cal element regardless of the total score. Table 1 describes the 49 items in the MAHC, with the matching 29 items used by HHD during swimming pool inspections. Table 2 describes the subsection of the statutes used in the HHD code and its matching MAHC item. We used descriptive statistics to describe pool violation data. SAS version 9.4 was used to group, analyze, combine items, and apply inspection data to the MAHC. All 2016 inspections and violation data from Houston were merged by unique identifiers in both data sets. Data were queried on active estab- lishment status, nonabatement license status, and annual routine inspections. If a pool had more than one routine inspection, then the first date of inspection was selected. Violation codes were grouped into 29 categories with a score assigned to each violation group. Results There were 3,107 swimming pools inspected in Houston in 2016. Of these, 3,100 had addresses and accounts located within the city limits of Houston; a total of 7 pools had addresses that were not in the city limits or had a post oce box listed and no current account associated. Table 3 describes the safety grades for swim- ming pool establishments based on the MAHC with 79.2% of the pools located in multifam- ily establishments. The second-most common type of establishment were pools located in hotels or motels (10.5%). Two swimming pools did not have a listed establishment. As shown in Table 3, the safety grading process resulted in 1,246 (40.2%) swimming pools with an A grade, 15 (0.5%) pools with a B grade, 0 pools with a C grade, and 1,839 (59.3%) pools with an F grade. Of the 1,839 pools that received an F grade, 14 (<1%) obtained their failing grade based on a failing overall percentage. The remainder of pools with failing grades were noncompliant with ≥1 critical safety item in the MAHC. Table 4 demonstrates the frequency of the pool violations for each of the 29 items in the MAHC that were observed during inspec- tions in Houston. Violations related to swim- ming pool enclosures were the most frequent, with 729 violations (18.0%), followed by 558 violations (13.8%) related to self-closing or self-latching gates. The third-most common violation was related to disinfectant levels (516, 12.7%). Application of the city code inspection criteria resulted in 1,285 swim-
TABLE 2
City of Houston Swimming Pool Violation Codes With Matching Model Aquatic Health Code (MAHC) Items
MAHC Item
City of Houston Swimming Pool Violation Code
Pool and spa
Enclosure in good repair
25 TAC §265.200, HSC 757.00, HSC 757.005 25 TAC §265.200, HSC 757.004
Self-closing/self-latching gates Protected overhead electrical wires
25 TAC §265.192 25 TAC §265.186 25 TAC §265.199 25 TAC §265.199
Grab rails, ladders secured; shell and deck in good repair
Float/safety line clearly present
Depth and no diving markers; stair stripes; in good repair and visible Skimmers: weirs and baskets installed; clean and operating; covers in good repair
25 TAC §265.191
Recirculation inlets functional
25 TAC §265.191
Main drain grate secured in place and in good repair
25 TAC §265.190, Sec 1404
Water is clear, main drain visible
25 TAC §265.203 25 TAC §265.186 25 TAC §265.186 25 TAC §265.199
Starting blocks removed, covered, or access blocked Pool deck free from obstructions; emergency exit marked Emergency phone or other communication device available and well-marked
First aid kit available
25 TAC §265.199 25 TAC §265.199
Appropriate safety equipment present and in good repair
Adequate supervision of the facility
N/A
Signs: bathing load, rules, chemicals, and spa legible and in good repair
25 TAC §265.205
Spa temperature ≤104 ºF (40 ºC)
25 TAC §265.205
Water chemicals Approved NSF/ANSI Standard 50 DPD test kit
Sec 43-4(b)
Proper disinfectant level pH between 7.2 and 7.8 Combined chlorine ≤0.4 ppm
25 TAC §265.204 25 TAC §265.204
N/A N/A
Cyanuric acid ≤100 ppm
continued on page 12
some of the 29 items that are common with the MAHC and HHD inspection forms. The 20 items in the MAHC that do not have a corresponding HHD code were not included for analysis and were listed as “not applicable.” Items in the MAHC are scored 5 or 10 points; critical items carry a higher value of 10 points. We used the same scor- ing in the MAHC for the corresponding HHD safety items. All 49 inspection items in the MAHC inspection form are not required
to generate a complete score; an option for “not applicable” is available (CDC, 2018a). Based on this scoring, the maximum number of compliance points possible after an HHD swimming pool inspection is 210. Letter grades were calculated as total com- pliance points scored after an inspection divided by the maximum possible compli- ance points. Letter grades were classified as: A = 95–100%; B = 85–94%; C = 75–84%; and fail (F) = <75% or noncompliance of a criti-
11
July/August 2023 • <B?;.9 <3 ;C6?<;:2;A.9 2.9A5
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