Managing swimming, spa, and other pools to prevent infection

Many different kinds of recreational and therapeutic pools now exist and all have the potential to transmit infection. This paper offers a brief review of reports of pool associated infections, along with short descriptions of the different kinds of pool and of the disinfection and filtration systems designed to minimise the possible transmission of infection by pool water. An outline of pool monitoring is included together with the rationale of microbiological testing and current microbiological guidelines. Good management is important; a well managed pool with an adequate disinfectant level, a pH value within the recommended range, regular filter backwashing, and satisfactory microbiological parameters will not present a significant infection risk. If management or design is poor, conditions can occur in which bathers become infected. Most infections reported in association with pools happen in these circumstances.