Microbiological quality of the water of recreational and rehabilitation pools: a 2-year survey in Naples, Italy

Assessment of Physicochemical and Microbiological Quality of Public Swimming Pools in Addis Ababa, Ethiopia

BACKGROUND

From swimming pools, bathers may acquire many potential pathogens or may be affected by the physicochemical characteristics of water used during bathing. Hence, this study aimed at assessing the physicochemical and microbiological quality of public swimming pools located at different hotels and recreation center in Addis Ababa, Ethiopia.

METHOD

A cross sectional study was carried out from February to May, 2016. Nine hotels and one recreation center which recognized to have public swimming services were included. A total of 60 swimming pool water samples from 10 swimming pools were collected at deeper, shallow and intake point twice on a weekly basis using a 250 ml sterile bottle containing sodium thiosulphate. PH, residual chlorine and temperature of samples were recorded at the time of collection. Sample containing bottles were transported in ice box to microbiological laboratory and analyzed on the same day. Standard cultural and biochemical methods were used for isolation and characterization of the main microbial groups. Total viable count, total coliform count, fecal coliform count and E. coli were determined. Data was analyzed using SPSS Version 20.

RESULTS

Average PH and temperature of swimming pool water samples were 7.1 and 29^oC respectively. Of all analyzed water samples, 58.4% (n=35/60) of them had PH range of 7.2-7.8, 58.3% (n=35/60) of samples had temperature in the range of 21^oC-32^oC and 25% (n=15/60) of water samples had residual chlorine in the range of 2-3mg/l. 73.3% (n=44/60) of the samples had a total viable count below 200 MPN/ml and 70% (n-42/60) of the samples had Total Coliform Count values less than 2 MPN/100 ml. Moreover, 66.7% (n=40/60) of the samples had fecal coliform counts falling below 1 MPN /100 ml. E. coli was absent in 70% (n=42/60) of the samples while it was present in 30% (n=18/60) of the samples.

CONCLUSION

PH, residual chlorine and temperature value of majority of the swimming pools' water samples were within the acceptable limit. Regarding microbial quality, most swimming pools' water samples complied to the WHO standard. Swimming pools that did not comply to the standard both in physicochemical levels and microbial quality need improvement due to their significant health implication.

Pseudomonas aeruginosa in Swimming Pool Water: Evidences and Perspectives for a New Control Strategy

Pseudomonas aeruginosa is frequently isolated in swimming pool settings. Nine recreational and rehabilitative swimming pools were monitored according to the local legislation. The presence of P. aeruginosa was correlated to chlorine concentration. The ability of the isolates to form a biofilm on plastic materials was also investigated. In 59.5% of the samples, microbial contamination exceeded the threshold values. P. aeruginosa was isolated in 50.8% of these samples. The presence of P. aeruginosa was not correlated with free or total chlorine amount (R² < 0.1). All the isolates were moderate- to strong-forming biofilm (Optical Density O.D.570 range 0.7-1.2). To control biofilm formation and P. aeruginosa colonization, Quantum FreeBioEnergy© (QFBE, FreeBioEnergy, Brisighella, Italy), has been applied with encouraging preliminary results. It is a new, promising control strategy based on the change of an electromagnetic field which is responsible for the proliferation of some microorganisms involved in biofilm formation, such as P. aeruginosa.

Health-Related Behaviors in Swimming Pool Users: Influence of Knowledge of Regulations and Awareness of Health Risks

Background: Swimming pool attendance exposes users to infection and chemical risks that could be largely reduced with the adoption of healthy behaviors. This study aims to investigate if the knowledge of swimming pool regulations and awareness of health risks can be associated with users’ health-related behaviors. Methods: A cross-sectional study was conducted using self-administered questionnaires to collect data from two different target groups of swimming users: 184 adults and 184 children/adolescents. The association between specific variables and patterns of behaviors and knowledge was assessed through multivariate logistic regression models. Results: Although more than 80% of both groups declared they knew the regulations, compliance with healthy behaviors was often unsatisfactory, especially in adolescents and youth. In the children/adolescents group, healthy behaviors significantly increased with the frequency of attendance per week. In both groups, compliance increased with educational level (of parents for children/adolescents), while no positive association was observed between viewing the regulations and adopting appropriate behaviors. In the adult group, a higher knowledge/awareness of health risks was related to decreased odds of at least one unhealthy behavior. Conclusions: Guaranteeing the public display of regulations in swimming facilities is not sufficient to promote and change health-related behaviors. Much more attention should be given to educational interventions aimed to increase knowledge of health risks and the awareness that bathers are directly responsible for their own well-being.

Evaluation of the Pseudalert/Quanti-Tray MPN Test for the Rapid Enumeration of Pseudomonas aeruginosa in Swimming Pool and Spa Pool Waters

This study assessed the performance of a new most probable number test (Pseudalert/Quanti-Tray) for the enumeration of Pseudomonas aeruginosa from swimming pool and spa pool waters by comparing it to the international and national membrane filtration-based culture methods for P. aeruginosa: ISO 16266:2006 and UK The Microbiology of Drinking Water-Part 8 (MoDW Part 8) which both use Pseudomonas CN agar. The comparison was based on the calculation of mean relative differences between the two methods conducted according to ISO 17994:2014. Using both routine pool water samples (149 from 8 laboratories) and artificially contaminated samples (309 from 7 laboratories), paired counts from each sample and enumeration method were analysed. For routine samples, there were insufficient data for a conclusive assessment, but the data do indicate at least equivalent performance of Pseudalert/Quanti-Tray to the reference methods. For the artificially contaminated samples, the data also did not result in a statistically conclusive assessment but did indicate potentially better performance of Pseudalert/Quanti-Tray. Combining the data from the routine samples and artificially contaminated samples resulted in an ISO 17994 outcome that the two methods were not statistically significantly different. Thus, the Pseudalert/Quanti-Tray method is an acceptable alternative to ISO 16266 and MoDW Part 8. The Pseudalert/Quanti-Tray method has the advantage in that it does not require confirmation testing, and of providing confirmed counts within 24-28 h incubation compared to 40-48 h or longer for the ISO 16266 and MoDW Part 8 methods.

Strategies to optimize monitoring schemes of recreational waters from Salta, Argentina: a multivariate approach

Several recreational surface waters in Salta, Argentina, were selected to assess their quality. Seventy percent of the measurements exceeded at least one of the limits established by international legislation becoming unsuitable for their use. To interpret results of complex data, multivariate techniques were applied. Arenales River, due to the variability observed in the data, was divided in two: upstream and downstream representing low and high pollution sites, respectively, and cluster analysis supported that differentiation. Arenales River downstream and Campo Alegre Reservoir were the most different environments, and Vaqueros and La Caldera rivers were the most similar. Canonical correlation analysis allowed exploration of correlations between physicochemical and microbiological variables except in both parts of Arenales River, and principal component analysis allowed finding relationships among the nine measured variables in all aquatic environments. Variable's loadings showed that Arenales River downstream was impacted by industrial and domestic activities, Arenales River upstream was affected by agricultural activities, Campo Alegre Reservoir was disturbed by anthropogenic and ecological effects, and La Caldera and Vaqueros rivers were influenced by recreational activities. Discriminant analysis allowed identification of subgroup of variables responsible for seasonal and spatial variations. Enterococcus, dissolved oxygen, conductivity, E. coli, pH, and fecal coliforms are sufficient to spatially describe the quality of the aquatic environments. Regarding seasonal variations, dissolved oxygen, conductivity, fecal coliforms, and pH can be used to describe water quality during dry season, while dissolved oxygen, conductivity, total coliforms, E. coli, and Enterococcus during wet season. Thus, the use of multivariate techniques allowed optimizing monitoring tasks and minimizing costs involved.

Comparison of chemical, biological and physical quality assessment of indoor swimming pools in Shahrekord City, Iran in 2013

Previous studies have shown that mismanaged swimming pools could transmit water-borne diseases. The objective of the present study was the quality assessment of chemical, biological and physical characteristics of swimming pools in Shahrekord city, southwest of Iran. The two main indoor swimming pools of Shahrekord city were considered during the summer and winter of 2013. The number of 459 samples were analysed from swimming pools, showers and dressing rooms for chemical, biological and physical quality assessment. The most prevalent fungi were Aspergillus (48.91%), Penicillium (22.9%), Nocardia (11.31%), Cladosporium (8.41%). Rhizopus (6.18%), Scopulariopsis (6.21%), Fusarium (5.31%), and Mucor (1.38%). The most fungal contamination sites for both swimming pools were showers. Results showed that the values of total faecal coliform, Pseudomonas aeruginosa, Legionalla, Escherichia coli and Heterotrophic Plate Count (HPC) for both swimming pools exceeded the guidelines, except for Staphylococcus aureus. The correlation coefficient between bathers load and total faecal coliform, heterotrophic bacteria was 0.949. The turbidity, free residual chlorine, and hardness of both swimming pools were not compliance with standard guidelines. Therefore, the improvement of disinfection and cleaning procedures is necessary, due to the different users and daily bather loads of each pool, as well as monitoring the water quality and increasing of the knowledge of swimming pool users on the risks of these potential diseases.

Swimming pools and health-related behaviours: results of an Italian multicentre study on showering habits among pool users

OBJECTIVES

Showering before entering a swimming pool is highly recommended to reduce the risk of biological and chemical contamination. This study evaluated the behaviour of indoor swimming pool users; analysed the variables associated with lack of showering; and assessed awareness of the importance of showering.

STUDY DESIGN

Cross-sectional study.

METHODS

A self-administered questionnaire was used to collect data about users of swimming pools located in five different Italian cities. The association between specific variables and the lack of showering was assessed. P < 0.05 was considered to indicate statistical significance.

RESULTS

In total, 4356 questionnaires were analysed. Sixty-five percent of interviewees always showered before entering the pool. The main reason given for pre-swim showering was 'to wash oneself' (50.5%); or 'to get used to the temperature of the water' (44.3%); and 5.2% answered 'for both reasons'. Risk factors significantly associated with lack of showering were: female sex (odds ratio (OR) 1.37, 95% confidence interval (CI) 1.2-1.59), age 14-17 years (OR 5.09, 95% CI 3.40-7.64); not reading the swimming pool rules (OR 1.24, 95% CI 1.10-1.41); living in Central Italy (OR 3.3, 95% CI 2.65-4.1) or Southern Italy (OR 1.35, 95% CI 1.18-1.55); and previous/current attendance of a swimming course (OR 1.7, 95% CI 1.48-1.97).

CONCLUSIONS

The results revealed low compliance with the rule of showering before entering a swimming pool, and little awareness of the preventive role of showering in the hygienic management of swimming pools. There is a need for targeted educational interventions to inform swimming pool users of the reasons for the importance of showering before entering a pool.

Assessment of water quality of some swimming pools: a case study in Alexandria, Egypt

In spite of the importance and popularity of swimming pools in summer, they have been identified as posing some public health risks to users due to either chemical or microbiological contamination. This study was carried out aiming at assessing the quality of water for some Alexandria's swimming pools in order to determine its compliance with the Egyptian standards no. 418/1995. Five swimming pools were selected randomly from different districts. Physical and chemical parameters, as well as biological examination of a total of 30 samples, were carried out using standard analytical methods. Water samples were collected from the studied swimming pools monthly over 6 months and pool water monitoring was carried out during afternoon of the weekends when the pools were most heavily used. The results indicated overall poor compliance with the standards. Compliance of the pool water to the microbial parameters, residual chlorine, pH, and turbidity were 56.7% (17 samples), 20% (6 samples), 46.7% (14 samples), and 46.7% (14 samples), respectively. Statistical analysis showed significant association between water contamination with microbial indicators and physical-chemical aspects such as residual chlorine, temperature, turbidity, and load of swimmers. Furthermore, Cryptosporidium oocysts and Giardia lamblia cysts has been found in 10% of samples. It was concluded that there is a need to improve disinfection and cleaning procedures, with consideration given to safety, and size of the pool in relation to bathing load. There is also a need to monitor swimming pool water quality continuously, and to increase bather hygienic practices and awareness of the risks as well as training of governmental inspectors.

Exposure levels to brominated compounds in seawater swimming pools treated with chlorine

Despite evidence of formation of brominated compounds in seawater swimming pools treated with chlorine, no data about exposure levels to these compounds have been reported. To address this issue, a survey has been carried out in four establishments (representing 8 pools) fed with seawater and devoted to relaxing and cure treatments (thalassotherapy centres located in Southeast of France). Carcinogenic and mutagenic brominated disinfection byproducts (trihalomethanes -THM- and halogenated acetic acids -HAA-) were quantified at varying levels, statistically related to organic loadings brought by bathers, and not from marine organic matter, and also linked to activities carried out in the pools (watergym vs swimming). Bromoform and dibromoacetic acid, the most abundant THM and HAA detected, were measured at levels up to 18-fold greater than the maximum contaminant levels of 60 and 80 μg/L fixed by US.EPA in drinking waters. The correlations between these disinfection byproducts and other environmental factors such as nitrogen, pH, temperature, free residual chlorine, UV(254), chloride and bromide concentrations, and daily frequentation were examined. Because thalassotherapy and seawater swimming pools (hotels, cruise ships,…) are increasing in use around the world and because carcinogenic and mutagenic brominated byproducts may be produced in chlorinated seawater swimming pools, specific care should be taken to assure cleanliness of users (swimmers and patients taking the waters) and to increase water circulation through media filters to reduce levels of brominated byproducts.

Drying eggs to inhibit bacteria: Incubation during laying in a cavity nesting passerine

Early incubation has been suggested as a defensive adaptation against potentially pathogenic bacteria colonizing avian eggshells in the wild. The inhibitory mechanisms underlying this adaptation are poorly understood and only recent experimental evidence demonstrates that keeping eggs dry is a proximate mechanism for the antimicrobial effects of avian incubation. We estimated partial incubation (the bouts of incubation that some birds perform during the egg-laying period, days of lay 3-5 in our population) intensity of female pied flycatchers breeding in nest-boxes using data loggers that allowed a precise measurement of temperature just between the eggs in the nest-cup. We also measured relative humidity within the nest-boxes and related it to incubation intensity, showing that more intense incubation during laying contributes to drying the air near the eggs. We analyzed separately the effects of incubation and of relative humidity on loads of three types of culturable bacteria known to be present on eggshells, heterotrophic bacteria, Gram-negative enterics and pseudomonads. Our results show an association of early incubation with an inhibition of bacterial proliferation through a drying effect on eggshells, as we found that incubation intensity was negatively and relative humidity positively associated with eggshell bacterial loads for heterotrophic bacteria, Gram-negative bacteria and pseudomonads, although the significance of these associations varied between bacterial groups. These results point to microclimatically driven effects of incubation on bacterial proliferation on eggshells during laying in a temperate cavity nesting passerine.

Molecular detection of Pseudomonas aeruginosa in recreational water

The aim of this study was the development of a new molecular assay for Pseudomonas aeruginosa identification in recreational water. The method includes bacterial cell concentration through membrane filtration, a short (6 h) culture-enrichment step, DNA extraction and its amplification through a Real-Time PCR assay. The performance of the molecular approach was evaluated on 44 samples of swimming pool water and compared with the reference method UNI EN ISO 16266:2008. Positivity rates of 6% and 74% in pool and inlet water, respectively, with the standard culture method, and of 23% and 74% with the molecular method were found. Statistical analysis indicated "substantial agreement" (Cohen's Kappa index: 0.6831) between the two approaches. RAPD typing of P. aeruginosa isolates showed identical fingerprint profiles, indicating their epidemiological correlation. The developed protocol showed very high specificity and a detection limit of 10 genomic units. This technique has the potential to screen large numbers of environmental samples, and could be proposed as part of a self-monitoring plan for recreational facilities, improving surveillance and early warning systems.