Presentation Title: Recreational Water Illness and Aquatic Facility–Related Events Associated with Swimming Pool Chemicals

CAPT Charles Otto

Michele C. Hlavsa


The U.S. Consumer Product Safety Commission estimates 4,635 people sought care in U.S. emergency rooms in 2007 due to exposure to swimming pool chemicals. This estimate is based on 115 such emergency room visits to 96 hospitals across the United States that year. Poisoning, which includes ingestion of chemicals as well as inhalation of fumes or gases, was the most common diagnosis (41% [47]) followed by dermatitis/conjunctivitis and chemical burns. The exposures tended to occur during the summer (63% [73]), on weekends (33% [38]), and at private homes (44% [51]). Half of the patients were white (50% [57]), 57% (65) were male, and 19% (22) were <6 years of age. Additionally, U.S. poison centers received 10,104 calls about single exposures to swimming pool or aquarium chemicals in 2006. Almost all (96.8% [9,778]) of these exposures were unintentional.


Lastly, a review of New York State investigation reports on >30 outbreaks or events (1983–2006), involving swimming pool chemicals and public venues, identified multiple contributing factors. They include:

1.      Chlorine gas being released when concentrated chlorine and acid mixed after the recirculation pump shut down but the chlorine/pH control feed pump continued running;

2.      Pool operators not using personal protective equipment (PPE) when handling chemicals; and

3.      Violent chemical reactions resulting from mixing incompatible chemicals (e.g., chlorine and acid) because labels on their containers were not read before use or the same equipment was used for different chemicals.


Engineering controls, educating pool operators and private pool owners on proper chemical storage and handling, and good maintenance can minimize the risk of exposure to swimming pool chemicals. Installing an electrical interlock system between the recirculation and chlorine/pH control feed pumps and establishing secondary, or spill, containment are examples of engineering controls. Operators and owners also need education on the incompatibility of certain chemicals, how to read the labels on containers of swimming pool chemicals, and appropriate use of PPE. Additionally, pool equipment service should only be done by trained personnel. These data underscore the need for improved education and training with an emphasis on instituting preventive maintenance programs to reduce future injuries.