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Recreational Water Illnesses and How to Prevent Them

For every sport or activity, a certain measure of precaution has to be taken to avoid dangers towards one’s health. In swimming, many known recreational water illnesses (RWI) are prevented simply by following proper pool etiquette.

What are recreational water illnesses (RWI)?

The Centers for Disease Control and Prevention (CDC) defines these illnesses as those that are “spread by swallowing, breathing, or having contact with contaminated water from swimming pools, spas, lakes, rivers, or oceans.” Some common examples of RWI are diarrheal illnesses, swimmer’s ear, hot tub rash, respiratory infection, and urinary tract infection.

What should you do to prevent recreational water illnesses (RWI)?

Avoid swallowing pool water

Unfortunately, many pool-goers jump into the water without washing up beforehand.

Instead, following the recommended practice of showering before swimming (which is actually essential in ensuring good hygiene and pool safety), 51% of Americans treat pools like bath tubs. This takes a toll on the pool’s cleanliness.

“All that sweat, dirt, oil, and products like deodorant and hair goop diminish the chlorine-based disinfectant’s power so it’s less effective at keeping the water clean. That leaves swimmers more vulnerable to germs that can cause infection, illness, and irritation.” – Jennifer Chesak (2019)

Many children do not understand what’s wrong with swallowing pool water. Therefore, it is the parent’s responsibility to explain why pool water is “icky” and should never be taken as they do with drinking water.

Shower before and after getting in the pool

As much as you wouldn’t want to be a victim of RWI, be mindful not to be one of its promulgators! Showering before swimming washes away bodily dirt, which may cause water contamination.

On the other hand, it is also crucial to shower after getting in the pool since doing so would drain many of the germs that you may have collected from the pool. This practice helps prevent or reduce many possible RWI such as folliculitis, urinary tract infection, and other diarrheal illnesses.

Don’t pee or poo in the pool

The swimming pool is not a bathroom! Toddlers and young children may need adult supervision to conform to this rule. There are two ways to help prevent peeing and pooing in the water:

  1. Take bathroom breaks It is advisable for parents to set regular bathroom breaks to ensure that their child won’t feel like peeing or pooing while playing in the water. For instance, parents can bring their child to the bathroom every 30 minutes to an hour.

  2. Use swim diapers Children (especially those who aren’t potty trained yet) can wear swim diapers. Parents should check the swim diapers at least every hour to make sure it is clean. In case the child poos and pees in it, the guardian must carry the child away from the water and change the swim diaper immediately.

  3. Don’t swim when you’ve had diarrhea for the past 2 weeks Someone with diarrhea carries germs like Cryptosporidium. This bacteria stays in the person’s body for at least 2 weeks after loose stool has stopped. The person carrying the bacteria may be responsible for spreading it in the water when he/she swims within the 2-week period. In fact, the Crypto parasite can live in chlorinated pools for as long as 10 days. Other bacteria that may upset the stomach, which may also be transmitted via exposed fecal matter in the pool, are Giardia, Shigella, norovirus, and E. coli.

Use a test strip to check how clean the pool is

Pools that do not have the correct chlorine or pH level are more likely to spread germs. To maximize germ-killing, the proper free chlorine level is 1-3mg/L or parts per million (ppm), and the proper pH level is 7.2-7.8. Aside from swallowing poo water, this is particularly important in avoiding respiratory infections caused by exposure to bacteria (ie. Legionella) that thrive in warm water. Smokers are most susceptible to this and must take extra caution.

Avoid getting into the pool right after shaving or waxing

Folliculitis (also known as “hot tub rash”) is a skin condition where hair follicles become inflamed due to bacterial or fungal infection. The germ associated with this rash is called Pseudomonas aeruginosa. Symptoms of folliculitis such as red, itchy bumps and/or small pus-filled blisters appear after dipping in a contaminated hot tub or pool. Nevertheless, washing up after being in the pool may help reduce the symptoms.

Dry your ears after swimming

Swimmer’s Ear, which is an infection in the outer ear canal, happens when contaminated water stays in the ear canal for too long thereby causing bacterial growth. This can be prevented by tipping your head to drain the water out of your ear and drying it with a towel after swimming. This can also be avoided by wearing swimming earplugs and can remedied with antibiotic ear drops.


Swimming is enjoyed when proper pool etiquette is practiced. Following the dos and don’ts prevent many recreational water illnesses such as diarrhea, rashes, respiratory infection, Swimmer’s Ear, and UTI. These rules ensure water safety to keep adults and children from being away or afraid of the pool. Therefore, on your next swimming trip, go ahead and take a dip! Enjoy the water but remember to follow the rules. :)



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