability of the MAHC stem from our recognition of the importance of partnerships, data-driven change, incorporation of input from all sides of aquatics, and implementable changes.
The culmination of our efforts, the MAHC 1st Edition, is now available to assist health departments in working on their pool codes through voluntary adoption. In targeting aquatic design, operation, and management, the code reflects modern epidemiological practice. The code's foundation is built on strong surveillance and investigation data from key national surveillance systems, such as National Electronic Injury Surveillance System, the National Outbreak Reporting System, and the Waterborne Disease and Outbreak Surveillance System. The annex that accompanies the MAHC lays out the rationale for code-specific requirements with scientific data and references to explain the why behind the what. The MAHC also recommends decision making informed by incorporating routine pool inspections as surveillance data.
Finally, CDC is setting up sentinel surveillance to track the impact of key MAHC elements on aquatic venue operation. We will have the opportunity to analyze these data, evaluate the model code's impact, and update the code based on findings. This will occur every two years as part of a meeting convened by the new non-profit organization, the Conference for the Model Aquatic Health Code, which is tasked with collecting national input and advising CDC on necessary updates.
If you work with or for a state or local health department, please consider taking the next step for improving health and safety at aquatic facilities: familiarize yourself with the Model Aquatic Health Code.
Your community can benefit from the MAHC's guidance for the prevention of chlorine-tolerant diseases such as cryptosporidiosis, improved training requirements, enhanced design features to reduce chemical injuries, and improved drowning and injury prevention. As the MAHC is fresh out of the box, you can also get involved with our conference to help drive future improvements. What CSTE members precipitated 10 years ago, based on sound epidemiologic practice and strong surveillance data, has now come to fruition.
We need CSTE to take a fresh look at the data and the MAHC and renew its commitment to health and safety improvement. CSTE members can bring the best of epidemiology to bear by raising awareness about the MAHC, driving discussion about potential adoption, and participating in future MAHC update discussions. With this renewed commitment, CSTE can continue drive data-based improvements in public health and safety at our nation's aquatic facilities.
Douglas Sackett is Executive Director for the Conference for the Model Aquatic Health Code. To learn more, look at CDC's easy-to-read infographic, outlining the problem, process, and product.
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