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Triple A’s of Healthy Swimming

Awareness, Action, Advocacy

Crowded wavepool with swimmers and inner tubes.

Recreational water illnesses (RWIs) can be caused by germs spread by swallowing, breathing in mists or aerosols of, or having contact with contaminated water in swimming pools, hot tubs, water parks, water play areas, interactive fountains, lakes, rivers, or oceans.

You have the power to help keep germs out the water in places we swim. Remember, chlorine and other disinfectants don’t kill germs instantly. Additionally, the mixing of chlorine with pee and sweat uses up the chlorine in the pool, which would otherwise kill germs.

We all share the water we swim in, and we each play an essential role in helping to protect ourselves, our families, and our friends from RWIs. The Triple A’s of Healthy Swimming were created to provide swimmers with the tools they need to be activist swimmers and take the lead in preventing RWIs in the places they swim. Follow the steps below to ensure that your swimming experience is healthy, and RWI-free!

1. Awareness

Visit CDC's Healthy Swimming website. Learn how all swimmers can help protect ourselves and others from RWIs and follow the Steps of Healthy Swimming:

Keep the pee, poop, sweat, and dirt out of the water!
  • Stay out of the water if you have diarrhea.
  • Shower before you get in the water.
  • Don’t pee or poop in the water.
  • Don’t swallow the water.
Every hour—everyone out!
  • Take kids on bathroom breaks.
  • Check diapers, and change them in a bathroom or diaper-changing area–not poolside–to keep germs away from the pool.
  • Reapply sunscreen.
  • Drink plenty of fluids.

2. Action

Check the free chlorine level and pH before getting into the water.
  • Pools: Proper free chlorine level (1–3 mg/L or parts per million [ppm]) and pH (7.2–7.8) maximize germ-killing power.
  • Hot tubs/spas: Proper disinfectant level (chlorine [2–4 parts per million or ppm] or bromine [4–6 ppm] and pH [7.2–7.8]) maximize germ-killing power.
  • Most superstores, hardware stores, and pool-supply stores sell pool test strips.

Free pool test strips: Go to the Water Quality & Health Council (WQHC)’s Healthy Pools page to order and receive free test strips. Please note that any questions regarding your order or the availability of test strips should be addressed to the WQHC, not CDC.

Ask the pool operator the following questions:
  •  Are the free chlorine level and pH checked at least 2 times per day and more often when the pool is heavily used?
  • What is the latest pool inspection score?
  • Has he/she completed specialized training in pool operation?

3. Advocacy

  • Encourage pool operators to take steps known to kill germs.
    • Add ultraviolet or ozone disinfection technology to pool water treatment.
    • Hyperchlorinate regularly; some of the toughest germs require free chlorine levels at 20 ppm for 12.75 hours to kill them.
  • Educate other swimmers about RWIs to promote healthy swimming.

To learn more about the importance of following the Triple A's of Healthy Swimming, read the CDC report on common pool inspection violations.

Contact Us:
  • Centers for Disease Control and Prevention
    1600 Clifton Rd
    Atlanta, GA 30333
  • 800-CDC-INFO
    TTY: (888) 232-6348
  • Contact CDC–INFO The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Road Atlanta, GA 30329-4027, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO
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