the aquatic therapist

The ADA Compliant Pool - It all changes starting now

It's not déjà vu, but it does seem like we've been here before. Fresh from an industry-shaking experience with VGB, another government mandate has arrived which will force public pool operators to spend money on pool equipment/alterations they hadn't planned for. This one's called ADA. Read more Aqua Magazine article here.

For instance, did you know that the deepest water that an ADA-compliant ramp can let out into is.... (drum roll please) 30".

Most pools start at 3' or 3.5' deep, so this is a rule destined to drive people to choose lifts instead of ramps to be considered ADA compliant.

More aquatic therapy data here.

 

 

Comprehensive Aquatic Therapy, 3rd edition (May 2011 release)

 

Hot off the presses!

 

Comprehensive Aquatic Therapy (CAT) authors just got their first-eyes copies of this 3rd edition. 

 

Over 8 years in the making.... It's HUGE.

 

At 560 pages and 1.5" thick, it's 140 pages bigger than the 2nd edition. It's truly the quintessential guide to aquatic therapy. 

• Get yours shipped today
  
• View contents

 

Comprehensive Aquatic Therapy remains the acknowledged reference text for aquatic therapists the world over. Featuring extensive updates from the 2nd edition, in this edition the editors have included extensive case studies, with multiple choice questions and answers as didactic content.New chapters have been added, covering the entire scope of aquatic therapy practice, including innovative new techniques with material for program development, including staff training and marketing.

News: Asthma Fears Prompt Infant Swimming Warning in Germany | February 2011

On the heels of a number of studies linking swimming to respiratory issues, a German agency has become the first to recommend that children younger than 2 years old with a family history of allergies avoid indoor pools.

The warning is based on a number of studies that suggest disinfection byproducts formed from the reaction of chlorine when combined with organic compounds — including human sweat and other body fluids — may contribute to respiratory issues.

Read more in aquaticsintl.com article

 

Therapeutic pool design inspiration? Look no farther than our aquatic options!

Why not benefit from those who have gone before you? A truly good aquatic design is derived from the best of the best features found in pools across the world. To get started on your tour of pools...

1. Findapool.com (to find therapy pools in your area to visit)
2. 2010 Dream Designs showcase (to see what is being done in industry)
3. How to Launch an Aquatic Therapy Practice manual (to get started on your project)

And, for those of you who dream big!
World's most extraordinary pools

 

 

Aquatic Therapy Start-Ups: Too Expensive to Buy? Lease Your Space Instead

So, you want to provide aquatic therapy to the masses. You first consider building, but the capital start-up costs are intimidating. There are no local pools that have the right size, temperature or depth. Plus, the "available" pool at the local health club is just nasty!

Consider renting your space instead! There is loads of empty retail space out there begging for tenants.

You may be able to rent and install your own prefabricated or custom-built therapy pool instead of building a facility from scratch.

Most real estate observers say that the vacancy rate is pretty much as high as it's going to get. So what steps can you take to capitalize on the favorable market?

• Negotiating tips on renting space from Phillip Perry...
• 12 steps to a better lease...
• Example of great therapy pool setup which was built into an empty retail space... (parent alert: the perfect place for children with autism!)

 

Think someone's taking good care of that pool? Mmmm. Not always so...

CDC. Violations Identified from Routine Swimming Pool Inspections --- Selected States and Counties, United States, 2008. Morbidity and Mortality Weekly Report. May 21, 2010 / 59(19);582-587.

To assess pool code compliance, the CDC analyzed 2008 data from 121,020 routine pool inspections conducted by a convenience sample of 15 state and local agencies.

Quick hits of results:

• 12.1% of inspections resulted in immediate closure because of serious violations (e.g., lack of disinfectant in the water). Interactive fountain inspections had the highest percentage of immediate closures (17.0%) 
  

• Another 10.7% of inspections identified disinfectant level violations. 

• Therapy pool inspections had the lowest percentage of disinfectant and pH level violations but the highest percentage of other water chemistry violations (43.9%).

• Child-care pool inspections had the highest percentage of immediate closures (17.2%), followed by hotel/motel and apartment/condominium pool inspections (15.3% and 12.4% respectively)

• Apartment/condominium and hotel/motel pool inspections had the highest percentage of disinfectant level violations (13.1% and 12.8%, respectively).

• Child-care and apartment/condominium pool inspections had the highest percentage of pH level violations (11.8% and 10.0%, respectively).

• Approximately 35% of inspections of apartment/condominium pools, hotel/motel pools, and water parks identified circulation and filtration violations.

• Kiddie/wading pool inspections had the highest percentage of disinfectant level violations (13.5%), followed by interactive fountain inspections (12.6%).

Source: www.cdc.gov/mmwr/preview/mmwrhtml/mm5919a2.htm

Therapy pool noise problems: The sound solution may be easier than you think

Question: I have a question regarding echoes in our pool room. Do you have any suggestions on what materials or plants to use in order to decrease the amount of echo? Any suggestions you have would be greatly appreciated. Thank you, Sarah

Answers: 

Aquatics International: A big reason for all the noise is that pool environments demand hard, readily cleanable surfaces, impervious to water or chemical attack. Such surfaces cause sound waves to bounce around the natatorium like rubber balls, creating a noisy echo effect. Much more on this topic here 

In addition, a tremendous amount of white noise (referred to as background noise) exists in pool areas: water moving and falling into the gutter system, HVAC systems, fans, motors, and music. Now add [pool patrons] into the mix, and you’ve got the recipe for a serious noise problem.

Fortunately, there are a number of solutions available to remedy poor acoustics. These solutions include sound panels, baffles, banners, fabric, suspended ceilings, clouds and acoustical decking. Sound panels usually are rigid panels mounted on the walls or ceiling that allow the sound to be dampened behind the panels. Softer materials such as cloth banners or fabric can effectively improve the situation.

Jim Stevenson PT: We used a company out of Texas that put up colored rectangular foam panels that work great and look great. The company we used is Perdue Acoustics, Amarillo TX (806)374 9402. We used 47 2'x4' wedge diffsorbers. The total cost with installation was 5900.00 and they do work quite well. They are glued to the wall so occasionally some of the glue runs down the wall if our dehumidification system is not working properly but it can be washed easily. We have had the panels up for 4 plus years with no problems.

Helen Tilden, RN: Many companies specialize in colorful bunting made of a material that looks like parachute material. It is artfully draped in "loops" from the ceiling. It takes care of a great deal of noise. 

Andrea Salzman, MS, PT: There are also products that can be sprayed up in the soffit, such as SonaSpray. Examples found here

From Aquatics International article 7 Signs you have a noise problem
When should poor acoustics become a concern for you, your employees and your patrons? Watch for these seven signs:
1	Casual conversations, when in close proximity to a coworker, cannot easily take place without raising your voices.
2	Emergency communication (whistle signals, emergency instructions and emergency responses) is hampered by the poor acoustics.
3	Fitness participants, swim lesson students or athletes cannot hear and understand the directions of the instructors or coaches.
4	The sounds in the natatorium after a long shift hurt the ears of the employees — employees experience a “ringing in the ears” when leaving work.
5	The PA system or sound system is inaudible and music lyrics cannot be easily understood.
6	White noise from the HVAC system drowns out the sounds of the PA system, normal conversation and emergency communication.
7	A reported occupational hearing loss by one or more of your employees.
If any or all of the above are a concern, your work environment may need to be tested.

Iphone App helps aquatic therapists test the waters... before getting in

Eyes itchy? Skin develop a rash? Smell the pool down the hall? Ever think that maybe you just shouldn't get in? (Read related story about therapists working in gross conditions...)

Tom Lachocki (National Swimming Pool Foundation) recommends you carry test strips from a professional pool store in your “pool bag” to test the water to make sure it has the proper amount of chlorine (at least not “zero” free chlorine).  

All test strips also test pH. Many test strips today also can test the total alkalinity (TA) & calcium hardness (CH). It is less common to have strips that have total dissolved solids (TDS), but TDS only impacts saturation index by 0.1, so you can tell if you are close to “balanced water” even without a TDS test. 

Now the unbelievable part. You can plug that data and the water temperature into a new iPhone App and calculate the water balance.  

If you don’t have proper chlorine and pH, don’t get in! Request the Certified Pool/Spa Operator® fix it immediately. 

If your water balance is off, ask for it to be corrected by your next visit. After all, the water balance makes the water less aggressive to users (and the equipment).   

These two tools will help you have numbers to better manage the equipment you use (water) to be friendly to you and your clients/patients.  

Just search “Saturation Index” in the Apps Store on your phone. Or go to this link and you can buy the App through your iTunes account. http://itunes.apple.com/us/app/saturation-index/id348049578?mt=8

Wonder if your therapy pool water is a mess? It just might be worse than you think

 

Ready for a gross but true story?

A therapist rented space at a local hotel pool. She was so pleased with the arrangement. What could be better?

The pool was warm, the pool had the right depths, it was never used. They only charged her $5 a person to use the pool. She was spectacularly lucky.  

Over the summer, she noticed the water quality was consistently pretty bad. In fact, if anything, it seemed to be trending downward. Finally, she went to the front desk to ask to speak with whoever was in charge of the pool. She had some questions.

Together, the day manager and she discovered...The pool operator had quit almost 3 weeks before and NO ONE else had been assigned to the pool. There wasn't a drop of chlorine in the entire building.  

Every day, across the world, therapists are working in pools with substandard chemistry.

Take back control of your skin! Self-test w/ your phone... and find out what your maintenance team hasn't been telling you

Help: We have an allergic reaction everytime we get into the therapy pool

HELP! We have a pool that uses chlorine and two aquatic therapists have developed a sensitivity to it with severe skin outbreaks. What can we do?

ANSWER: Sorry you are having problems. Unfortunately, it can be an occupational hazard of being an aquatic therapist especially if you spend more than 4 hours in the water a day.

Unfortunately, a halogen sensitivity, once developed, usually remains. So what does a chlorine allergy look like? For one, exposure to the same levels of chlorine will typically result in a similar response.

The best answer is to add  a supplemental disinfection system (such as ultraviolet light, or an ozone generator) to your pool. It can reduce the amount of chloramines in your water dramatically. Also, it is now much cheaper than it used to be. It is possible to add an UV component to your system for under $5,000.

More info on how to reduce chlorine with supplemental systems (especially Tips #36, #47, #54).

One last point. Everyone assumes that skin rashes are due to exposure to chlorine. Often times, it can be an improper pH that is causing the problem. First rule of thumb, check the pH religously. Human skin will not tolerate exposure to pH which is not at or near 7.3-7.4 for long.

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Rashes are a common complaint with both pool and spa users. Rashes may be caused by a reaction to chemicals in the water or by a bacterial infection. The first step in investigating rash outbreaks should be to identify the cause. The simplest way to differentiate chemically- and bacterially-induced rashes is the incubation period (onset longer than 12 hrs; probably not chemically induced).

Best Practices to Reduce Chemical Rashes

• Maintain the proper sanitizer level at all times – this not only provides oxidation but also prevents bacterial growth, including Pseudomonas aeruginosa that will cause bacterial rashes.
• Maintain proper pH and alkalinity – improper pH has been linked to some irritant rashes.
• Use routine supplemental oxidation to reduce combined chloramines and bromamines. Supplemental treatments include quick-dissolving chlorine compounds (cal hypo, dichlor, granular trichlor, lithium hypo, and bleach), non chlorine shock-oxidizers (monopersulfate), and ozone. Supplemental oxidation is particularly important when using bromine compounds (BCDMH, DBDMH or sodium bromide).
• In spas, routinely replace the water. There are several guides available for this, including one from the APSP (visit APSP’s website at http://apsp.org/54/index.aspx for a free download of APSP’s complete Water Treatment Information Bulletins.)
• When the water appears cloudy or foamy, the facility should be closed at once.

These all seem rather obvious. Yet in reported cases one or more of these were not followed by the operator.

The single largest group reporting chemical rashes is hydrotherapists (therapists providing therapy in aquatic settings). These individuals are exposed to chlorine- or bromine-treated water up to ten hours per week. The temperature and bather loading of these therapy pools resembles hot tubs.

One Israeli study revealed that 45 percent of the 190 therapists surveyed developed skin disease after beginning work (Lazarov, Nevo, Pardo, and Froom. 2005. Self-reported skin disease in hydrotherapists working in swimming pools. Contact Dermatitis 53:327-331). The authors concluded that skin disease for hydrotherapists is an occupational hazard resulting from cumulative exposure.

So what is the exact cause of chemical rashes? We don’t know. The published cases do not provide enough information on the treatment system being used by the facility or chemistry discovered during the incident investigation.

We do know that hypobromous acid (the active portion in “bromine”) is a poor oxidizer when compared to hypochlorous acid (the active portion in “free chlorine”). We also know that hypobromous acid reacts with organic matter to form combined bromamines, just as free chlorine does. And bromamines and chloramines are known skin irritants.

A further complication is that there is no readily available test to determine the concentration of combined bromamines. OTO and DPD kits measure only total bromine, which includes the free bromine and combined bromine.

Excerpted from: The Association of Pool and Spa Professionals.  Chemically-induced Rashes. Recreational Water Quality. (A Publication of the APSP Recreational Water Quality Committee). Jan 2008. Available at: http://apsp.org/APSPRWQE-news/Jan16/rash.htm