Recreational Water Illness In Public Swimming Pools

By Ashley Henshaw. May 7th 2016

Swimming can be a great activity for both fun and physical fitness, especially in the hotter months of the year. However, there are certain risks that come with swimming in public pools, including the possibility of catching a Recreational Water Illness (RWI). It’s important to understand how you can be exposed to RWIs and how to prevent them.

The Basics Of RWIs

An RWI is an illness that is caused by germs found in contaminated water in swimming pools. The germs could come from the people entering the pool, chemicals used in the pool or germs found naturally in water, soil, rain runoff, etc. Due to the higher level of usage that is commonly associated with public pools, there is often a greater risk that these pools will contain contaminated water as opposed to a private or personal pool.

There are several types of RWIs, but the most common ones include:

  • Diarrhea: This is usually caused by exposure to germs like Crypto, Giardia, norovirus, E. coli and Shigella. Diarrhea is the most common RWI.
  • Infections: Examples of potential RWIs in this category include ear infections, skin infections, respiratory infections, eye infections, wound infections and neurologic infections. “Swimmer’s ear” and “hot tub rash” fall into this category.
  • Chlorine poisoning: This RWI occurs due to overexposure to chlorine. (For more information on chlorine in swimming pools, read Health Effects Of Chlorine In Swimming Pools.)

How You Can Get An RWI

There are three main ways that an RWI can be contracted:

  • Swallowing water: When you swallow water from a public pool that has been contaminated with germs, you may get an RWI. The most common RWI that is contracted from swallowing contaminated water is diarrhea. According to the CDC, the average person has about 0.14 grams of feces on their body, so getting into a pool could contaminate the water in a public pool. Swallowing water that has been contaminated with germ-containing feces can cause diarrhea illness.
  • Contact with water: Coming into contact with contaminated water can also cause an RWI. This is often the cause of certain types of RWI infections, such as eye infections, skin infections and wound infections.
  • Breathing in vapors: When contaminated water evaporates into the air, there’s a possibility that those who breathe in those vapors could get an RWI. This is more common when public pools contain too many chemicals or an improper balance of chemicals. It’s also much more likely to occur in an enclosed space, such as an indoor public pool.

Although public pools have a higher risk of containing contaminated water, keep in mind that RWIs can be found in other swimming locations as well. Other areas where RWIs may be a factor include water parks, hot tubs, interactive fountains, rivers, lakes and oceans.

(To learn more about contamination in public pools, see Are Public Swimming Pools Really That Dirty?)

Preventing RWIs

There are numerous precautions you can take to reduce your risk of contracting an RWI, including:

  • Don’t swallow water in the pool. If you or someone near you is splashing water, remember to keep your mouth shut.
  • Try to keep water out of your eyes. Use goggles to swim with your eyes open underwater.
  • If you have a wound or skin irritation, consider waiting until it heals to go swimming. Keep in mind that wearing bandages may not prevent germs from entering your wound or from spreading germs into the water.
  • Shower before and after swimming. This prevents more germs from entering the pool and keeps them from staying on your body after swimming.
  • Don’t swim when you have diarrhea since you could easily infect others who are swimming.
  • Have small children take regular bathroom breaks to avoid having an accident in the pool.
  • If a swimmer does have an accident in the pool, inform the lifeguard on staff immediately and stay out of the water until the pool has been properly cleaned.
  • Always wash your hands thoroughly after using the bathroom or changing a diaper.
  • If possible, visit public pools which are well-maintained and have a good record or keeping pools clean.

RWI Treatment

Certain symptoms may indicate that you have an RWI. However, those symptoms may vary widely based on which type of RWI you have. The most common is diarrhea. However, ear pain or trouble hearing may indicate swimmer’s ear, while others may get a skin rash from swimming in contaminated water. If you find that you are feeling unwell or experiencing any unusual symptoms after swimming in a public pool, see a doctor right away to determine the best treatment. Fortunately, most RWIs are not severe and are easy to treat, especially when they are diagnosed early on.

Bottom Line

Keep in mind that certain individuals – namely children, pregnant women and people with weakened immune systems – are more susceptible to getting an RWI. If you are concerned about getting an RWI or are concerned that you may have one, talk to your doctor for more information.


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