Unfortunately, thirst isn't always a reliable gauge of the aquatic therapist's need
for water.
Instead, take the runner's test. Long distance runners have learned that a quick look back into the toilet bowl after peeing can give them a heads-up as to their hydration status.
Clear or light-colored urine? You're
well hydrated.
But if you're seeing dark yellow or amber colored urine (see photo above!), you're simply not getting enough to drink.
Immersion causes the body to excrete more fluids. The more time you spend in the water, the more fluid you lose.
You've got to drink more. A lot more. Or you're going to develop a chronic case of "feeling old" before your time.
Did you miss the Aquatics International webcast on implementing the Pool and Spa Safety Act?
Experts from CPSC, APSP and other industry pros
discussed the Act in a roundtable discussion. Here is the Q&A
session from registered participants to some of the questions asked and answered.
Note: We have not received any response from the CPSC to our questions about whether therapy pools must comply with this act. We will keep you posted, but for now, assume that you must even though therapy pools are not always considered "public pools" by the states.
It's a "best practice" issue even if it isn't the law.
Is it lack of patient interest? Pool water quality? Need for space for other offices?
No. It's because pools can hemorrhage money. Or -- more precisely -- pools evaporate money. Your therapy pool will never make you one red cent until you get your evaporation problem under control.
Did you know?
Raising your pool's water temperature just 1°F can cost an additional 10-30%
It's much more
efficient to keep as much of the water you've already heated (and paid to heat)
in the pool than to keep replacing that heat when lost.
The Department of
Energy has found that water evaporation is overwhelming the single largest
source of energy over consumption, accounting for 70% of total energy lost in
both outdoor and indoor pools.
Take a look at thisconcrete exampleof the waste that comes with evaporation:
Take your typical 1,000 square foot pool (let's say 20 x 50
dimension)
A typical indoor pool loses 1-1.5" of water each week to
evaporation
One inch of water lost = 625 gallons of water lost (assuming 1000 sq foot pool)
One gallon of water needs 10 BTU to raise it one degree
It took 62.5 therms of natural gas to heat those 625 gallons
Although it differs state to state and season to season, each therm costs between $1.00-$2.00
You just lost between $62.50-$125 per week (assuming you only
lost 1" of water)
That's can be a loss of $500/month
If your pool is larger -- or if you lost 1.5" instead of 1" of water -- you lost even more.
So what's the answer?
Since evaporation is the chief culprit of both indoor and
outdoor pool heat loss, the best way to reduce the effects would be the
addition of a thermal blanket.
On an
outdoor pool, the use of a thermal blanket translates into an energy savings of
60 - 80 percent.
On an indoor pool, the use of a thermal blanket translates
into an energy savings in upwards of 85 percent.
How long would it take for a thermal blanket to "pay for itself"?
Glad you asked! Generally, the payback time is 9 - 18 months.
Need more specifics?
Energy Smart Pools is a program that was written by the U.S.
Department of Energy to determine the annual cost savings generated by the use
of pool blanket systems.
The software takes into account the surface area of
the water, the flow of air across the surface, whether shading is present, the
water and room temperature, the size of the pump and ventilation motors, the
activity level, the relative humidity and fuel costs to derive the approximate
operating cost of the facility.
The system will calculate monthly energy costs
and also yields comparison costs for the same pool with a cover. This
information is invaluable as it relates to budgeting for a pool blanket system. [Download the DOE software]
Below are some actual examples of the energy savings calculated from actual examples when using pool covers and solar heating options. The assumptions of pool size, water temperature, air temperature, humidity etc. are also provided below.
Projected Pool Heating Costs / Savings
(Keep in mind that the Annual Heating Costs provided in the below chart are for 82 degree pools. Your therapy pool (89-94 degrees) will cost much more to heat -- and subsequently you will save much more with the use of a pool blanket. Also, natural gas costs have more than doubled since this chart was created, from 50 cents/therm to over 1.00/therm. Thus, you will need to more than double the annual heating cost estimate. Better yet, download the DOE software and do the number crunching yourself!).
City
Pool Type
Annual Heating Costs
Pool Cover Savings
Solar System Savings
Atlanta
Indoor
$4,598
$1,919
$1,314
Outdoor
$490
$421
$417
Boston
Indoor
$4,695
$2,028
$906
Outdoor
$1,389
$790
$565
Chicago
Indoor
$4,698
$1,996
$978
Outdoor
$1,042
$693
$648
Dallas
Indoor
$4,468
$1,881
$1,641
Outdoor
$250
$191
$176
Denver
Indoor
$4,097
$1,819
$1,302
Outdoor
$1,408
$858
$730
Kansas City
Indoor
$4,584
$1,992
$1,251
Outdoor
$483
$393
$369
Los Angeles
Indoor
$4,739
$2,087
$1,517
Outdoor
$5,827
$2,615
$1,512
Miami
Indoor
$4,038
$1,549
$2,023
Outdoor
$2,615
$1,452
$1,174
New York
Indoor
$4,567
$1,966
$1,021
Outdoor
$951
$627
$582
Philadelphia
Indoor
$4,567
$1,966
$1,021
Outdoor
$951
$627
$582
Phoenix
Indoor
$3,630
$1,669
$2,208
Outdoor
$4,094
$2,011
$1,402
Sana Francisco
Indoor
$4,869
$2,091
$1,315
Outdoor
$1,826
$924
$518
Seattle
Indoor
$4,743
$2,034
$639
Outdoor
$1,756
$818
$395
Input Variables for Above Examples
Variable
Outdoor
Indoor
Pool Surface Area
1000
1000
Pool Temperature
82°
82°
Pool Activity Level
low
low
Air Temperature
site specific
82°
Relative Humidity
site specific
50%
Wind Speed at Pool Surface
site specific
still air
Annual Operating Dates
May 20-Sep 5*
year around
Daily Operating Hours
9:00am-9:00pm
9:00am-9:00pm
Heating System Efficiency
75%
75%
Heating Fuel and Cost
Gas
$.50/therm
Gas
$.50/therm
Solar Collector Area
750 sqft
750 sqft
* Except for Los Angeles, Phoenix and
Miami which were year around.
High chloramine levels can cause illness
in those who spend time in or near indoor swimming pools.
And, quite frankly, it can be the aquatic therapists, instructors and other staff who come down with the symptoms instead of the public.
Why? A typical aquatic therapy or aquatic exercise client may attend the pool 3x/week for 30-60 minutes sessions. In contrast, therapists and instructors often spend 4-6 hours (if not more) in the water each day of the week.
There are now products created to prevent skin irritation. Try Sprint Chimal Skin Shield or Kiefer SwimScreen (these are lotions which prevent skin irritation with prolonged immersion).
So how do you know if you are being exposed to high chloramine levels? One recent study showed common symptoms include cough
and other respiratory symptoms (84%), eye irritation (78%) and rash (34%).
In another study of aquatic therapists, 44.4% reported the development of skin
disease for the first time after the beginning of work at the swimming pool. The most common symptoms included pruritus and erythematous patches affecting
mainly the extremities and trunk. Both smoking and increased exposure time increased the risk of acquiring a contact dermatitis.
The study concluded that contact dermatitis should be
recognized as an occupational disease in aquatic therapists.
Of special note: The prevalence of contact dermatitis in
pools chlorinated by gaseous chlorine was significantly higher than that in
pools disinfected by other forms of chlorine compounds.
ePro Learning online training to learn more about rashes and other contact dermatitis risks.
"Chemically Induced Rashes" article will help you decide if the rash you experience after pool time is due
to chemical irritation or to a bacterial infection. In a nutshell, take a look at the chart below.
"How long is too long" - article about length of time therapists should spend in the water.
Table 1 –
Comparison of rashes
Rashes caused by a chemical reaction
Rashes caused by a bacterial infection
Time to first symptoms
<24 hours, can be <10 minutes
>24 hours, often >2 days, occasionally up to 14 days
Duration of symptoms
Days to weeks
<14 days, usually 8 days
Typical appearance
Red itchy rash
Red rash (like bug bites if small or poison ivy if severe)
Many aquatics professionals are hearing reports
about swim meets where athletes have to queue up in the hallway because
the natatorium air is too polluted to breathe.
Similarly, therapists are beginning to complain about the air quality in their therapeutic pools. After all, its the therapists who are breathing the stuff 4-8 hours a day. Worse, what if you have asthma? Or are pregnant? Are you at risk?
In the past, we've been focused on ensuring the cleanliness of our pool water; we have been worried about RWI (recreational water illnesses). Unfortunately, no one was thinking about the offgasing of chemicals and byproducts that tend to hover about 18 inches above the water's surface (right where your intake valve is!)
According to Robert Kappel, Siemens Water Technologies, the health issues relating to disinfection byproducts (DBPs) and indoor
air contamination may soon overtake the concerns about recreational
waterborne illnesses (RWIs).
Aquatic professionals now have a respected source for the most current information about pool and spa accident and illness prevention with the Prevention Advisor™.
This free monthly e-newsletter is published by the National Swimming Pool Foundation® (NSPF®) as a service to pool and spa operators, service technicians, health officials, and other professionals committed to staying abreast of key prevention topics. The Prevention Advisor allows NSPF to keep pool professionals up-to-date on the latest improvements until they are ready to re-certify.
Each month, the Prevention Advisor contains information which focuses on a specific subject such as health and safety information, regulations and legal topics, training opportunities, preventive maintenance tips, research findings, and other important subject matter.
The Aquatic Resources Network gets questions from clinicians each day. We think everyone should learn from the answers!
Question: We have an interest and need to work with our residents in our therapy pool. However, several of these residents have incontinence issues (bladder and/or bowel). What products can you recommend that have been tried, tested and proven?
Answer: Incontinence often stands in the way for patients to experience the joys and triumphs associated with aquatic therapy. And although bowel incontinence can be a strong precaution -- or even a contraindication - for water therapy, bladder incontinence should not be.
Fecal contamination of pool water can cause serious illnesses. Ingestion of contaminated water while swimming, inhalation of water vapor above the pool surface, and body contact with pathogenic organisms and absorption through the skin, body orifices or open wounds while swimming can result in transmission of a variety of diseases.
To lessen the probability of fecal contamination, ask clients to use the toilet. Do not permit diaper changing at poolside. Request that patrons not use the pool if they are suffering from an illness that causes diarrhea or have had diarrhea in the past two weeks. Require the wearing of "swimsuit diapers" or tight fitting rubber/plastic pants by children who are not yet toilet trained or individuals who do not have bowel control. Request that patrons remove their street shoes when walking on the pool deck.
The Aquatic Resources Network gets questions from clinicians each day. We think everyone should learn from the answers!
Question: What kind of policy should we have regarding posting a lifeguard on duty at the pool? Are therapeutic pools held to the “public pool” standard?
Answer: There are over 100 bathing codes in effect in the U.S. and no two of them have identical wording concerning lifeguards. In most states, therapy pools are considered "public" pools and are subject to all the same codes and regulations as any other public pool in the state.
Some states have a “semi-public" or "special pool" or “therapeutic pool supervised by a licensed medical practitioner" category. Since surveillance requirements vary from state to state depending on the categorization, each practitioner should make himself aware of the requirements which pertain to his state or locality.
Regardless of whether or not a state code requires that lifeguards be posted, the facility is still required to provide a safe environment, and to provide rescue assistance and necessary First Aid.
The prevailing standard that public pools must hold to includes the following requirements:
The standard of care in the industry (in the U.S.) is the "10/20 Supervision Rule". Trained and qualified lifeguards must be posted in a way that they can observe and scan their entire area of responsibility once every 10 seconds, and respond to and manage an emergency situation within another 20 seconds.
Lifeguards should be properly dressed in uniforms (provided and paid for by the employer) and readily identifiable to patrons.
At least two certified or licensed lifeguards should be in attendance at all public pools at all times the pool is in operation.
Lifeguards should have no duties to perform other than the close general supervision of participants in water contact activities.
Lifeguards should be alert, rotate to a new position at least once every 40 minutes, and be given frequent relief breaks from surveillance duties.
The number of lifeguards should be adequate for the activities being conducted, the size and shape of the facility, and environmental conditions which might limit the ability to provide supervision.
Lifeguards should be at least 18 years old, medically fit, have good eyesight, be physically capable of meeting the demands of the job, possess current certifications or licenses (in lifeguarding, CPR, and First Aid) from a recognized training agency, have adequate specific training for the facility, and be qualified and practiced in emergency procedures and other job aspects including use of rescue equipment (a minimum of four hours/month inservice training).
Source: Osinski A. Aquatic Therapy Listserv. Aquatic Consulting Services: San Diego, CA; 2001. For more information: Aquatic Consulting Services, Phone (619) 224-3100, Hotline (900) 446-6075 x 820. Web: www.AlisonOsinski.com
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