4 Attachment 4 - AFMAN48-114.pdf

BY ORDER OF THE

SECRETARY OF THE AIR FORCE

AIR FORCE MANUAL 48-114

23 JULY 2019

Aerospace Medicine

RECREATIONAL WATERS AND

MISSION TRAINING POOLS

COMPLIANCE WITH THIS PUBLICATION IS MANDATORY

ACCESSIBILITY: Publications and forms are available on the e-Publishing website at www.e-Publishing.af.mil for downloading or ordering.

RELEASABILITY: There are no releasability restrictions on this publication.

OPR: AF/SG3/4PB

Supersedes: AFI48-114, 27 October 2014

Certified by: AF/SG/3/4

(Maj Gen Robert I. Miller)

Pages: 35

This publication implements requirements of AFPD 48-1, Aerospace and Operational Medicine

Enterprise. It provides guidance and procedures on the operation and maintenance of swimming pools, mission training pools, hot tubs and spas, splash pads, therapeutic pools, and natural bathing areas under Air Force (AF) jurisdiction. It applies to individuals at all levels who operate, maintain, and monitor swimming pools, mission training pools, hot tubs and spas, splash pads, therapeutic pools, and natural bathing areas AF-wide, including the Air Force Reserve and

Air National Guard (ANG), except where noted herein. This publication may be supplemented at any level, but all supplements must be routed to the Office of Primary Responsibility (OPR) listed above for coordination prior to certification and approval. Refer recommended changes and questions about this publication to the OPR listed above using the AF Form 847, Recommendation for Change of Publication; route AF Forms 847 from the field through the functional chain of command. The authorities to waive wing or unit level requirements in this publication are identified with a Tier (“T-0, T-1, T-2, T-3”) number following the compliance statement. See AFI 33-360, Publications and Forms Management, for a description of the authorities associated with the Tier numbers. Submit requests for waivers through the functional chain of command to the appropriate Tier waiver approval authority, or alternately, to the requestors commander for non-tiered compliance items. Ensure that all records created as a result of processes prescribed in this publication are maintained in accordance with Air Force Manual

33-363, Management of Records, and disposed of in accordance with Air Force Records

Information Management System Records Disposition Schedule. The use of the name or mark of any specific manufacturer, commercial product, commodity, training curricula, facility standards, or service in this publication does not imply endorsement by the Air Force.

2 AFMAN48-114 23 JULY 2019

SUMMARY OF CHANGES

This document has been substantially revised and must be completely reviewed. Major changes include: changed publication title; converted from an Air Force Instruction to an Air Force

Manual; updated water quality monitoring requirements and technical details to align with

United States Department of Health and Human Services Centers for Disease Control Model

Aquatic Health Code; and added specific requirements for swimming pools used for mission training purposes.

Chapter 1—PROGRAM OVERVIEW 4

1.1. Overview

1.2. Safety and Health Risk

Chapter 2—ROLES AND RESPONSIBILITIES 5

2.1. The Assistant Secretary of the Air Force for Installations, Environment, and

Energy (SAF/IEE)

2.2. The Air Force Surgeon General (AF/SG):

2.3. The United States Air Force School of Aerospace Medicine (USAFSAM)

2.4. The Air Force Civil Engineer Center (AFCEC)

2.5. The Air Force Safety Center (AFSEC)

2.6. The Air Force Services Activity (AFSVA)

2.7. Major Commands (MAJCOM)

2.8. Installation Commander shall:

2.9. The Installation Civil Engineer (CE) shall:

2.10. Installation Occupational Safety (SEG)

2.11. Installation Public Health shall:

2.12. Installation BE (BE) shall:

2.13. The Outdoor Recreation Manager shall:

2.14. Lifeguards shall:

Chapter 3—GENERAL OPERATION AND MAINTENANCE 8

3.1. Safety

3.2. Sanitation

3.3. Pool treatment plant operation

AFMAN48-114 23 JULY 2019 3

Chapter 4—WATER QUALITY AND MONITORING 12

4.1. Swimming Pools, Hot Tubs and Spas, and Splash Pads

Table 4.1. Water Quality Requirements for Swimming Pools, Hot Tubs, Spas, Splash Pads. . 13

4.2. Natural Bathing Areas

4.3. Bacteriological Monitoring for Swimming Pools, Hot Tubs and Spas, and Natural

Bathing Areas

4.4. Responding to a Fecal, Vomit, or Blood Incident

Chapter 5—MISSION TRAINING POOLS 20

5.1. Overview

5.2. Mission Training Pool Managers shall:

5.3. Odor Complaints and Breathing Difficulties

5.4. Maintenance

5.5. Construction

Table 5.1. Water Quality Requirements for Mission Training Pools

Attachment 1—GLOSSARY OF REFERENCES AND SUPPORTING INFORMATION 24

Attachment 2—CONSIDERATIONS FOR REVIEWING BATHING FACILITY

DESIGNS 29

Attachment 3—SAFETY AND HEALTH RULES 31

Attachment 4—CONSIDERATIONS FOR SITING OF NATURAL BATHING AREAS 33

Attachment 5—WATER CONTAMINATION RESPONSE RECORDKEEPING 34

Attachment 6—SUPERCHLORINATION AND HYPERCHLORINATION 35

4 AFMAN48-114 23 JULY 2019

Chapter 1

PROGRAM OVERVIEW

1.1. Overview. This publication establishes guidance and procedures for identifying, analyzing, and controlling health and safety risks for aquatic venues such as swimming pools, mission training pools, hot tubs and spas, therapeutic pools, splash pads, and natural bathing areas on AF installations. There is no federal regulation to govern the water quality of these aquatic venues, or to prohibit swimming in natural bathing areas. This instruction outlines the minimum requirements for guidance, extracted from the United States Department of Health and Human

Services Centers for Disease Control Model Aquatic Health Code, 3rd Edition and the

Environmental Protection Agency (EPA) criteria identified in Title 40, Code of Federal

Regulations (CFR) Part 131, Water Quality Standards. These procedures require collaboration among Bioenvironmental Engineering (BE), the Base Civil Engineer (CE), Force Support

Squadron (FSS), Public Health (PH), and Occupational Safety (SEG).

1.2. Safety and Health Risk. Swimming pools, mission training pools, hot tubs and spas, splash pads, therapeutic pools, and natural bathing areas can present multiple safety risks, such as drowning, slips and falls, and accidents with ladders, ropes, or drains. In addition, these facilities present health risks that include infectious disease, excess combined chlorine, and other contaminants which may be transmitted to humans via the water.

AFMAN48-114 23 JULY 2019 5

Chapter 2

ROLES AND RESPONSIBILITIES

2.1. The Assistant Secretary of the Air Force for Installations, Environment, and Energy

(SAF/IEE). The Assistant Secretary of the Air Force for Installations, Environment, and Energy

(SAF/IEE) shall provide guidance, direction, and oversight for Environment, Safety, and

Occupational Health Programs.

2.2. The Air Force Surgeon General (AF/SG):

2.2.1. Ensures AF swimming pools, mission training pools, hot tubs and spas, splash pads, therapeutic pools, and natural bathing areas are properly surveyed, sampled, analyzed, and monitored to provide a healthy and safe swimming, bathing, and workplace environment.

2.2.2. Establishes resources for health oversight of AF swimming pools, mission training pools, hot tubs and spas, splash pads, therapeutic pools, and natural bathing areas to protect public health.

2.2.3. Develops AF implementation standards to promote a clean, healthful, and safe swimming environment and workplace.

2.2.4. Advocates for funding or oversees budgeting, programming, and execution of AF/SG responsibilities for swimming pools, mission training pools, hot tubs and spas, therapeutic pools, and natural bathing areas.

2.3. The United States Air Force School of Aerospace Medicine (USAFSAM). The United

States Air Force School of Aerospace Medicine (USAFSAM) provides technical guidance and consultative support for water quality and health risk assessments for AF swimming pools, mission training pools, hot tubs and spas, therapeutic pools, and natural bathing areas. (T-1)

2.4. The Air Force Civil Engineer Center (AFCEC). The Air Force Civil Engineer Center

(AFCEC) provides technical assistance on environmental regulatory requirements and design and maintenance requirements related to swimming pools, mission training pools, hot tubs and spas, splash pads, therapeutic pools, and natural bathing areas.

2.5. The Air Force Safety Center (AFSEC). The Air Force Safety Center (AFSEC) provides technical assistance on safety issues related to swimming pools, hot tubs and spas, splash pads, therapeutic pools, and natural bathing areas.

2.6. The Air Force Services Activity (AFSVA). The Air Force Services Activity (AFSVA) develops policy and guidance related to day to day operation of AF swimming pools, mission training pools, hot tubs and spas, splash pads, and natural bathing areas.

2.7. Major Commands (MAJCOM). Major Commands (MAJCOM) provide technical assistance and policy guidance to installations to ensure the recreational water and mission training pool programs conform to this instruction.

2.8. Installation Commander shall:

2.8.1. Oversee overall operation and maintenance of swimming pools, mission training pools, hot tubs and spas, splash pads, therapeutic pools, and natural bathing areas under Air

Force jurisdiction.

6 AFMAN48-114 23 JULY 2019

2.8.2. Approve locations of all natural bathing areas, with input from the medical group commander or director. Natural bathing area approvals shall be based on the considerations in Attachment 4. (T-1)

2.9. The Installation Civil Engineer (CE) shall:

2.9.1. Construct and maintain swimming pools, mission training pools, hot tubs and spas, therapeutic pools, and splash pads as outlined in this manual, AFI 32-1022 Planning and

Programming Nonappropriated Fund Facility Construction Projects; AFMAN 32-1084

Facility Requirements; Unified Facilities Criteria (UFC) 3-230-02 Operation &

Maintenance: Water Supply Systems; United Facilities Guide Specifications GS 22-00-00

Plumbing, General Purpose; Public Law 110-140, Energy Independence and Security Act of

2007; and Title 15 United States Code Sections 8001-8008, Virginia Graeme Baker Pool and

Spa Safety Act. (T-0)

2.9.2. Designate a pool treatment plant manager and ensure that he or she maintains and operates the pool equipment and keeps records as outlined in this instruction and in accordance with UFC 3-230-02 (T-0)

2.9.3. In coordination with Force Support Squadron, address access and suitability of natural bathing areas for swimming and other outdoor recreation activities in the Integrated Natural

Resources Management Plan. (T-2)

2.10. Installation Occupational Safety (SEG). Installation Occupational Safety (SEG).

Installation Occupational Safety (SEG). Installation Occupational Safety (SEG) shall provide consultation and advice related to safety issues for swimming pools, mission training pools, hot tubs and spas, therapeutic pools, and natural bathing areas. (T-1)

2.11. Installation Public Health shall:

2.11.1. Perform epidemiological monitoring for potential disease outbreaks associated with bathing areas according to AFI 48-105, Surveillance, Prevention, and Control of Disease and

Conditions of Public Health or Military Significance, and report potential recreational water illness (RWI) outbreaks to the appropriate offices. (T-1)

2.11.2. Provide oversight of sanitation practices for swimming pools, mission training pools, hot tubs and spas, therapeutic pools, natural bathing areas, showers, and toilets. (T-1)

2.12. Installation BE (BE) shall:

2.12.1. Identify, analyze, and recommend controls for any occupational and environmental health (OEH) hazards due to daily operations, processes, and locations of pools, mission training pools, hot tubs and spas, and natural bathing areas. (T-1)

2.12.2. Provide water quality oversight, including review of AF Form 708, Swimming Pool

Operational Log, of swimming pools, mission training pools, hot tubs and spas, splash pads, therapeutic pools, and natural bathing areas under Air Force jurisdiction. (T-1)

2.12.3. Provide bacteriological monitoring in support of specific requests attributable to disease outbreaks. (T-1)

2.12.4. Review engineering designs for new or modified swimming pools, mission training pools, hot tubs and spas, splash pads, therapeutic pools, and associated equipment and

AFMAN48-114 23 JULY 2019 7

facilities to ensure adequacy of sanitary processes and controls. See Attachment 2 for potential considerations when reviewing bathing facility designs. (T-3)

2.13. The Outdoor Recreation Manager shall:

2.13.1. Oversee the day-to-day operation of public bathing facilities in accordance with AFI

34-110, Air Force Outdoor Recreation Programs, to provide patrons with sanitary and safe conditions and employees with a safe, healthful workplace. (T-1)

2.13.2. Appoint certified (where applicable) bathing facility personnel. (T-1)

2.13.3. Train and equip bathing facility personnel (i.e., lifeguards or other outdoor recreation personnel) to perform required routine chemical testing as indicated in Table 4.1, and to document these measurements on AF Form 708. (T-1)

2.13.4. Retain documentation of training required in paragraph 2.16.3. (T-3)

2.13.5. Obtain approval of BE and CE before purchasing chemical testing equipment and implementing training required in paragraph 2.1.4.3.(T-3)

2.13.6. Ensure all bathing facility personnel are properly trained in cleaning up body fluid spills on pool surfaces. (T-1)

2.13.7. Ensure one biohazard kit per pool or waterfront is available to clean up blood or other potentially infectious material from pool decks or locker rooms, in accordance with

AFI 34-110. (T-1)

2.13.8. Coordinate pre-opening and semi-annual facility inspections with appropriate agencies.

2.13.9. For installation swimming pools shared for use by mission training, establish a signed agreement with the mission training point of contact, to specify how and when water quality monitoring is accomplished by the mission training organization. (T-1)

2.13.10. Ensure routine chemical measurements outlined in this instruction are performed by lifeguards or other qualified bathing facility personnel. (T-1)

2.14. Lifeguards shall:

2.14.1. Enforce healthful and safe pool practices and rules. (T-3)

2.14.2. Hold current lifesaving, first aid, and cardiopulmonary resuscitation (CPR) certifications in accordance with AFI 34-110. (T-1)

2.14.3. Notify outdoor recreation manager when biohazard kit is used and needs replacement. (T-3)

2.14.4. Perform routine chemical measurements outlined in this instruction. (T-1)

2.14.5. Complete AF Form 708 or equivalent, daily, and as indicated by Table 4.1. (T-1)

2.14.6. Contact Base Civil Engineer and BE immediately when water quality parameters fall outside acceptable ranges. (T-1)

8 AFMAN48-114 23 JULY 2019

Chapter 3

GENERAL OPERATION AND MAINTENANCE

3.1. Safety.

3.1.1. Rules and Signs. The outdoor recreation manager shall establish rules in coordination with Installation Public Health and Occupational Safety. Rules must include, at a minimum, the rules in Attachment 3. (T-1)

3.1.1.1. The rules shall be posted so they are clearly visible to patrons entering the pool area or sitting in the hot tub or spa. (T-1)

3.1.1.2. A copy of these rules and this instruction shall be posted at the facilities for the bathing facility staff, pool operators, and patrons. (T-2)

3.1.2. Natural Bathing Areas. The outdoor recreation manager, in coordination with Public

Health, Occupational Safety, and CE shall jointly establish safety and warning guidelines for hazards particular to the bathing area. For example, marine bathing beaches shall warn swimmers of the possible presence of rip tides, jellyfish, stingrays, or other potentially dangerous aquatic life. Also, post a sign indicating that swimming with no lifeguard present is at the bather’s own risk. If the area is to be marked, clearly define and mark swimming areas and mark the outermost limits at regular intervals with buoys or similar devices, bearing signs warning all watercraft to keep out. Post signs on offshore floats or rafts indicating whether or not diving is permitted. Clearly post a sign at a dedicated emergency phone, indicating emergency telephone numbers. (T-1)

3.1.2.1. If diving from offshore rafts or floats is permitted, pre-operational or semiannual inspections should include an underwater survey for hazards and minimum safe water depth.

3.1.3. Pool Opening. The outdoor recreation manager and mission training pool manager shall coordinate with BE, Public Health, CE, and Occupational Safety to conduct a pre-opening inspection of seasonal swimming pools, mission training pools, hot tubs and spas, splash pads, and natural bathing areas no later than three weeks before swimming season starts. (T-1)

3.1.3.1. The outdoor recreation manager, mission training pool manager, and pool treatment plant manager shall ensure all chemical operational parameters are in acceptable limits no later than 7 days prior to opening. (T-3)

3.1.3.2. The outdoor recreation manager shall approve the opening based upon the recommendations provided during the inspection. (T-1)

3.1.3.3. For facilities open year-round, semi-annual inspections and approvals are required. (T-1)

3.1.4. Pool Closure. The outdoor recreation manager and mission training pool manager shall immediately close the swimming pool, mission training pool, spa or hot tub, therapeutic pool, or splash pad if any of the following water quality conditions occur:

3.1.4.1. The water fails clarity test; (T-1)

AFMAN48-114 23 JULY 2019 9

3.1.4.2. The pH, disinfectant residual (i.e., free available chlorine), combined chlorine, or oxidation reduction potential (ORP) level is outside acceptable range identified in Table

4.1 (T-1)

3.1.4.3. Fecal or vomit accident in the pool. (T-1)

3.1.5. Emergency Preparedness. The outdoor recreation manager shall prepare for emergencies by implementing the following requirements:

3.1.5.1. Maintain the required safety and rescue equipment in accordance with AFI 34-

110. (T-1)

3.1.5.2. When feasible, ensure the availability of an Automatic External Defibrillator

(AED). When available, the location of the AED shall be clearly marked and readily available for use in the event of an emergency. Follow procedures outlined in AFI 44-

177, Public Access Defibrillator Program, for AED use. (T-3)

3.1.6. Adverse Weather Conditions. The outdoor recreation manager shall follow procedures in AFMAN 91-203, Air Force Occupational Safety, Fire, and Health Standards, when lightning or other adverse weather conditions are present. (T-1)

3.1.7. Pump Room and Chemical Storage Areas. The outdoor recreation manager shall maintain a safe pump room and chemical storage area by implementing the following requirements:

3.1.7.1. Lighting. The pump room area shall be well-lighted. (T-1)

3.1.7.2. Supervisors, who have personnel handling chemicals, will follow the requirements found in AFMAN 91-203 Chapter 14, Personal Protective Equipment

(PPE). (T-1)

3.1.7.3. All openings and holes in the floor shall be covered by a covering that will not become dislodged unintentionally. It is permissible to install posts with chains, or similar devices, which will prevent accidental entry in the opening. Drains shall be covered with an appropriate drain cover. (T-1)

3.1.7.4. Chemicals shall only be stored with compatible chemicals. Dry chemicals shall be stored on a pallet or other device that prevents contact with the ground. (T-1)

3.1.7.5. Chemicals shall be stored in appropriate containers, which are in good repair and free of leaks. (T-1)

3.1.7.6. Containers, storage cabinets, and rooms containing chemicals shall be labeled or placarded in accordance with all applicable federal laws and regulations, as well as installation policies and guidelines. (T-1)

3.1.7.7. Entry points to rooms in which containers of five (5) or more gallons of a liquid chemical are stored in a single container shall have the appropriate National Fire

Protection Association placard posted. (T-1)

3.1.7.8. All containers, including spray bottles, containing chemicals, not filled by the chemical manufacturer, shall be properly labeled with a National Fire Protection

Association label and have the chemical name and manufacturer name clearly written on the label or bottle. (T-1)

10 AFMAN48-114 23 JULY 2019

3.1.7.9. Cabinets that are used for chemical storage shall have the appropriate National

Fire Protection Association placard indicating the hazards presented by the contents. (T-

1)

3.1.7.10. Equipment Storage. Excess equipment and supplies being stored shall be done in a manner that does not create a tripping or other safety hazard. When possible, items shall be stored on shelving or in containers that are resistant to corrosion. (T-1)

3.1.7.11. Proper footwear shall be worn in all pump rooms and chemical storage rooms.

(T-1)

3.1.7.12. Pump rooms and chemical storage areas should be locked when not accessed by outdoor recreation manager and/or delegated officials. (T-3)

3.2. Sanitation. The outdoor recreation manager shall maintain a sanitary environment by implementing the following requirements:

3.2.1. Clean toilets, shower facilities, and dressing rooms in accordance with AFI 48-117, Public Facility Sanitation. (T-1)

3.2.2. Drain and clean recirculation filter pools, spas, and hot tubs in accordance with paragraph 4.1.5. Coordinate draining with designated Base Civil Engineer personnel. (T-2)

3.2.3. Clean pools daily with a suction cleaner or other bottom-cleaning device. (T-2)

3.2.4. Drain and clean non-circulation wading pools with a 50 parts per million (ppm) chlorine solution daily. Note: To mix a 50 ppm chlorine solution, add one teaspoon of household bleach to each gallon of water. (T-2)

3.2.5. Ensure pools and hot tubs and spas equipped with overflow gutters are overflowed each day to remove scum and surface debris. Maintain the water in pools equipped with only surface skimmers at a level such that the skimmer continuously operates. (T-2)

3.2.6. Ensure pool deck and area surrounding a spa or hot tub are free of debris.

Furthermore, when pooling of water occurs on pool deck and if matting is used over a concrete surface (such as ventilated plastic matting), routinely clean the surface with a 50 ppm chlorine solution. (T-2)

3.2.7. Establish and follow cleaning and maintenance (e.g., raking) schedules for managed beach areas. (T-3)

3.2.8. Designate picnic areas near the beach and provide waste receptacles. Prohibit picnicking and bottles and cans for food and drink on the beach proper. (T-3)

3.3. Pool treatment plant operation. (Note: Explanations of the different types of swimming pool treatment are found in the Centers for Disease Control and Prevention 2018 Annex to the

Model Aquatic Health Code, 3rd Edition.)

3.3.1. The pool treatment plant manager shall maintain a piping diagram of water and sewer lines and post a copy near the pool chemical equipment. (T-1)

3.3.2. During months that pools are open, the pool treatment plant manager shall complete the monthly operating checklist for swimming pools, as written in the current edition of the

UFC 3-230-02. (T-0)

AFMAN48-114 23 JULY 2019 11

3.3.3. The pool treatment plant manager shall ensure excess pool water is discharged to the local sanitary sewer in compliance with 40 CFR 122, EPA Administered Permit Programs:

The National Pollutant Discharge Elimination System, and local treatment works ordinances and dechlorination requirements. (T-0)

12 AFMAN48-114 23 JULY 2019

Chapter 4

WATER QUALITY AND MONITORING

4.1. Swimming Pools, Hot Tubs and Spas, and Splash Pads.

4.1.1. Source Water. The pool, hot tub, spa, and splash pad treatment plant manager shall ensure the pool, hot tub, spa, and splash pad water comes from an approved drinking water source. (T-1)

4.1.2. Chemical Operational Parameters. The pool, hot tub, spa, and splash pad treatment plant manager shall measure for parameters indicated in Table 4.1 at intervals specified, making corrective actions to meet the guidelines or informing the facility manager of additional treatments recommended. (T-1)

4.1.2.1. Detailed information on parameters can be found in the Centers for Disease

Control and Prevention 2018 Annex to the Model Aquatic Health Code, 3rd Edition at https://www.cdc.gov/mahc/editions/index.html.

4.1.2.2. The lifeguard or other bathing facility personnel shall measure for parameters indicated in Table 4.1 at intervals specified. (T-1)

4.1.2.3. All samples shall be obtained from a location with the following qualities:

4.1.2.3.1. At least 18 inches (45.7 centimeters) below the surface of the water.

4.1.2.3.2. A pool water depth of between 3 and 4 feet (91.4 centimeters to 1.2 meters) when available.

4.1.2.3.3. A location between water inlets. (T-2)

4.1.2.3.4. Sampling locations shall rotate around the shallow end of the pool. (T-2)

4.1.2.3.5. Sampling locations shall include a deep end sample in the water sampling rotation once per week. (T-2)

4.1.2.4. The values shall be recorded on the AF Form 708 or equivalent. If results are outside the acceptable range indicated in Table 4.1, immediately contact BE and the pool, hot tub, spa, or splash pad treatment plant manager. (T-1)

4.1.2.5. Quality Check. BE shall perform quality checks of the lifeguard or bathing facility personnel’s and mission pool manager’s pH and disinfectant residual measuring proficiency. These quality checks will occur at least once every 30 days while the pool, hot tub, spa, or splash pad is operating, and applies to both indoor and outdoor pools, hot tubs and spas, and splash pads. BE will measure the pH and disinfectant residual levels, enter the results on the AF Form 708 or equivalent, and compare the results to the lifeguard, bathing facility personnel, or mission pool manager’s readings. If the readings are inconsistent with the lifeguard, bathing facility personnel, or mission pool manager results, BE shall determine the cause of the discrepancy and ensure the lifeguards, bathing facility personnel, or mission pool managers are following the correct measurement procedures. BE shall increase the frequency of quality checks if needed to ensure that discrepancies are corrected. (T-1)

AFMAN48-114 23 JULY 2019 13

4.1.2.6. Increased Risk Aquatic Venues. Water quality monitoring and chemical operational parameters for therapeutic pools, splash pads, and wading pools shall be the same as defined for swimming pools in Table 4.1. (T-1) Requirements for mission training pools are defined in Chapter 5.

4.1.2.7. The Medical Group Commander may establish more stringent or specific monitoring requirements than outlined in this instruction.

Table 4.1. Water Quality Requirements for Swimming Pools, Hot Tubs, Spas, Splash Pads.

Parameter Acceptable

Range

Ideal Applicability Monitoring

Frequency

Responsible

Organization

Free available chlorine

(FAC)*

1.0 – 4. 0 ppm* Pools and splash pads

Prior to opening

&

every 2 hours

(manual disinfectant system);

Prior to opening

& every 4 hours

(automated disinfectant system)

Outdoor recreation manager, lifeguard, or other bathing facility personnel

3.0 – 5.0 ppm Hot tubs and spas

Bromine 3.0 – 8.0 ppm Pools and splash pads

Every 2 hours Outdoor recreation manager, lifeguard, or other bathing facility personnel

4.0 – 8.0 ppm Hot tubs and spas

Every hour pH 7.2 -7.8 Pools, splash pads, hot tubs and spas

Every 2 hours Outdoor recreation manager, lifeguard, or other bathing facility personnel

Total alkalinity

60 – 180 ppm Pools and splash pads

Once per week Outdoor recreation manager, lifeguard, or other bathing facility

Hot tubs and spas

Weekly

14 AFMAN48-114 23 JULY 2019

Parameter Acceptable

Range

Ideal Applicability Monitoring

Frequency

Responsible

Organization personnel

Calcium hardness

Not to exceed

(NTE) 2,500

ppm

200 –

400 ppm

Pools and splash pads

Monthly Pool

Treatment

Plant

Manager 100 –

200 ppm

Hot tubs and spas

Total

Dissolved

Solids

(TDS)

NTE 1500 ppm above the concentration in the fill water

Pools, splash pads, hot tubs and spas

Quarterly Pool

Treatment

Plant

Manager

Clarity

The bottom of the pool at its deepest point must be clearly visible and sharply defined from any point on the deck up to

30 ft. away in a direct line of sight. Perform this test when water is in a non-turbulent state.

Pools and splash pads

Daily Outdoor recreation manager, lifeguard, or other bathing facility personnel

The bottom of the spa at its deepest point shall be clearly visible. Perform this test when water is in a non-turbulent state and bubbles have dissipated.

Pools, splash

Outdoor manager, lifeguard, or other bathing facility personnel

Cyanuric

Acid (CYA)

Ideal concentration is between 25-50 ppm, but must not exceed 90 ppm

Pools, splash pads, hot tubs and spas using CYA as a stabilizer

Monthly unless the pool utilizes stabilized chlorine as its primary disinfectant, then it shall be tested every two weeks. It

Base Civil

Engineer personnel, if used

AFMAN48-114 23 JULY 2019 15

Range

Ideal Applicability Monitoring

Frequency

Responsible

Organization shall be tested

24 hours after the addition of

CYA to the pool; for salt water pools, monitoring may be required more frequently -consult the manufacturers' instructions for appropriate frequency

Oxidation

Reduction

Potential

(ORP)

Greater than 720 mV if using a silver or silver chloride electrode;

Greater than 680 mV if using a calomel electrode

Not a required parameter;

however may supplement direct measurement of disinfectant residual as indicator of water quality

Not a required parameter; if used, recommend at least daily readings at same time

FAC and pH readings are performed

Base Civil

Engineer personnel, if used

Salt Pools, splash pads, hot tubs and spas using in-line electrolytic chlorinators

At least weekly, or per the manufacturer’s instructions

Base Civil

Engineer personnel, if used

Temperature Maximum 104°F Pools, splash

Prior to opening and every two hours (manual disinfectant system) or every four hours

(automated disinfectant system) at the same time the

FAC and pH

Outdoor recreation manager, lifeguard, or other bathing facility personnel

16 AFMAN48-114 23 JULY 2019

Range

Ideal Applicability Monitoring

Frequency

Responsible

Organization tests are performed

Algae No visible algae in water or on pool surfaces when open to swimmers

Pools, splash

Continuous Outdoor manager, lifeguard, or other bathing facility personnel

Combined chlorine

0 – 0.4 ppm

0 ppm Pools, splash

Every 2 hours Outdoor manager, lifeguard, or other bathing facility personnel

Saturation

Index

-0.3 to +0.3 Pools, splash pads, hot tubs and spas

Monthly Base Civil

Engineer personnel

Copper or

Silver

Per manufacturer’s recommendations

Pools, splash pads, hot tubs and spas utilizing copper or silver systems

Daily Outdoor recreation manager, lifeguard, or other bathing facility personnel

*Pools using cyanuric acid shall maintain a minimum FAC concentration of 2.0 ppm

4.1.3. Test Kits.

4.1.3.1. Water quality testing devices and kits shall be stored and maintained as specified by the manufacturer’s instructions. Failure to properly store water quality testing devices will result in incorrect readings. (T-1)

AFMAN48-114 23 JULY 2019 17

4.1.3.2. Water quality testing devices shall be listed and labeled to NSF (NSF

International, formerly National Sanitation Foundation)/ANSI (American National

Standards Institute) 50 by an ANSI-accredited certification organization. (T-2)

4.1.3.3. A hazardous chemical list shall be maintained on site to provide a list of the chemicals used in the swimming pool and surrounding deck, in accordance with AFI 90-

821, Hazard Communication (HAZCOM) Program. These records shall include the expiration date for water quality chemical testing reagents. (T-1)

4.1.4. The pool treatment plant manager shall superchlorinate the pool as necessary to correct poor water quality and shall annotate each instance of superchlorination on AF Form

708 or equivalent. (T-3)

4.1.5. Water Replacement. Many contaminants enter pool and spa water from the environment, from the bathers themselves, and from byproducts of chemicals used to treat the water. Although filtration and oxidation are effective in removing many of these contaminants, many of them remain and accumulate in the water. In pools and hot tubs and spas, water replacement is generally the only practical way to correct for excessive contaminants, calcium hardness, total dissolved solids, and cyanuric acid. Water replacement can be accomplished by periodic draining or continuous dilution; however, continuous dilution does not preclude the need for periodic draining and thorough cleaning of the pool or spa.

4.1.6. Turnover Rate. The turnover rate is the time taken for all of the water in a pool to be circulated through the pump-filter system. The turnover rate is calculated by the following formula: Turnover rate (hours) = Pool volume (gal) ÷ Flow rate (gal/min) ÷ 60 (min/hour).

To determine the flow rate required to achieve a turnover rate of 6 hours, use the following formula: Flow rate (gal/min) = Pool volume (gal) ÷ 360 min.

4.1.6.1. Turnover rate for swimming pools shall not exceed 6 hours, or 360 minutes. (T-

2)

4.1.6.2. The turnover rate for wading pools and baby pools shall be one hour. (T-1)

4.1.6.3. The turnover rate for splash pads shall be 30 minutes. (T-1)

4.1.6.4. The turnover rate for hot tubs and spas, therapeutic pools, and mission training pools shall be four hours or less. (T-1)

4.1.7. Troubleshooting. Refer to UFC 3-230-02 for a troubleshooting checklist for swimming pools. The UFC are maintained on the Whole Building Design Guide website, at www.wbdg.org.

4.2. Natural Bathing Areas.

4.2.1. Risk-Based Sampling. BE shall perform water quality sampling at natural bathing areas based on risk. Risk factors to consider include, but are not limited to, proximity to suspected pollution sources, frequency of bathing area use, historical water quality data, and occurrence of sewage spills or other pollution events. If local or state regulatory agencies have current data, those data may be used and BE can determine what, if any, additional parameters need to be evaluated. If BE decides not to sample at natural bathing areas, the rationale behind the decision shall be documented. This documentation must be reviewed and updated at least annually. (T-2)

18 AFMAN48-114 23 JULY 2019

4.2.2. Sampling Methods. If bacteriological sampling is conducted, refer to 40 CFR 131.41, Bacteriological criteria for those states not complying with Clean Water Act section

303(i)(1)(A). for guidance. E.coli and Enterococci shall be used as the indicator organisms for evaluating the microbiological suitability of the water in freshwater natural bathing areas.

Enterococci shall also be used as the indicator organism in marine (i.e., salt) waters, and

Enterolert® or any equivalent method that measures viable criteria, as indicated in 40 CFR

Part 136, Guidelines establishing test procedures for the analysis of pollutants, shall be used.

For E.coli, Colilert® or any equivalent method that measures viable criteria, as indicated in

40 CFR Part 136 shall be used. All sampling shall follow guidance in Standard Methods for the Examination of Water and Wastewater, current edition. The use of certified laboratories for bacteriological analyses is not required if BE adheres to Standard Methods. (T-0)

4.2.3. Additional Sampling. Additional sampling shall be conducted when: (T-1)

4.2.3.1. A bacterial concentration exceeds the applicable water quality standard identified in 40 CFR 131.41.

4.2.3.2. A storm, sewage spill, or pollution event occurs that could affect the natural bathing area.

4.3. Bacteriological Monitoring for Swimming Pools, Hot Tubs and Spas, and Natural

Bathing Areas. BE will provide bacteriological monitoring only in support of specific requests attributable to disease outbreaks. (T-3) If sampling is performed, and bacteriological water quality of pools, hot tubs and spas, or natural bathing areas does not meet standards, BE shall:

4.3.1. Recommend closure of the pool, spa, hot tub, or natural bathing area until the area meets standards. (T-1)

4.3.2. Collect repeat sample from the points of previous collection. (T-1)

4.3.3. Conduct an immediate investigation to determine if any unusual conditions such as repairs to facilities, storms, spills, etc. might have caused a problem. For pools and hot tubs and spas, Base Civil Engineer personnel shall determine if the filtration and disinfection systems have been operating properly. (T-1)

4.3.4. Ensure pH and disinfectant residuals are within acceptable ranges for pools and hot tubs and spas. (T-1)

4.3.5. Notify Public Health whenever conditions are encountered which may pose a health hazard to patrons. (T-1)

4.3.6. If the results of the re-sample again exceed standards, hyperchlorination of pools and spas and hot tubs may be required. (T-1).

4.3.7. Public Health shall take any measures deemed necessary to initiate surveillance or investigate the occurrence of illnesses associated with unhealthy water quality. (T-1)

4.4. Responding to a Fecal, Vomit, or Blood Incident. Fecal and vomit incidents in the pool require hyperchlorination to disinfect the pool because of the risk of contamination by Giardia and Cryptosporidium organisms, which may be present in stool but are resistant to chlorine. The risk posed by potential bloodborne pathogens is greatly diminished by dilution and normal free available chlorine levels; therefore blood contamination of a properly maintained pool does not require hyperchlorination, and does not pose a public health risk to swimmers.

AFMAN48-114 23 JULY 2019 19

4.4.1. Procedures. Respond in accordance with sections 6.5.2. - 6.5.3 of the United States

Department of Health and Human Services Centers for Disease Control and Prevention

Model Aquatic Health Code, 3rd Edition, July 2018.1

4.4.2. Surface Contamination Cleaning and Disinfection. If a bodily fluid, such as feces, vomit, or blood, has contaminated a surface in or around a pool, spa, or hot tub, complete remediation procedures in section 6.5.4. of the Model Aquatic Health Code, 3rd Edition, July

2018.

4.4.3. Recordkeeping. Outdoor recreation managers shall document each incident by recording date and time of the event, whether it involved vomit, blood, formed stool or diarrhea, and the free chlorine and pH levels at the time of observation of the event. Before reopening the pool, record the free chlorine and pH levels and the procedures followed in response to the incident (including the process used to increase chlorine levels if necessary).

An example log is at Attachment 5. These records shall be kept for a minimum of 3 years.

(T-1)

1 United States Department of Health and Human Services Centers for Disease Control and Prevention. Model Aquatic Health Code, 3rd Edition, July 2018. https://www.cdc.gov/mahc/editions/current.html

20 AFMAN48-114 23 JULY 2019

Chapter 5

MISSION TRAINING POOLS

5.1. Overview. Mission training operations require frequent and extensive training in aquatic environments. Special considerations are required due to the unique nature of activities occurring in the mission training pool. Trainees wear clothing or battle gear while in the pool, remain in the pool for extended periods of time, and practice a variety of vigorous movements in the pool.

There are also times when high numbers of trainees are in the pool at one time. These factors can lead to an increased risk of unhealthy levels of some water quality parameters in the pool, especially combined chlorine. Combined chlorine forms when organic material in the water

(e.g., dirt, perspiration, urine) reacts with the free chlorine in the pool. Excess combined chlorine can lead to strong objectionable odors and respiratory problems, as well as eye, mucous membrane, and skin irritation.

5.2. Mission Training Pool Managers shall:

5.2.1. Operate, maintain, and ensure water quality monitoring of pools used only for mission training. (T-1)

5.2.2. Perform routine chemical measurements outlined in this instruction. (T-1)

5.2.3. Complete AF Form 708, or equivalent, daily, and as indicated by Table 5.1. (T-1)

5.2.4. Contact Base Civil Engineer personnel and BE immediately when water quality parameters fall outside acceptable ranges. (T-1)

5.2.5. Participate in all safety inspections of the facility. (T-1)

5.2.6. Ensure that uniforms and boots are hosed clean of all visible debris prior to pool entry with fresh water. (T-1)

5.2.7. Provide necessary equipment (such as basins and brushes) to clean boots in the shower room prior to pool entry. (T-1)

5.2.8. Require periodic rest breaks to allow trainees to exit the pool to use the restroom.

This should preclude any accidental urination in the pool. (T-1)

5.3. Odor Complaints and Breathing Difficulties. When complaints regarding odor or respiratory health occur:

5.3.1. Use a diethyl-p-phenyleneldiamine (DPD) test kit to monitor combined chlorine, then sample again hourly and document pool usage. (T-1)

5.3.2. If a reading exceeds 0.2 ppm combined chlorine, notify BE, and superchlorinate the pool if possible. Remove all personnel before superchlorinating. Swimmers may not re-enter the pool until the free available chlorine level drops to the acceptable range indicated in

Table 5.1. (T-1)

5.3.3. If a reading exceeds 0.5 ppm combined chlorine, remove all personnel immediately and superchlorinate. Swimmers may not re-enter the pool until the free available chlorine level drops to the acceptable range indicated in Table 5.1. (T-1)

AFMAN48-114 23 JULY 2019 21

5.4. Maintenance. Mission training pool managers shall ensure pool maintenance is accomplished as recommended by manufacturer to prevent algae buildup and increased turbidity and to maintain optimal performance and safety for mission training. (T-1)

5.5. Construction. Mission training pools shall be constructed of materials which are impervious and permanent. When funds permit, tile is the best option, followed by pebble or quartz or plaster finished in white or light colors (light blue, blue-green or turquoise). Ensure pumps, filters, and water lines are sized appropriately to sustain water quality and temperature as specified in this AFMAN. (T-1)

5.5.1. Military platforms shall be constructed in accordance with Naval Medical Command

(NAVMED) P-5010-4, Manual of Naval Preventive Medicine, Swimming Pools and Bathing

Places. (T-1)

5.5.2. Indoor mission training pool facilities must be ventilated at all times to remove excess combined chlorine vapors. Design, construction, and installation of indoor mission training pool facilities’ air handling systems shall comply with the 2015 ASHRAE Handbook – HVAC

Applications and ASHRAE Standard 62.1, Ventilation for Acceptable Indoor Air Quality. (T-

1)

Table 5.1. Water Quality Requirements for Mission Training Pools.

Acceptable

Range

Ideal Applicability Monitoring

Frequency

Responsible

Organization

Free available chlorine

(FAC)

1.0 – 4. 0 ppm*

2.0-3.0 ppm

Mission

Training Pool

Prior to opening

&

every 2 hours

(manual disinfectant system);

Prior to opening

& every 4 hours

(automated disinfectant system)

Mission

Training Pool

Manager

Ozone

UVC

Germicidal

Lights

Less than 0.1 ppm

Mission

Training Pool

Every 2 hours Mission

Training Pool

Manager Mission

Training Pool

Every hour pH 7.2 -7.8 7.6 Mission

Training Pool

Prior to opening

& every 2 hours

Mission

Training Pool

Manager

Total alkalinity

60 – 180 ppm

80-100 ppm

Mission

Training Pool

Weekly Mission

Training Pool

22 AFMAN48-114 23 JULY 2019

Ideal Applicability Monitoring

Frequency

Responsible

Organization

Manager

Calcium hardness

NTE 2,500

ppm

200 – 400 ppm

Mission

Training Pool

Monthly Mission

Training Pool

Manager

Total

Dissolved

Solids (TDS)

NTE 1500

ppm above the concentration at startup

Mission

Training Pool

Quarterly Mission

Training Pool

Clarity

The bottom of the deep water tank at its deepest point must be clearly visible and sharply defined from any point on the deck.

Mission

Daily

Mission

Manager

The bottom of the shallow water tank at its deepest point shall be clearly visible.

Mission

Training Pool

Mission

Training Pool

Manager

Cyanuric

Acid

Ideal concentration is between

25-50 ppm, but must not exceed 90 ppm

Mission

Training Pool using CYA as a stabilizer

Monthly; for salt water pools monitoring may be required more frequently -consult the manufacturers' instructions for appropriate frequency

Mission

Training Pool

Manager

Oxidation

Reduction

Potential

(ORP)

Greater than

720 mV if using a silver or silver

Not a required parameter;

however may supplement

Not a required parameter; if used, recommend at

Mission

AFMAN48-114 23 JULY 2019 23

Ideal Applicability Monitoring

Frequency

Responsible

Organization chloride electrode;

Greater than

680 mV if using a calomel electrode direct measurement of disinfectant residual as indicator of water quality least daily readings at same time

FAC and pH readings are performed

Salt Mission training pool using in-line electrolytic chlorinators

At least weekly, or per manufacturer’s instructions

Mission

Training Pool

Manager

Temperature 78°F - 86°F 83°F -

84°F

Low demand pool training, e.g. knot tying

Every 2 hours Mission

Training Pool

Manager

76°F - 82°F 78°F -

80°F

High Demand training activities, e.g.

fin training

Algae No visible algae when open to swimmers

Mission

Training Pool

Continuous Mission

Training Pool

Manager

Combined chlorine

0 – 0.4 ppm

0 ppm Mission

Every 2 hours Mission

Training Pool

Manager

Air Temp for

Indoor

Mission

Training

Pools

1-5°F warmer than water temp in winter

3°F warmer than water temp in winter

Mission

2 hours prior to start of training and every 2 hours during training

Mission

Training Pool

Manager or

1-10°F warmer than water temp in summer

8°F warmer than water temp in summer

Mission

Training Pool

2 hours prior to start of training and every 2 hours during training

Mission

Training Pool

Manager or

*Pools using cyanuric acid shall maintain a minimum FAC concentration of 2.0 ppm

DOROTHY A. HOGG

Lieutenant General, USAF, NC

Surgeon General

24 AFMAN48-114 23 JULY 2019

Attachment 1

GLOSSARY OF REFERENCES AND SUPPORTING INFORMATION

References

AFPD 48-1, Aerospace and Operational Medicine Enterprise, 7 June 2019

AFI 33-360, Publications and Forms Management, 1 December 2015

AFMAN 33-363, Management of Records, 1 March 2008

Centers for Disease Control and Prevention. Model Aquatic Health Code, 3rd Edition. July 2018

40 CFR 131.41. Bacteriological criteria for those states not complying with Clean Water Act section 303(i)(1)(A)

AFI 32-1022 Planning and Programming Nonappropriated Fund Facility Construction Projects, 30 December 2015

AFMAN 32-1084, Facility Requirements, 26 Feb 2016

UFC 3-230-02, Operation and Maintenance: Water Supply Systems, 10 July 2001

UFGS 22-00-00, Plumbing, General Purpose, November 2015

Public Law 110-140, Energy Independence and Security Act of 2007

15 USC § 8001-8008, Virginia Graeme Baker Pool and Spa Safety Act

AFI 48-105, Surveillance, Prevention, and Control of Disease and Conditions of Public Health or Military Significance, 15 July 2014

AFI 34-110, Air Force Outdoor Recreation Programs, 29 Aug 2018

AFI 44-177, Public Access Defibrillator Program, 5 Jun 2014

AFMAN 91-203, Air Force Occupational Safety, Fire, and Health Standards, 11 December

AFI 48-117, Public Facility Sanitation, 11 September 2018

Centers for Disease Control and Prevention. Annex to Model Aquatic Health Code, 3rd Edition.

July 2018

40 CFR 122, EPA Administered Permit Programs: The National Pollutant Discharge

Elimination System.

AFI 90-821, Hazard Communication (HAZCOM) Program, 27 Jan 2014

40 CFR Part 136. Guidelines establishing test procedures for the analysis of pollutants.

Department of the Navy, Bureau of Medicine and Surgery. NAVMED P-5010-4, Manual of

Naval Preventive Medicine, Swimming Pools and Bathing Places. 6 Jun 2002

ASHRAE. 2015 ASHRAE Handbook - HVAC Applications. 2015

ASHRAE Standard 62.1, Ventilation for Acceptable Indoor Air Quality. 2016

AFMAN48-114 23 JULY 2019 25

Prescribed Forms

AF Form 708, Swimming Pool Operational Log

Adopted Forms

AF Form 847, Recommendation for Change of Publication

Environmental Protection Agency. 2012 Recreational Water Quality Criteria, December 2012

Abbreviations and Acronyms

AED—Automated External Defibrillator

AF—Air Force

AFCEC—Air Force Civil Engineer Center

AFMAN—Air Force Manual

AFMSA—Air Force Medical Support Agency

AFPD—Air Force Policy Directive

AFSVA—Air Force Services Activity

AFSEC—Air Force Safety Center

ANG—Air National Guard

ANSI—American National Standards Institute

ASHRAE—American Society of Heating, Refrigeration, and Air Conditioning Engineers

BE—Bioenvironmental Engineering

CDC—Centers for Disease Control and Prevention

CFR—Code of Federal Regulations

CE—Civil Engineer

CPR—Cardiopulmonary Resuscitation

CYA—Cyanuric Acid

DPD—Diethyl-p-phenyleneldiamine

EPA—Environmental Protection Agency

FAC—Free Available Chlorine

FSS—Force Support Squadron

MAJCOM—Major Command mV—millivolts

NAVMED—Naval Medical Command

NSF—NSF International (formerly National Sanitation Foundation)

NTE—Not to Exceed

26 AFMAN48-114 23 JULY 2019

PH—Public Health ppm—Parts per million (equivalent to milligrams per liter)

OEH—Occupational and Environmental Health

OPR—Office of Primary Responsibility

ORP—Oxidation Reduction Potential

PPE—Personal Protective Equipment

RWI—Recreational Water Illnesses

SEG—Occupational Safety

UFC—Unified Facilities Criteria

UFGS—Unified Facilities Guide Specifications

USAFSAM—United States Air Force School of Aerospace Medicine

UV—Ultraviolet

TDS—Total Dissolved Solids

Terms

Breakpoint Chlorination—Occurs when there is enough extra chlorine to completely consume the contaminants in the pool water. Any excess chlorine left over will become free available chlorine.

Bromine—An acceptable disinfecting chemical used in some swimming pools.

Calcium Hardness—The amount of dissolved calcium (plus some other minerals like magnesium) in the water. Water containing high concentrations of calcium and magnesium is said to be “hard water.”

Chlorine—The most common disinfectant used in pool and spa treatment. In this method, chlorine in a liquid, powder, tablet, or gas form is added to the pool water. Chlorine generators are an alternative method of chlorination. Instead of adding chlorine directly, chlorine generators use salt and an electrolytic cell to produce chlorine in the pool.

Clarity—A term describing the clearness of the water. Water clarity is important to identify swimmers in distress, and for swimmers to see potential underwater hazards.

Combined Chlorine—Compounds that form when free…