Update on the model aquatic health code.

The Centers for Disease Control and Prevention (CDC) recognize swim­ ming as an excellent form of physi­ cal activity, with benefits of reducing risk for chronic diseases and improving mental health. Aquatic facilities can pose a risk, however, to public health from both illness and injury. Although local and state public health codes typically regulate pools, spas, and other aquatic venues, these codes may not always be based on up-to-date science, cover the newest construction developments in the aquatics field, or respond to new outbreak data such as those addressing spray pad–asso­ ciated outbreaks or indoor air quality events. Lack of consistent health regulation in state and local codes not only confuses pool and spa owners, operators, suppliers and users, but also leaves persons unnecessarily vulner­ able to disease and injury. In recent years reported recreational water­ borne disease outbreaks linked to aquatic facilities have steadily increased (Hlavsa et al., 2014). Figure 1 illustrates this increase, which is driven largely by the challenges of maintaining an aquatic facility and prevent­ ing the transmission of a variety of ailments, particularly diarrheal diseases. Additionally, aquatic venues are the sites for many injuries, particularly among chil­ dren. Some of those injuries include the more common slips, falls, cuts, and bruises; others are life threatening, such as drowning, suc­ tion entrapment from pool drains, diving injuries, and chemical injuries (Hlavsa & Beach, 2013).