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Pools

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									Standards for Public Bathing Beaches and Wading Pools*
BEFORE proceeding with the discussion of the two topics assigned to us for special consideration at the 1928 meetings of the Conference of State Sanitary Engineers, and' of the Public Health Engineering Section, your committee wishes to call attention to the need
for special precautions to prevent the spread of infectious skin diseases of the feet at swimming pools and other public bathing places.
FOOT DISEASES

Although such diseases are not reportable, and their prevalence is not a matter of official record, unofficial reports of the occurrence of ring worm, toe itch, toe scald, fungus foot, papilloma, and similar infections at pools and beaches in various parts of the country are becoming more and more frequent. Most, if not all, of these foot diseases are caused by a fungus which is spread by infection of the floors of dressing rooms, etc., at pools, bath houses, gymnasiums, and other places where persons go barefoot. While control methods have not been completely worked out, the following preventive measures will prove useful in checking the spread of these diseases: 1. The feet, and especially the toes, of all bathers should be inspected regularly, and those persons showing infection should be excluded from the pool and dressing rooms and advised to consult a skin specialist. The disease may show around the base of the nails or between the toes as raw open sores-the sodden type; as small or large blisters-the vesicular type; or it may resemble eczema. The type which the disease exhibits may change from time to time in the same patient, depending on circumstances. 2. Wash all floors, benches, and stools in dressing rooms, diving boards, out-of-water portions of ladders or steps, rubber mats, etc., daily with a strong solution of chlorinated lime or chlorinated soda. It is known that the fungus will grow readily on silk and cotton goods and on leather, and it is believed that it will also grow on damp wood;
* Report of the Joint Committee on Bathing Places of the A. P. H. A. and the Conference of State Sanitary Engineers, presented to, the Public Health Engineering Section of the American Public Health Association at the Fifty-eighth Annual Meeting at Minneapolis, Minn., October 1, 1929.

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so special attention should be paid to disinfection of any woodwork with which the feet of bathers may come in contact. Canvas mats or pads should be abolished. 3. Take precautions to insure that there is no exchange of unsterilized towels, suits, bathing slippers, etc., among bathers. All suits and towels should be thoroughly sterilized by boiling before being dried for reissue, as recommended in the last report of this committee.
BATHING BEACHES

The committee would again call attention to the sanitary requirements for public bathing beaches recommended in paragraphs II, III, XII, XIII, XIV, XIX, XX, and XXI of its report for 1926,* entitled " Standards for the Design, Construction, Equipment, and Operation of Swimming Pools and other Bathing Places." As stated in paragraph III, A, the committee is of the opinion that "It is very desirable that the bathing waters at public bathing places on natural streams, lakes, and tidal waters should be of the same standard of bacterial quality as is required for swimming pools." It is recognized, however, that the strict application of swimming pool water standards to all public bathing waters would probably not be practicable at present. Furthermore, since there is not now available any sufficient volume of data as to the quality of waters now used for bathing, nor any sufficient record of the causation of disease by bathing in moderately polluted waters, your committee feels that any definite standard of bacterial quality which it might propose would be purely

empirical. In the case of swimming pools it was entirely fair to set up a high standard of bacterial quality, since effective methods were available by which such quality could be maintained at a reasonable cost. The bathing beach problem is distinctly different. In certain instances it may be feasible to treat the water at the beach satisfactorily with chlorine or other disinfectant. In the majority of instances, however, to set up and attempt to enforce a high standard of bacterial quality would mean that we would be forced either to condemn many waters now used for bathing, or to attempt to reduce the pollution by elimination of the sources or by treatment of sewage discharged therein. As in many cases there has been a considerable capital investment at these beaches, not only in bath houses and bathing equipment, but also in amusement facilities, any attempt at condemnation, except following an epidemic traceable to the pollution of the waters, would meet with strong opposition both from the public, who have been accustomed to
*A.
1928.
J. P. H., XVI, 12: 1186 (Dec.), 1926. For 1927 Report, see A. J. P.'H., XVIII, 2: 194 (Feb.),

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bathe regularly at these beaches, and from persons whose investment would be wiped out by their closing. On the other hand, the reduction of pollution usually means a large expense for sewage treatment and considerable delay while such treatment works can be planned, financed, and constructed. It would seem to your committee, therefore, that while it is entirely legitimate to use pollution of bathing beaches as an argument in a program for a clean-up of public waters, the bathing beach problem is one which should properly be worked out by local and state authorities for the best interests of all parties concerned in each particular locality, unhampered by any empirical standards. In a swimming pool the major danger to health of bathers comes from fresh secretions introduced into the water by other bathers. At a public bathing beach where a large volume of water is available for dilution, the danger of infection by such personal discharges is very much reduced, and the major health hazard becomes that of pollution of the water by sewage. The potential danger to health from bathing in water at any particular beach can only be determined by a complete survey, in which dilution of the polluting sewage, and the effect of tides, winds, and other factors in producing currents, are given full weight in the interpretation of the results of bacterial and chemical analyses of the water. In such an interpretation it must ever be borne in mind that the time-travel-distance factor of polluting waters is of paramount importance from a public health viewpoint. Direct pollution by fresh sewage from nearby sources, even though relatively small in amount, is potentially more dangerous than pollution by a much greater volume of sewage some distance away. It should also be recognized that a bather is much less likely to take into his mouth and swallow salt water than fresh, and for this reason the same degree of pollution may be potentially less dangerous at the sea-shore than at a bathing place on an inland stream or lake.
WADING POOLS

With increasing attention paid to the sanitation of swimming pools throughout the country, the attention of many sanitary authorities is being attracted to the need for improvement in the sanitation of the numerous shallow wading pools which have been installed for use of children in public parks and playgrounds. Early in the summer, your committee sent out a questionnaire asking the opinion of the various state sanitary engineers as to the advisability of attempting to control the sanitation of these pools, and as to what standards of water quality, cleanliness, etc., it would be practical to establish. Replies

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have been received from only 12 states, an insufficient number to enable your committee to determine the consensus of opinion of the health authorities of the states on these questions, and make any definite recommendations. The replies already received, however, indicate that:
1. It is both desirable and practicable to establish a system of supervision over sanitation of public wading pools similar to that now exercised by public health authorities over swimming pools. 2. It appears inadvisable at present to require the same standards of water quality for very shallow pools used for wading only as are required for swimming pools. 3. For administrative purposes a distinction on a basis of maximum depth of water should be established between swimming pools and wading pools. STEPHEN DEM. GAGE, Chairman HARRY F. FERGUSON E. S. TISDALE GEORGE W. SIMONS C. G. GILLESPIE RICHARD MESSER JACK J. HINMAN, JR.

Men's Clothing
wears light fabrics, which quickly show the dirt, but are easily and frequently cleaned. Have you ever considered how long a man's suit goes without being thoroughly cleaned? Men's clothes actually come into contact with and absorb more dirt than women's; but it'does not show so much because of the darker color of the cloth. The dirt is there all the same, although not seen, and where there is dirt you will find germs. Consider hygiene in a broader sense. The many layers and heavy, thick material of men's garments make them thoroughly unsatisfactory from a health point of view. What chance has sunlight or fresh air of gaining access to the body? The perspiration, instead of evaporating freely with an inappreciable odor, is retained by the inner and outer layers of clothing. They become clammier and clammier, giving off an unpleasant and unhygienic odor. These damp, clammy clothes are also responsible for many of the so-called summer colds. What are the remedies? Changes can only come about by desire, thought and action. Men should realize their conservatism in dress and the need for more progressive ideas.-Dr. Vynne Borland, quoted in Med. Off., Sept. 21, 1929, p. 135.

DR. Borland says: Take the question of cleanliness. The average woman


								
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