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When 6-year-old Ethan Cory drowned at the Swimmin’ Hole waterpark in Joplin, Mo., this past summer, his parents filed a lawsuit against almost anyone who could be held responsible. They alleged that the water slide, under which Ethan had drowned, was a hazard, and the lifeguards were not properly trained.

But when the Corys tried to confirm their allegations through the local health department, they discovered something disturbing. No health inspector had ever set foot in the Swimmin’ Hole, nor any other facility in the county. “We don’t regulate anything right now,” confirms Bob Kulp, director of Newton County Health Department. “You’ll find most health departments have a hard time keeping up with what they’re expected to do because they don’t have enough resources.”

So who in the government is watching out for the Corys and the rest of the swimming public? According to a special Aquatics International investigation, the answer in Newton County is the same for a growing number of facilities across the nation: No one.

That’s because pools are only a fraction of a health inspector’s job. Also called environmental health specialists, the inspectors may spend a day checking day-care centers, nail salons, nursing homes, tattoo parlors, restaurants, hotels, campgrounds and swimming pools. Because inspectors tend to be spread thin across all of those areas, pools fall to the bottom of the priority list, leaving their operators as the only safety check.

Apparently, that’s not enough. More than half of all inspected pools had health code violations ranging from water quality issues to poor management, according to a 2002 study by the Centers for Disease Control and Prevention in Atlanta, the most recent data available. Close to 10 percent were so bad, they had to immediately shut down. That’s just for pools.

One of the fastest-growing segments of aquatics is waterparks. Who should be inspecting those? Few local jurisdictions have the answers. So these highly complicated rides on which users can achieve speeds of up to 60 mph slip through government inspection cracks, only to gain attention when a ride collapses and people get hurt, or die.

As state and local budgets become even tighter, and government agencies focus more resources on homeland security, experts say the problem is likely to worsen. Not only will more pools be ignored, but the few inspectors out there won’t have the training or education necessary to spot problems before they become injuries, or worse. Many aquatics veterans say this is especially worrisome for the numerous hotel and apartment pools, where operators are rarely trained or even on staff.

Aquatics experts say the problem is compounded further because, unlike the restaurant industry, the pool industry is not governed by a national code. Some jurisdictions don’t even have a local code to follow. As a result, pools and waterparks are more liable for injuries and illnesses because inspectors can’t, or won’t, do their jobs. And when something bad happens, as it did to the Corys, aquatics facilities end up shouldering the blame — and the liability.

Inspecting the problem

That something was amiss became evident with the CDC’s 2002 study. It showed that more than half of operators failed to maintain their pools at code, and put patrons at risk. It raised even more questions about the many pools that go uninspected year after year.

According to the study, 67.5 percent of all hotel and motel pools had code violations; 26.9 percent of apartment and hotel/motel pools violated proper chlorine levels, and 18.9 percent violated proper pH. Both are critical to proper water quality.

Even more troubling is where these water quality violations were occurring most frequently: children’s wading pools, which are often the epicenters for recreational water illness outbreaks. Such outbreaks in Utah this year have sickened more than 1,300, prompting officials to take the extraordinary measure of banning toddlers under age 5 from pools. Considering that almost 40 percent of municipal facilities violated codes surrounding filtration and recirculation, both of which are critical to healthy water, that may be a prudent move.

Water quality and circulation can be handled by a certified pool operator, but many pools aren’t run by trained professionals.

Indeed, 25 percent of pools were cited for having improperly trained operators. Health inspectors are supposed to pick up where aquatics operators leave off, a kind of safety spot- check for the public. Aquatics experts say a code violation sometimes is the best way to get the authority — and the money — to fix problems. Tina Dittmar, aquatics supervisor for the city of Laguna Niguel, Calif., says when operators are cited, it gives “documentation for funding.” She says operators can take

the paperwork to the city as proof that the pool needs something fixed or added.

Kevin Johnston, former aquatics director at Washington State University in Pullman, agrees that being written up is helpful. “You can use the documentation to get funding with the administration. It’s one way of getting stuff done,” he says. “A health report will require you to make changes.”

Pools that go uninspected miss out on the opportunity to get additional funding to fix a violation. So these breaches remain and perpetuate until they become a serious problem and someone gets hurt.

It’s not that the inspectors are lazy. In many cases, they don’t have the resources — and sometimes the authority ‐ to police these pools and waterparks.

“They’re not just doing pools,” says Michael Beach, Ph.D., team leader for the CDC’s Division of Parasitic Diseases. “They’re doing food and myriad things. People are stretched pretty thin. We have to take our hats off to them that with such limited resources, they do what they can do.”

Tracynda Davis’ department was so shorthanded that sometimes pools weren’t inspected at all. “There’s not a lot you can do with 4,000 pools and only 20 inspectors,” says the director of environmental health

programs at the National Swimming Pool Foundation in Colorado Springs, Colo., who was formerly with the city of Madison, Wis. “Some wouldn’t be inspected for years.”

Davis also headed up the state program for swimming pools, training the local health departments and drafting new policies to ensure that pools would be checked as often as possible. She says the majority of states have similar programs, but she doesn’t know how effective each one is.

Pools are also tricky because, unlike restaurants, many of them are only open in the summer. Inspectors have to shift their schedules to focus on aquatics without slacking off on other inspections that continue year ’round.

In many cases, venues aren’t inspected at all until a crisis occurs. In Oklahoma, it took a water coaster collapse at Big Splash waterpark in Tulsa this summer to change policies. Before that, waterpark rides and structures were never inspected. Water quality was checked by the health department, and dry amusement rides were inspected by the state Labor Department, but waterpark attractions fell through the cracks.

When the ride collapsed with an 11-year-old girl on it, the state took action. The Labor Department took over waterpark structures, and began inspecting all the major waterparks in the state. While the issue of inspecting waterparks had been debated for a few years, nothing happened until the collapse.

The death of a man in 2005 at Sun ’n Fun waterpark in Ponca City, Okla., had jolted the Labor Department to survey the state of waterparks and many alarming factors were found, says Tom Monroe, director of safety standards for the Labor Department. But even after that, the issue was set aside until the recent Tulsa park ride collapse.

“There’s no doubt the accident at Big Splash … brought attention to the fact [inspections] needed to be done,” Monroe says.

In Missouri, pools are regulated by local jurisdictions, not state. And, in cases such as Newton County, aquatics facilities aren’t regulated at all, though Kulp hopes to change that before next swim season starts — if he can find the resources.

Cost of public health

Finding those funds seems to be the underlying issue plaguing inspectors nationwide. “Lack of budget causes problems,” says Alison Osinski, president of Aquatic Consulting Services in San Diego. “You can’t get to pools frequently enough. You don’t have modern equipment, and you have no time for training.”

One reason for the squeeze is how pool inspections are classified: They fall under preventive care rather than active response, says Kimberly Thompson, Sc.D., associate professor at the Harvard School of Public Health in Boston. It’s hard to prove that a preventive program is effective when there are no real numbers or data to prove it’s working.

“I think the main things is having [health departments] not be constantly reacting to emergencies as opposed to planning,” Thompson says.

Stephen Keifer, public pool specialist at the Oregon Department of Human Services in Portland, agrees. “It’s difficult to say you’re doing a good job if nothing is happening. ‘I prevented 4,000 people from getting sick.’ How do you know that? When you get into the legislature or decision-making bodies, it’s really hard to argue for more money when you can’t show that you’re doing a good job.”

In Brattleboro, Vt., several training programs were replaced by a 4-inch-thick manual due to budget cuts. And in Westchester County, N.Y., pool inspections were reduced after 76 local health department jobs were cut in 2003.

In addition, funding has funneled away from the bread-and-butter programs of many health departments and toward post-9/11 emergency preparedness, including bioterrorism and anthrax scares, Thompson says. Other issues that have taken precedence are avian flu and West Nile virus.

With the current economic state of the country, Beach doesn’t expect the situation to improve anytime soon. “There’s a large deficit in the United States. Lack of a federal funding base is a huge thing,” he says. “There’s no funding to send [inspectors] out from the federal level, and no research for key questions.”

As a result, many health departments are feeling the squeeze. In Illinois, it’s a constant challenge to keep the state pool code up to date with current designs, and to educate the inspectors, says Kevin Hoffman, director of member services at the Park District Risk Management Agency in Wheaton, Ill. “The budget cuts … really limit the services that are provided to those licensed pools,” he says. “[Inspectors] come out, do basic checks, but really can’t drill down too deep into operations as much as they want to.”

It’s a scenario Osinski sees often, and she says it’s a result of not having enough funding to be taken seriously. “The pool operator has a $1,000 test kit and the inspector has a $29.99 kit,” she says. “You have to provide them with testing equipment that’s better than the pool’s.”

The same goes for salaries. Pay should correlate to the seriousness of the jobs. According to the U.S. Department of Labor’s Bureau of Labor Statistics, the median annual earnings of occupation health and safety technicians were $42,130 in May 2004, the latest data available. The highest 10 percent earned more than $70,460, while the lowest 10 percent earned less than $22,860.

Some areas budget for seasonal pool inspectors, whose job is to focus on pools only through the summer. In Baltimore, those inspectors are paid $9 an hour. In DuPage County, Ill., seasonal pool inspectors working in the Chicago metro area were paid $9 to $9.50 an hour in 2006.

Training manual

These seasonal inspector positions require nothing more than a high school diploma and driver’s license, and new hires go through a basic training before setting out with test kit and clipboard. For other health departments, full-time employees may not receive much more training than that either, and may not have the education they need.

“What we don’t know is the level of quality of training in each department, when you look at the whole country,” says Tom

Lachocki, CEO of NSPF. “[Inspectors] may not connect how important a self-latching, self-closing gate is, or screws in the main drain cover. They’re not always obviously intuitive as to what the risks are.”

Like a cop who doesn’t know traffic rules, some pool inspectors face professional judgment from operators who know more than they do. “They have to bring a level of respect and professionalism to their positions,” says Johnston, senior instructor of recreation at the University of Idaho in Moscow. He recalls that he knew more than his health inspector most of the time. Though he had a good relationship with his inspector, he says lacking knowledge of the code can cause conflicts between a visiting inspector and an operator.

Tom Griffiths used to lecture summer college interns who were conducting inspections but had never worked for a pool before. Putting a rookie before a veteran would be fairly daunting. “It’s extremely hard to question someone who has been running a pool for 25 years,” says the director of aquatics and safety officer for athletics at Penn State University.

Because inspectors are checking such a wide variety of places in a day, they face the challenge of switching expert caps on a

regular basis. Few specialize in just one type. “There’s tremendous variety and it’s very hard for them because of the number of

facilities,” Keifer says. “They might forget some stuff, or don’t get an inspection routine established to make sure [they] cover all these items on an inspection sheet. They don’t do it enough.”

Keifer is the only one in his state department who specializes in pools. He says some of the larger communities have pool specialists, but most are spread across the other fields. The inspectors are required to have environmental health or similar college degrees and must pass the National Environmental Health Association exam to certify them on a national level, in addition to state-level certification.

His inspectors are not required to take an operator certification course, though many do. That way, they can look at procedures on an advanced level. “Instead of learning how to backwash a filter, spend time learning what you must look for to make sure it’s working right,” he says. “What do you look for in a room when you only have 10 to 15 minutes to pass judgment?”

In the past, a state association would organize instructors to teach certification classes, Keifer says, but nowadays an instructor has to take the initiative to organize it himself.

Seasonal employees come in when the full-time staff is too busy to check up on pools. Aquatics experts are torn over whether it’s better to send in a rookie with a high school diploma, or to forgo the inspection altogether.

“Having uneducated or unknowledgeable inspectors out there inspectingis not the right answer, but not inspecting at all is not an answer either,” NSPF’s Davis says.

Beach says having someone out there is better than not having anyone at all. “Whenever we know we are accountable for how we run the pool, knowing we’ll be checked is always a good thing,” he says.

The checklist

But even if they are being checked, what are they being checked against? That question frustrates many aquatics operators, who point out that the industry lacks a national code or federal agency to mandate pool regulation.

Unlike the food industry, which is heavily regulated by the Food and Drug Administration, the closest federal program is the CDC’s Healthy Swimming initiative. However, the CDC is not a regulating or

enforcement agency for pools. Because there’s no federal governing body, many codes — if they exist at all — differ greatly across the board, from state to state, county to county.

Another problem is that while the aquatics industry is changing rapidly, local codes are not. Only when an emergency occurs will regulations be updated, such as in Lake Geneva, N.Y. After the cryptosporidium outbreak at a local spraypark sickened thousands, state officials enacted emergency codes requiring all public sprayparks to be either spray-to-drain or equipped with an ultraviolet system that could zap the parasite.

Even more confusing, pool inspections are handled by different departments across the country. It could be any one of these

departments: public health, environmental conservation, environmental health, agriculture or labor. In some cases, multiple departments handle the pool, such as Oklahoma’s system, where the health department checks water while the labor department checks slides and structures.

And within the departments, inspections are not always standardized, or organized either. Osinski has become accustomed to receiving files of chicken-scratched inspection notes when asked to be an expert witness. “I get files with a hundred violations on the same thing, but a different inspector each time,” she says, noting that the inspectors often don’t check the last inspector’s notes to see if there are repeat violations.

Suggesting a solution

A joint project between the CDC and NSPF aims to address at least part of this problem. The two groups are working with existing codes and aquatics experts to create a national code that local jurisdictions can adopt.

While the code is being created, aquatics operators can do their part by reaching out to their local pool inspectors. “Having that cooperative approach and realizing [inspectors] can help you and you can help them is a lot more valuable than knocking heads hard every time on your pool deck,” Johnston says.

Many inspectors prefer to remain strictly professional. Dittmar says her inspectors come in, don’t talk to anyone, sign the forms and leave. Others are more talkative, which helps managers and inspectors learn better. Charlie Case, program director at the Flint YMCA- Pierson Road Branch in Flint, Mich., says his inspector drops by unannounced once a year and will walk with them through the pool area and filter room. “Generally, it’s pretty businesslike, but at the end he’ll ask how the Y is going in general,” he says.

Griffiths tells of encountering an inspector who went beyond her checklist to make suggestions, such as using striping on steps to be safer. He says that Pennsylvania, where his pool is located, has “very little in our health code regarding pools. Doing health inspections is a breeze because they’re looking at very few items.”

This partnership can help operators and inspectors learn from each other. The inspectors then can take the knowledge gained at the municipal pool and apply it at smaller hotel and apartment pools.

To maintain a sharp staff, Griffiths suggests hiring college interns who are majoring in environmental health rather than pay someone $9 an hour to inspect pools. Working for academic credit is taken more seriously by the student than the wage, he says. Then the student will gain more industry experience and have something valuable for his or her résumé, while the health department has someone better qualified to perform inspections.

Lastly, educate the public about its responsibility to help keep pools up to code. Post signs, hand out pamphlets and hold workshops to teach patrons how to keep the pools clean, to alert staff of any problems and to communicate with each other.

“We need … to push on consumers to take part as well,” Beach says. “It has to be a three-way deal with the public health department, aquatics staff and consumers to maintain pools as well as they can be.”