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Overview & Anticipated Public Health Outcomes of the Model Aquatic Health Code (MAHC)

It is 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 responsible for aquatic facilities. As a result, most pools and spas are regulated at the state or local level; 68% of local health departments have public pool inspection programs 1. Those same state and/or local public health agencies individually devote significant time and resources to regularly develop, review, and update their pool codes, which govern the design, construction, operation, and maintenance of swimming pools and other aquatic facilities. This translates into considerable variation in requirements for preventing and responding to recreational water illnesses, injuries, and drowning among local and state agencies across the United States.

To assist state and local agencies, CDC has led a collaborative effort with public health, industry, and academic partners from across the United States to develop guidance to prevent drowning, chemical injuries, and the spread of recreational water illnesses at public swimming pools and spas. This guidance document, called the Model Aquatic Health Code (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. As a result, local and state agencies needing to create or update swimming pool and spa codes, rules, regulations, guidance, laws, or standards can now use the MAHC as a resource to improve health and safety while conserving valuable time and resources previously used to write or update code language. To further assist users, CDC is working with public health and aquatics industry partners such as the Conference for the Model Aquatic Health Code (CMAHC), to ensure the MAHC is regularly updated so it stays current with the latest science, industry advances, and public health findings.

References
  1. National Association of County and City Health Officials (NACCHO). National profile of local health departments [PDF - 76 pages]. 2013. See page 40.
  2. US Census Bureau. Statistical Abstract of the United States: 2012. Arts, Recreation, and Travel: Participation in Selected Sports Activities 2009 [PDF - 2 pages] 
  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):344-347.
  5. CDC. Ten leading causes of injury deaths by age group highlighting unintentional injury deaths, United States – 2010 [PDF - 1 page].
  6. 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.
  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. 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.
  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. 2013. See Page 40.
 
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