ADVANCEMENT OF THE SCIENCE
ming pools that failed safety inspection (30% less) compared with 1,839 pools that would have failed based on applying the MAHC. Figures 1 and 2 demonstrate the spatial distribution of swimming pools in Houston based on their safety grades. Most swimming pools, irrespective of the degree of pool safety violations, were located in the Southwest sec- tion of Houston. Discussion In this study, we applied the MAHC inspec- tion checklist to Houston pool violation data to grade swimming pools for safety in a jurisdiction that has not adopted the MAHC. The safety grading of commercial swimming pools revealed that pool safety violations were widespread, with more than one half of the pools receiving a failing grade. In almost all cases, the cause of the fail- ing grade was a critical violation that could have been life-threatening if not corrected. The majority of swimming pools that failed inspection occurred in multifamily establish- ments. A prior study in Harris County, Texas, for which Houston is the county seat, found that out of 196 unintentional drownings, one half occurred in multifamily residential pools (Warneke & Cooper, 1994). Another study in the same region revealed that pediatric drownings are 28 times more likely in a mul- tifamily swimming pool than a single-family pool (Shenoi et al., 2015). We observed that the most common safety violations were due to faulty swimming pool enclosures, gates and safety equipment, and improper disinfectant levels. Swimming pool chemical violations also occurred fre- quently. Our results are consistent with the high incidence of faulty pool enclosures and improper levels of pool chemicals docu- mented on pool inspections conducted else- where in the U.S. Documenting the magni- tude of pool violations and the number of RWIs is a first step toward advocating for improved legislation and enforcement of swimming pool safety regulations. Additionally, data from 15 jurisdictions found that pool chemical violations were pres- ent in 10.7% of pool inspections (CDC, 2010). Hlavsa et al. (2016) described similar results with disinfectant concentration violations and pool chemical safety violations, which were identified in 11.9% and 4.6% of routine inspec- tions, respectively. These findings are impor-
City of Houston Swimming Pool Violation Codes With Matching Model Aquatic Health Code (MAHC) Items TABLE 2 continued from page 11
MAHC Item
City of Houston Swimming Pool Violation Code
Equipment and chemical room Automated feeder operable
25 TAC §265.197, 25 TAC §265.204
Automated controller operable
N/A
Piping and valves identified and marked
25 TAC §265.187 25 TAC §265.187 25 TAC §265.189 25 TAC §265.188 25 TAC §265.189
Flow meter present and operating
Recirculation pump: approved, in good repair, operating
Filter: approved, in good repair, operating
Pump strainer: baskets in good condition, not clogged Filter gauges operable: filter inlet and outlet, strainer; sight glass Proper functioning UV system; ozone system Chemicals: labeled, stored safely, secured Appropriate personal protective equipment available
25 TAC §265.187, 25 TAC §265.188
N/A
25 TAC §265.197
N/A
Hygiene facilities Diaper-changing station present; sink, adjacent trash can, sanitizer
N/A N/A N/A N/A N/A
Used equipment separated from clean equipment
Toilets: clean, in good repair, bathroom appropriately stocked
Rinse showers: in good repair, accessible
Cleansing showers: warm, nonscalding water available; in good repair; soap Records room Operator training certification available on-site Lifeguard training certification available on-site Inspection report conspicuously posted at each entrance Operator inspection daily items: checklist used daily Operator inspection items: evidence of appropriate steps promptly taken
N/A
25 TAC §265.199
N/A N/A N/A N/A N/A N/A N/A N/A
Chemical records: filled out daily
Chemical records: evidence of appropriate steps promptly taken
Emergency action plan available on-site
Substantial unauthorized alterations/equipment replacement Other: imminent health hazards are a 10-point critical violation
Note. Bolded items represent critical code items in the MAHC. HSC = Texas Health and Safety Code; N/A = not applicable; TAC = Texas Administrative Code.
tant because the median estimated number of persons visiting emergency departments for chemical-related injuries from pools was 4,247 per year between 2003 and 2012 (Hlavsa et al., 2014). Identifying these violations and enforc- ing corrective action can mitigate the risk of swimming pool chemical-related injuries.
We also observed that faulty swimming pool enclosures and gates and inappropriate safety equipment were the most common vio- lations found during routine pool inspections. Many of these violations resulted in immediate pool closure. This finding is similar to another study where pool enclosure violations and
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