Report on Recreational Water Illnesses and Alignment with Sustainable Development Goals

This report examines the public health risks associated with recreational water facilities, such as public swimming pools, and analyzes these challenges through the lens of the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being) and SDG 6 (Clean Water and Sanitation).

Analysis of Water Contamination and Public Health

The safety of treated recreational water is a significant public health concern. While chemical disinfectants like chlorine are standard, their efficacy is not instantaneous, allowing certain pathogens to persist and cause illness. The rising incidence of waterborne disease outbreaks in recreational settings poses a direct challenge to achieving SDG 3, which aims to ensure healthy lives and promote well-being for all.

Sources of Contamination

Water quality is compromised by substances introduced by swimmers. The Centers for Disease Control and Prevention (CDC) reports that an average swimmer can introduce significant contaminants, including:

• 8 million microbes per drop of saliva
• 140 billion microbes from fecal matter
• Up to 60 milliliters of sweat
• Approximately 240 milliliters of urine

These substances react with chlorine to form chloramines, chemical byproducts that cause eye and respiratory irritation. The resulting strong “pool smell” is often misinterpreted as a sign of cleanliness when it actually indicates a high level of contamination, undermining the principles of sanitation outlined in SDG 6.

Pathogen Survivability and Associated Health Risks

The primary mode of transmission for most pool-related illnesses is the ingestion of or contact with contaminated water. The resilience of various pathogens to chlorine disinfection presents a major obstacle to ensuring public health (SDG 3).

Chlorine-Resistant Pathogens

Different pathogens exhibit varying levels of resistance to standard chlorine levels:

1. Hepatitis A: This virus can survive for approximately 16 minutes in chlorinated water and can cause liver inflammation.
2. Giardia: This parasite requires 45 minutes or more of chlorine exposure for inactivation and can cause severe gastrointestinal distress.
3. Cryptosporidium: A microscopic parasite with a protective outer shell, Cryptosporidium is highly resistant to chlorine and can survive for up to 10 days. It is a leading cause of recreational water illness outbreaks.

The Challenge of Cryptosporidiosis

Cryptosporidium represents a severe threat to public health. CDC data from 2009 to 2017 documented nearly 450 outbreaks linked to this parasite, sickening over 7,400 individuals. The 13% annual increase in outbreaks, primarily traced to treated swimming pools, highlights a critical gap in water safety management that directly impacts the targets of SDG 3.

Additional Microbial Threats

Other pathogens contribute to the burden of recreational water illnesses:

• Bacteria: Legionella can cause a severe form of pneumonia, while Pseudomonas is associated with skin rashes and ear infections (otitis externa).
• Viruses: Norovirus and adenovirus can cause significant gastrointestinal illness.
• Fungi: Pool decks and locker rooms can harbor fungi, leading to infections such as athlete’s foot.

These infections underscore the need for comprehensive sanitation and hygiene protocols that align with the objectives of both SDG 3 and SDG 6.

Preventative Strategies and Contribution to SDGs

Mitigating the risk of waterborne illness requires a multi-faceted approach that combines facility management with public education and individual responsibility. These measures are essential for advancing public health and sanitation goals.

Public Health Recommendations for Swimmers

To support safe swimming environments, the CDC recommends the following personal hygiene practices:

• Refrain from swimming when experiencing diarrhea and for two weeks after symptoms have ceased.
• Shower for at least one minute before entering the pool to remove contaminants.
• Take children on frequent bathroom breaks and check diapers hourly, changing them away from the poolside.
• Avoid swallowing pool water.
• Dry ears thoroughly after swimming to prevent infection.

Improving Sanitation Practices and Public Awareness

Public behavior is a critical factor in maintaining water quality. A recent national survey indicated that over half of adults admit to urinating in pools. Furthermore, data from New York City in one year showed that public pools were closed 203 times due to fecal contamination. Addressing these behaviors through public awareness campaigns is fundamental to achieving the sanitation targets of SDG 6 and protecting community health as envisioned in SDG 3.

Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being

  The article directly addresses public health by focusing on the rise of waterborne illnesses contracted in public swimming pools. It details various diseases such as cryptosporidiosis, giardiasis, hepatitis A, E. coli, and Legionella, which cause symptoms ranging from diarrhea and vomiting to liver inflammation and pneumonia. The discussion on how germs spread and the increasing number of outbreaks clearly links to the goal of ensuring healthy lives and promoting well-being for all ages.

• SDG 6: Clean Water and Sanitation

  This goal is relevant as the article centers on the quality and safety of recreational water. The contamination of pool water by human waste (feces, urine, sweat) is a primary theme. The article explains how this contamination compromises water safety, even in chlorinated environments, and discusses practices to prevent it, such as showering before swimming and not using the pool when ill. This connects to the broader principles of water quality management and safe sanitation practices to protect human health.

What specific targets under those SDGs can be identified based on the article’s content?

1. Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.

   • The article explicitly discusses the prevention and spread of several waterborne and communicable diseases. It names specific pathogens like “hepatitis A,” “cryptosporidium,” “giardia,” “E. coli,” “Shigella,” and “norovirus.” The text highlights a concerning trend, stating that “outbreaks of waterborne illnesses tied to pools and other recreational venues are on the rise,” and specifically notes that crypto outbreaks “jumped 13% each year” between 2009 and 2017. This directly relates to the target of combating waterborne diseases.

2. Target 6.3: By 2030, improve water quality by reducing pollution, eliminating dumping and minimizing release of hazardous chemicals and materials, halving the proportion of untreated wastewater and substantially increasing recycling and safe reuse globally.

   • While swimming pools are not “wastewater,” the principle of improving water quality by reducing pollution is central to the article. The text identifies pollutants as “germs, grime and bodily fluids,” including “feces,” “urine,” and “sweat.” It discusses how these substances contaminate the water and reduce the effectiveness of chlorine. The article promotes behavioral changes to reduce this pollution, such as showering before entry, taking bathroom breaks, and not urinating or defecating in the pool, which aligns with the goal of improving water quality for safe human use.

Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Indicators for Target 3.3 (Combat water-borne diseases)

   • Incidence of specific waterborne diseases: The article provides concrete numbers that serve as a baseline for this indicator. It states, “Between 2009 and 2017, crypto caused nearly 450 outbreaks across 40 states and Puerto Rico, sickening more than 7,400 people.” It also quantifies the trend: “Outbreaks jumped 13% each year.” Tracking these figures over time would measure progress.
   • Number of public facility closures due to contamination: The article offers a specific metric: “New York City’s parks department had to shut down pools 203 times to clean up after someone defecated” in a single year. This can be used as a proxy indicator for the risk of disease transmission and the prevalence of unsanitary behaviors.

2. Indicators for Target 6.3 (Improve water quality)

   • Prevalence of polluting behaviors: The article cites a “national survey released last month, [where] more than half of participants admitted to urinating in the pool as an adult.” This percentage serves as a behavioral indicator. A reduction in this figure over time would indicate progress toward reducing water pollution.
   • Indirect water quality indicators: The article mentions that a “strong chlorine smell” is a “red flag” for contamination by chloramines, which form when chlorine mixes with bodily fluids. While informal, the presence or absence of this smell could be used as a sensory indicator of water quality by the public.

Source: nypost.com