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Using the Model Aquatic Health Code (MAHC)

Overview

Swimming and other water-related activities are excellent ways to get the physical activity and health benefits needed for a healthy life. Americans swim hundreds of millions of times in pools, oceans, lakes, rivers, and hot tubs/spas each year 1 and most people have a safe and healthy time enjoying the water. However, outbreaks of recreational water illnesses (RWIs) have increased significantly over the last several decades 2 and drowning 3-5 and pool-related chemical injuries 6-9 continue to occur. This makes it important that public pools and spas are designed, constructed, operated, and inspected to keep swimmers healthy and safe.

In the United States, there is no federal regulatory agency that regulates aquatic facilities so public pools and spas are regulated at the state or local government level. To assist state and local agencies, CDC has led a national collaborative effort with public health, industry, and academic partners from across the United States to develop a national guidance document, called the Model Aquatic Health Code (MAHC), to prevent drowning, injuries, and the spread of recreational water illnesses at public swimming pools and spas. The MAHC integrates the latest knowledge based on science and best practices with specific code language and explanatory materials covering the design, construction, operation, and maintenance of swimming pools, spas, hot tubs, and other public disinfected aquatic facilities.

References
  1. US Census Bureau. Statistical abstract of the United States: 2012. Arts, recreation, and travel: Participation in selected sports activities 2009 [PDF - 2 pages]
  2. Hlavsa MC, Roberts VA, Kahler AM, Hilborn ED, Wade TJ, Backer LC, Yoder, JS. Recreational water–associated disease outbreaks — United States, 2009–2010. MMWR Morb Mortal Wkly Rep. 2014;63(1):6-10.
  3. Gilchrist J, Parker EM. Racial/ethnic disparities in fatal unintentional drowning among persons aged ≤29 Years — United States, 1999–2010. MMWR Morb Mortal Wkly Rep. 2014;63(19):421-6.
  4. CDC. Drowning — United States, 2005–2009. MMWR Morb Mortal Wkly Rep. 2012;61(19):344-7.
  5. CDC. Ten leading causes of injury deaths by age group highlighting unintentional injury deaths, United States – 2010[PDF - 1 page].
  6. Anderson AR, Welles WL, Drew J, Orr MF. The distribution and public health consequences of releases of chemicals intended for pool use in 17 states, 2001-2009. J Environ Hlth 2014;76(9):10-5.
  7. CDC. Pool chemical–associated health events in public and residential settings — United States, 1983–2007. MMWR Morb Mortal Wkly Rep. 2009;58(18):489-93.
  8. CDC. Acute illness and injury from swimming pool disinfectants and other chemicals — United States, 2002-2008. MMWR Morb Mortal Wkly Rep. 2011:60(39):1343-1347.
  9. Hlavsa MC, Robinson TJ, Collier SA, Beach MJ. Pool chemical–associated health events in public and residential settings — United States, 2003–2012, and Minnesota, 2013. MMWR Morb Mortal Wkly Rep. 2014;63(19):427-30.
  10. Mack KA. Swimming related injuries among children age 0-9 years treated in emergency departments, NEISS-AIP 2001-2006. Presented at American Public Health Association, Nov. 7-11, 2009.
  11. Yoder JS, Beach MJ. Cryptosporidium surveillance and risk factors in the United States. Exp Parasitol. 2010;124:31-9.
  12. CDC. Violations identified from routine swimming pool inspections — Selected states and counties, United States, 2008. MMWR Morb Mortal Wkly Rep. 2010;59(19):582-7.
  13. CDC. Surveillance data from public spa inspections — United States, May-September 2002. MMWR Morb Mortal Wkly Rep. 2004;53(25):553-5.
  14. CDC. Microbes in pool filter backwash as evidence of the need for improved swimmer hygiene — metro-Atlanta, Georgia, 2012. MMWR Morb Mortal Wkly Rep. 2013;62(19):385-88.
  15. Shields JM, Gleim ER, Beach MJ. Prevalence of Cryptosporidium spp. and Giardia intestinalis in swimming pools, Atlanta, Georgia. Emerg Infect Dis. 2008;14(6):948-950.
  16. EPA. Beaches. July 30, 2014.
  17. National Association of County and City Health Officials (NACCHO). National profile of local health departments  [PDF - 76 pages]. 2013. See Page 40.
 
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