New signs target 'code brown' incidents at the pool

When the lifeguard at the Finley Aquatic Center ordered everyone out of the pool Monday afternoon, Hanna Turbeville, along with many other parents, naturally assumed it was a "code brown" incident — the term used by parents and lifeguards alike for poop in the pool.

Once the Santa Rosa mom had shepherded her kids out of the water, she and others learned that a small child had actually vomited in the pool. Even so, a cleaning crew was dispatched and water testing soon followed.

With the summer season in full swing, potty accidents are once again a major concern among pool operators and, of course, swimmers.

This year, pool operators are posting new rules designed to keep swimmers healthy. The warning signs, required by a state law, order swimmers to stay out of the water if they currently have diarrhea or have experienced a bout within the last two weeks.

"That's a good rule," said Turbeville. "We definitely don't want any 'code browns.'"

It may seem like a no-brainer, but public health officials say there's a very good reason for the new signs.

The most common illness associated with recreational water is diarrhea, and a common cause of that is cryptosporidium, a parasite that can live in chlorinated water for days before it finally succumbs to the disinfectant. Local health officials said a person could be over their bout with diarrhea and still be "shedding" the parasite.

"For crypto, it's known that people can continue to shed the organism for up to two weeks," said Dr. Karen Holbrook, Sonoma County's deputy public health officer.

The new pool signs, which were mandated last September, are part of a number of recent revisions to the California Building Code that apply to public pool health and safety. These include such pool construction issues such as drain sizes and the steepness of pool sides.

But with the summer months here, its the diarrhea signs that are getting most of the attention.

The signs, which have drawn measures of disgust and support, are popping up at public pools across the state.

The city of Santa Rosa has not yet installed the diarrhea signs at its two pools. Don Hicks, aquatics supervisor for the Santa Rosa Recreation and Parks Department, said he is reviewing all safety- and health-related signs and is waiting on direction from county health officials.

However he stressed that health procedures are a high priority at both the Finley and Ridgway swim centers. He has been reviewing the possible installation of an ultraviolet sanitation system, a procedure that would be more effective in combating crypto.

The new rules are a response to the most recent public health safety science rather than any uptick in recreational water illness, Holbrook said.

"It is an evolving science of understanding," she said.

The Centers for Disease Control and Prevention have in recent years conducted a national study around swimming pool health violations and a surveillance of cryptosporidiosis, a gastrointestinal illness caused the chlorine-tolerant cryptosporidium.

These studies set the groundwork for the new state rule, Holbrook said.

Aside from the crypto parasite, diarrhea can also be caused by the giardia parasite, the shigella bacteria and the norovirus. But the most common, Holbrook said, is cryptosporidium.

The new rule applies to all public pools, which the state defines broadly as all pools that are used by the public, not just municipal pools. This includes school pools, apartment or condominium pools and pools at gyms, spas, tennis clubs or golf clubs.

Pool operators and managers are required to maintain proper levels of pH and chlorine in pools. Doing so should render most pool contaminants harmless.

"If the chlorine and the pH are at appropriate levels — if there is any fecal material — it's being disinfected," said Christine Sosko, Sonoma County's director of environmental health and safety.

But since cryptosporidium is so chlorine-tolerant, health officials are encouraging smart hygiene at the pool. These recommendations include the following:

-- Don't swallow pool water.

-- Don't swim when you have diarrhea.

-- Don't change diapers at the pool-side. Use bathrooms.

-- Parents should supervise kids and encourage bathroom breaks every hour.

-- Wash hands after using the bathroom, and the CDC recommends showering with soap before entering a public pool.

Health officials said the new diarrhea warning signs are a common-sense way to prevent disease. Most fecal contamination is a product of "accidents" and residual matter that remains on a person's body, such as a child's leg, and isn't completely cleaned, Holbrook said.

"Keeping public water facilities safe requires an ongoing joint effort from pool managers, environmental health inspectors and the public," she said.