APPENDIX_1_Air_Force_Occupational_Safety_and_Health_Standard_48-114.docx.pdf

BY ORDER OF THE

SECRETARY OF THE AIR FORCE

AIR FORCE INSTRUCTION 48-114

7 MARCH 2012

Aerospace Medicine

SWIMMING POOLS, SPAS AND HOT TUBS,

AND NATURAL BATHING AREAS

COMPLIANCE WITH THIS PUBLICATION IS MANDATORY

ACCESSIBILITY: Publications and forms are available for downloading or ordering on the e-

Publishing website at: http//www.e-publishing.af.mil.

RELEASABILITY: There are no releasability restrictions on this publication.

OPR: AFMSA/SG3PB

Supersedes: AFOSHSTD48-14, 1 April

Certified by: AF/SG3

(Col Jim Collier)

Pages: 37

This Air Force Instruction (AFI) describes how the Air Force operates and maintains its swimming pools, public hot tubs and spas, and other bathing areas under its jurisdiction. This instruction applies to Air Force, the US Air Force Reserve, and the Air National Guard units which operate, maintain, and monitor swimming pools, hot tubs, spas, and natural bathing areas worldwide. It assigns responsibility for the healthful use and safe operation of bathing facilities and emphasizes the preventive medicine principles of hygiene and sanitation to ensure a clean, safe swimming and bathing environment. This AFI does not apply to water obstacles, although some information contained herein may be relevant. Refer recommended changes and questions about this publication to the Office of Primary Responsibility (OPR) using the AF Form 847, Recommendation for Change of Publication; route AF Form 847s from the field through Major

Command (MAJCOM) publications/forms managers. Ensure that all records created as a result of processes prescribed in this publication are maintained in accordance with Air Force Manual

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

Records Information Management System (AFRIMS) Records Disposition Schedule (RDS) located at https://www.my.af.mil/afrims/afrims/afrims/afrims.cfm. The use of the name or mark of any specific manufacturer, commercial product, commodity, or service in this publication does not imply endorsement by the Air Force. This publication requires the collection and or maintenance of information protected by the Privacy Act (PA) of 1974. The authority to collect and or maintain the records prescribed in this publication is Department of

Defense Instruction (DODI) 6055.1 DoD Safety and Occupational Health Program.

THIS PUBLICATION CONTAINS COPYRIGHTED MATERIAL.

http://http/www.e-publishing.af.mil.

https://www.my.af.mil/afrims/afrims/afrims/afrims.cfm

2 AFI48-114 7 MARCH 2012

SUMMARY OF CHANGES

This AFI has been converted from an Air Force Occupational Safety and Health (AFOSH)

Standard. It significantly revises AFOSH Std 48-14, dated 1 Apr 1996, incorporating major changes that clarify roles and responsibilities, update regulatory requirements and incorporate modern treatment technologies.

Chapter 1—GENERAL GUIDANCE 4

1.1. Purpose

1.2. Applicability

1.3. Regulatory Basis

1.4. Hazardous Exposures and Human Factors

Chapter 2—RESPONSIBILITIES 6

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

(SAF/IE)

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

2.3. The Air Force Medical Support Agency (AFMSA)

2.4. The United States Air Force School of Aerospace Medicine (USAFSAM/OE and

Detachment 3, USAFSAM)

2.5. The Air Force Civil Engineer (AF/A7C)

2.6. The Air Force Center for Engineering and the Environment (AFCEE)

2.7. The Air Force Civil Engineer Support Agency (AFCESA)

2.8. The Air Force Safety Center (AFSC)

2.9. The Air Force Services Agency (AFSVA)

2.10. Major Command (MAJCOM)

2.11. Installation

Chapter 3—TYPES OF SWIMMING POOL, SPA AND HOT TUB TREATMENT 10

3.1. Background

3.2. Sanitizers

3.3. Filters

Chapter 4—WATER QUALITY IN SWIMMING POOLS, SPAS, AND HOT TUBS 13

4.1. Chemical Operational Parameters

4.2. Turnover Rate

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

4.3. Test Kits

AFI48-114 7 MARCH 2012 3

Chapter 5—GENERAL OPERATION AND MAINTENANCE OF POOLS AND SPAS 18

5.1. Safety

5.2. Sanitation

5.3. Pool treatment plant operation

Table 5.1. CT Inactivation Values

5.4. Measurements

5.5. Inspections

5.6. Chlorine Gas Safety

Chapter 6—NATURAL BATHING AREAS 22

6.1. Safety

6.2. Sanitation

6.3. Water Quality

6.4. Inspections

Chapter 7—REMEDIAL ACTIONS 24

7.1. Inadequate Water Quality

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

Attachment 1—GLOSSARY OF REFERENCES AND SUPPORTING INFORMATION 26

Attachment 2—CONSIDERATIONS FOR REVIEWING BATHING FACILITY DESIGNS 30

Attachment 3—POOL WATER QUALITY PROBLEM SOLVING 31

Attachment 4—SAFETY RULES 33

Attachment 5—INSPECTION GUIDANCE 34

Attachment 6—RESPONSE TO FECAL, VOMIT, AND BLOOD INCIDENTS 36

4 AFI48-114 7 MARCH 2012

Chapter 1

GENERAL GUIDANCE

1.1. Purpose. The purpose of this instruction is to provide information on potential health threats from swimming pools, spas and hot tubs, and natural bathing areas on AF installations, and to provide requirements, guidelines, and best management practices to monitor and mitigate these threats. Many portions of this instruction were taken from ANSI/APSP-11 2009 American

National Standard for Water Quality in Public Pools and Spas with permission from the

Association of Pool & Spa Professionals (APSP).

1.2. Applicability. This instruction applies to personnel responsible for all AF-owned and/or operated swimming pools, hot tubs and spas, and natural bathing areas.

1.3. Regulatory Basis.

1.3.1. Swimming Pools, Hot Tubs, and Spas. There are currently no federal regulations governing water quality in swimming pools, hot tubs, and spas. In the absence of federal authority and subsequent inapplicability of state and/or local regulations, this instruction outlines the minimum requirements that shall be met.

1.3.2. Natural Bathing Areas. There are currently no federal regulations which prohibit swimming in natural bathing areas that exceed Clean Water Act water quality criteria. In the absence of federal authority, this instruction adopts the EPA criteria identified in Title 40, Code of Federal Regulations, Part 131, Water Quality Standards as the minimum water quality criteria. This instruction will apply the most recent updates to 40 CFR 131. Any subsequent updates to 40 CFR 131 water quality criteria will apply on the date of implementation.

1.4. Hazardous Exposures and Human Factors.

1.4.1. Hazardous Exposures. Gastrointestinal Recreational Water Illnesses (RWI) are caused by the ingestion of water contaminated with pathogenic microorganisms including, but not limited to, Cryptosporidium, Giardia, E.coli, Shigella, and norovirus. These microorganisms are spread in recreational water contaminated with fecal matter. For example, swimmers with diarrhea can easily contaminate a pool. Other RWI’s may be respiratory (caused by inhaling water droplets containing organisms such as Legionella) or dermal (caused by organisms such as Pseudomonas.) Legionella and Pseudomonas are organisms prevalent in the environment and are likely to contaminate a pool or spa. The microorganisms listed above are examples only and do not represent a complete list. Public

Health (PH) should be consulted to determine if there are threats from other microorganisms, including those endemic to the local area.

1.4.2. Other non-microbial contaminants are introduced by bathers, such as oils and lotions, and the environment, such as leaves and dirt. These can interfere with the clarity of the water. Cloudy water increases the risk of injury due to poor visibility for swimmers. In chlorine disinfection, ammonia can be converted to chloramines and disinfection byproducts

(DBPs) can be generated and may result in eye, skin, and respiratory tract irritation as well as objectionable odors.

AFI48-114 7 MARCH 2012 5

1.4.3. Human Factors. The guidance contained in this instruction ensures patrons of AF swimming pools, spas, hot tubs, and natural bathing areas will enjoy a healthy and safe bathing environment.

6 AFI48-114 7 MARCH 2012

Chapter 2

RESPONSIBILITIES

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

(SAF/IE). Responsible for providing guidance direction and oversight for Environment, Safety, and Occupational Health Programs.

2.2. The Air Force Surgeon General (AF/SG). Ensures AF swimming pools, hot tubs and spas, and natural bathing areas are properly surveyed, sampled, analyzed, and monitored to provide a healthy and safe swimming, bathing, and workplace environment. Establishes resources for health oversight of AF swimming pools, spas and hot tubs, and natural bathing areas to protect public health.

2.3. The Air Force Medical Support Agency (AFMSA). Develops AF implementation standards to ensure a clean, healthful, and safe swimming, bathing, and workplace environment.

2.4. The United States Air Force School of Aerospace Medicine (USAFSAM/OE and

Detachment 3, USAFSAM). Provides technical guidance and consultative support for water quality and health risk assessments for AF swimming pools, spas, and hot tubs.

2.5. The Air Force Civil Engineer (AF/A7C). Ensures AF swimming pools, spas, and hot tubs are properly designed, constructed, and maintained to provide a safe and healthy swimming and bathing environment and ensures compliance with all applicable infrastructure and operations standards.

2.6. The Air Force Center for Engineering and the Environment (AFCEE). Provides technical assistance on the environmental regulatory requirements for discharge of swimming pool water and wastewater.

2.7. The Air Force Civil Engineer Support Agency (AFCESA). Issues swimming pool, hot tub, and spa design and maintenance guidance; provides technical assistance to MAJCOMs and installations.

2.8. The Air Force Safety Center (AFSC). Provides technical assistance on safety issues related to swimming pools, spas and hot tubs, and natural bathing areas.

2.9. The Air Force Services Agency (AFSVA). Develops policy and guidance related to day to day operation of AF swimming pools, spas and hot tubs, and natural bathing areas.

2.10. Major Command (MAJCOM). Provides technical assistance and policy guidance to installations to ensure the swimming pool, spa and hot tub, and natural bathing area programs conform to this instruction.

2.11. Installation.

2.11.1. The Installation Commander. Responsible for the overall operation and maintenance of swimming pools and bathing facilities under Air Force jurisdiction.

2.11.2. Base Civil Engineer.

2.11.2.1. Constructs and maintains swimming pools and public spas and hot tubs, as outlined in this instruction, AFI 32-1022 Planning and Programming Nonappropriated

Fund Facility Construction Projects, AFH32-1084 Facility Requirements, UFC 3-230-02

AFI48-114 7 MARCH 2012 7

O&M: Water Supply Systems, UFGS 22-00-00 Plumbing, General Purpose, Public Law

110–140, Energy Independence and Security Act of 2007, December 19, 2007, and Title

15 United States Code Sections 8001-8008, Virginia Graeme Baker Pool and Spa Safety

Act, as well as all other applicable federal, state and local laws.

2.11.2.2. Designates a competent and responsible pool treatment plant operator.

2.11.2.3. Conducts inspections as necessary (such as pre- and post-season) to ensure continuous safe and sanitary operation and maintenance of bathing areas. Facilities operated continuously will be inspected twice a year at a minimum (use the guidance contained in this instruction to determine if more frequent inspections are required).

Pools, hot tubs, and spas which have been closed for renovation or repair will be inspected to ensure compliance with this instruction prior to re-opening.

2.11.2.4. Ensures the pool operator maintains and operates pool equipment and keeps records as outlined in this instruction and in accordance with UFC 3-230-02.

2.11.2.5. Ensures pool drain, excess and splash waters are discharged to local sanitary sewer in compliance with local treatment works ordinances, dechlorination requirements and AFI 32-7041, Water Quality Compliance.

2.11.3. Force Support Squadron (FSS).

2.11.3.1. Oversees the general 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.

2.11.3.2. Appoints competent, certified (where applicable), and responsible bathing facility personnel.

2.11.3.3. Trains and equips life guards to perform required routine chemical testing, e.g.

free available chlorine (FAC) measurements, and retains documentation of this training.

Equipment and training will be approved by BE and Civil Engineer (CE) prior to purchase/implementation.

2.11.3.4. Conducts inspections as necessary (such as pre- and post-season) to ensure continuous safe and sanitary operation and maintenance of bathing areas. Facilities operated continuously will be inspected twice a year at a minimum (use the guidance contained in this instruction to determine if more frequent inspections are required).

Pools, hot tubs, and spas which have been closed for renovation or repair will be inspected to ensure compliance with this instruction prior to re-opening.

2.11.3.5. Life Guards.

2.11.3.5.1. Know, understand, and enforce healthful pool practices and rules.

2.11.3.5.2. Hold current lifesaving, first aid, and Cardiopulmonary Resuscitation

(CPR) certifications in accordance with AFI 34-110.

2.11.3.5.3. Perform routine chemical determinations outlined in this instruction.

2.11.3.5.4. Complete the AF Form 708, Swimming Pool Operational Log, daily and as measurement requirements indicate.

2.11.3.6. Bathing Facility Manager.

8 AFI48-114 7 MARCH 2012

2.11.3.6.1. Ensures sanitary upkeep of facilities and complies with this instruction.

2.11.3.6.2. Ensures the availability of an Automatic External Defibrillator (AED) when feasible. Location of the AED should be clearly marked and readily available for use in the event of emergency.

2.11.4. Public Health (PH).

2.11.4.1. Performs routine facility sanitation inspections based upon locally developed criteria in accordance with AFI 48-117, Public Facility Sanitation.

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

Diseases and Conditions of Public Health or Military Significance and reports potential recreational water illness (RWI) outbreaks to the appropriate offices.

2.11.4.3. Participates in pre-season, post-season, and other inspections, as necessary, of all such bathing areas, and submits recommendations to MDG/CC, MSG/CC and other responsible persons for the safe and sanitary operation and maintenance of the facilities.

For facilities operated continuously, conduct inspections at least twice per year. If a pool or hot tub/spa is closed for renovation or repair, it shall be inspected before re-opening.

2.11.4.4. Ensures source water quality guidelines in Attachment 5 are met.

2.11.5. Bioenvironmental Engineering (BE).

2.11.5.1. Provides water quality supervision of swimming pools, spas and hot tubs, and natural bathing areas under Air Force jurisdiction.

2.11.5.2. Participates in pre-season, post-season, and other inspections, as necessary, of all such bathing areas, and submits recommendations to MDG/CC, MSG/CC and other responsible persons for the safe and sanitary operation and maintenance of the facilities.

For facilities operated continuously, conduct inspections at least twice per year. If a pool or hot tub/spa is closed for renovation or repair, it shall be inspected before re-opening.

2.11.5.3. Provides bacteriological monitoring in support of specific requests attributable to disease outbreaks.

2.11.5.4. Reviews engineering designs for new and/or modified swimming pools, spas, and hot tubs and associated equipment and facilities to ensure adequacy of sanitary processes and controls. See Attachment 2 for potential considerations when reviewing bathing facility designs.

2.11.5.5. Identifies, analyzes and recommends controls for any occupational and environmental health (OEH) hazards due to daily operations, processes, and location of pools, spas and hot tubs, and natural bathing areas.

2.11.6. Ground Safety (SEG).

2.11.6.1. Conducts inspections as necessary (such as pre- and post-season) to ensure continuous safe and sanitary operation and maintenance of bathing areas. Facilities operated continuously will be inspected twice a year at a minimum (use the guidance contained in this instruction to determine if more frequent inspections are required).

AFI48-114 7 MARCH 2012 9

Pools, hot tubs, and spas which have been closed for renovation or repair will be inspected to ensure compliance with this instruction prior to re-opening.

10 AFI48-114 7 MARCH 2012

Chapter 3

TYPES OF SWIMMING POOL, SPA AND HOT TUB TREATMENT

3.1. Background. Many chemical substances sold or distributed in the United States must be registered by the Environmental Protection Agency (EPA). This includes disinfectants and sanitizers such as chlorine and bromine used in swimming pools and spas. (It is important to note that an EPA-registered sanitizer does not kill all bacteria in the pools or spas, but controls them and reduces their opportunity to spread disease.) A measurable amount, known as a

―residual,‖ of an EPA-registered sanitizer shall be present at all times and in all areas of the swimming pool or spa. Any system used shall incorporate an EPA-registered sanitizer. Follow the product manufacturer’s EPA-accepted label for use and/or operation requirements.

3.2. Sanitizers. Sanitizers currently approved for use by the EPA are chlorine, bromine, polyhexamethylene biguanide (PHMB), and silver-based systems. However, chlorine and bromine are the most commonly used. AF installations interested in using a primary sanitizer other than chlorine or bromine must obtain approval from the MDG/CC.

3.2.1. Chlorine. Chlorine is the most common sanitizer 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 (NaCl) brine in an electrolytic cell to produce chlorine in the pool. Chlorine reacts with the pool water to form hypochlorite (OCl ) and hypochlorous acid (HOCl) which kills pathogens. Combined chlorine, also known as chloramines, can form when free chlorine reacts with amine-containing compounds (proteins and ammonia from perspiration and urine). These compounds can cause eye, mucous membrane, and skin irritation and have strong objectionable odors. Chlorine tends to degrade in sunlight. A stabilizer such as cyanuric acid may be used to counteract this degradation.

3.2.1.1. Cyanuric acid. Cyanuric acid is available as either cyanuric acid or as chlorinated isocyanurate. Cyanuric acid stabilizes chlorine by loosely binding to chlorine and thus inhibiting degradation by UV in sunlight. However, binding with chlorine decreases the disinfectant effectiveness. At cyanuric acid concentrations in the range of

100-200 ppm, binding results in a condition termed ―chlorine lock‖ in which disinfection is ineffective. Cyanuric acid does not degrade. Hence, the pool must be overflowed or partially drained and refilled in order to reduce cyanuric acid concentrations. The optimum concentration for cyanuric acid is 25-50 ppm. Use of cyanuric acid in indoor pools or with bromine disinfectant is prohibited.

3.2.2. Bromine. If bromide salt is used, an oxidizer (such as HOCl) is required for the conversion of bromide to hypobromous acid (HOBr). Bromochlorodimethylhydantoin

(BCDMH) is an alternate method for generating HOBr. BCDMH generates both HOCl and

HOBr. The HOCl is consumed first, leaving HOBr as the disinfectant. Bromine is effective over a wider pH range than chlorine, but cannot be stabilized against degradation by sunlight

(cyanuric acid cannot be used with bromine). In the same way that chlorination can result in

The Association of Pool and Spa Professionals. ANSI/APSP-11 2009. American National Standard for Water

Quality in Public Pools and Spas, 15 June 2009.

AFI48-114 7 MARCH 2012 11

chloramines, bromination can result in byproducts called bromamines. However, bromamines are not known to be harmful at concentrations normally found at swimming pools, spas, and hot tubs. Of note, a pool disinfected with bromine cannot be converted to chlorine disinfection without draining and refilling.

3.2.3. Polyhexamethylene biguanide (PHMB). PHMB is an effective pool and spa sanitizer. Its advantages include minimal degradation in sunlight and low eye and skin irritation. Its disadvantages are high costs, the need for additive chemicals as algicides, and lack of understanding of compatibility with other pool chemicals (for example, chlorine degrades PHMB). Because of these disadvantages, PHMB is not recommended for AF owned or operated pools and spas and shall not be used without approval of the MDG/CC.

3.2.4. Supplemental sanitizers. Ozone and ultraviolet (UV) light are types of supplemental

(optional) sanitizers. A benefit of systems that use supplemental sanitizers is that they use less chlorine than chlorination alone. In addition, supplemental sanitizers are especially effective against some chlorine-resistant microorganisms, such as Cryptosporidium and

Giardia. However, these supplemental sanitizers do not provide a lasting disinfectant effect or residual that reaches the pool and continues to act upon chemicals and microorganisms in the water. Because of this, they are not adequate for stand-alone uses and if used, shall be used in conjunction with an EPA-registered sanitizer.

3.2.4.1. Ozone. Ozone is generated onsite at the point of use. When ozone is used for indoor installations, air monitoring may be required within the enclosed swimming pool area. For installations using ozone, coordinate with USAFSAM for guidance on the need for air monitoring and appropriate occupational and environmental exposure limits.

(There is limited research discussing the hazard of ozone in indoor swimming pools.)

3.2.4.2. UV. UV light can be used for disinfection but the pool water shall be treated beforehand to meet manufacturer’s recommendations (including filtration) for the color, turbidity, particulate size and chemical composition. Note: UV degrades hypochlorite/hypochlorous acid to chloride ion (bromine to bromide) and thus interferes with maintaining disinfectant residuals.

3.2.4.3. Silver-based sanitizers. Silver is used as an antibacterial agent in many applications, including swimming pool sanitizers. Positively charged silver ions attach to negatively charged contaminants and destroy them. On AF installations, silver should not be used as a primary sanitizer but may be used as a supplemental sanitizer.

3.3. Filters.

Filters are not designed to remove bacteria, but are designed to improve clarity of pool water. Water clarity is important to identify swimmers in distress, and so swimmers can see potential underwater hazards. In addition, particulates negatively interfere with the disinfection process. Filters should be sized to accommodate the appropriate pool turnover rate as described in paragraph 4.2 There are a number of types of filters available. The choice of filter will be based on several factors, including quality of source water; amount of filter area available and number of filters; filtration rate; ease of operation; method of backwashing; and degree of operator training required. Typically the higher the filtration rate, the lower the filtration efficiency.

World Health Organization. Guidelines for safe recreational water environments. Volume 2: Swimming pools and similar environments. 2006.

12 AFI48-114 7 MARCH 2012

3.3.1. Cartridge filters. Cartridge filters can nominally filter down to 10-20 microns and last up to two years. The filter medium is spun-bound polyester or treated paper. Cleaning is achieved by removing the cartridge and washing it. The main advantage is the relatively small space requirement compared with other filter types, and they are often used with small pools and hot tubs.

3.3.2. Sand filters. Medium-rate sand filters can nominally filter down to 30 microns in size with the addition of a suitable coagulant. A coagulant is needed for a sand filter to perform optimally. To clean sand filters, pool operators perform manual reverse flow backwashing.

3.3.3. Diatomaceous earth filters. These filters use replaceable diatomaceous earth filter medium added after each backwash. Diatomaceous earth filters particles 3-5 microns and has been reported to filter 99.9% of Cryptosporidium when operated and maintained correctly.

AFI48-114 7 MARCH 2012 13

Chapter 4

WATER QUALITY IN SWIMMING POOLS, SPAS, AND HOT TUBS

4.1. Chemical Operational Parameters.

The pool treatment plant operator shall ensure the pool water comes from an approved drinking water source and meets the requirements described in this chapter and outlined in Table 4.1. Attachment 3 lists some common pool water quality problems, potential causes, and potential solutions.

4.1.1. FAC. Free available chlorine (FAC) is the indicator used to measure the level of sanitizer residual for chlorination systems. For swimming pools, a minimum FAC residual of 1.0 ppm shall be maintained at all times and in all areas of the pool. A maximum of 4.0 ppm shall not be exceeded when the pool is open to swimmers. For spas and hot tubs, the

FAC shall be between 2.0 – 5.0 ppm. Chlorine disinfectants will dissipate quicker than bromine and mineral stabilizers in the higher temperatures of spas and hot tubs. Table 5.1 shows the amount of time, known as the inactivation time, required to control the organisms of interest in recreational waters with 1.0 ppm free chlorine residual.

4.1.2. Bromine. If bromine is used, a minimum residual of 1.0 ppm (as Br2) shall be maintained at all times and in all areas of the pool. A maximum of 8.0 ppm (as Br2) shall not be exceeded when the pool is open. For spas, the bromine residual shall be between 2.0 – 8.0 ppm. If a chlorine DPD test kit is used to measure bromine, the FAC reading should be multiplied by 2.25 to obtain the bromine concentration.

4.1.3. Ozone. If an ozone supplemental sanitizer is used, especially for an indoor pool, air monitoring may be required (see paragraph 3.2.4). In addition, CE should periodically leak check for gaseous ozone at the ozone generator.

4.1.4. pH. pH shall be maintained within a range of 7.2 – 7.8 to ensure optimal performance of the sanitizer. If the pH is higher than this range, the HOCl concentration will not be high enough to adequately sanitize. If the pH is below this range, chlorine gas could form which is a health hazard to swimmers, and also wastes chlorine that could be used in the pool.

4.1.5. Total alkalinity. Alkalinity is the measure of the ability of water to resist a pH change, known as the buffering capacity. A total alkalinity of 60 ppm – 180 ppm shall be maintained.

4.1.6. Calcium hardness. Calcium concentration should be kept below the maximum to avoid production of scale and cloudy water. The acceptable range for pool water is 150 ppm

– 1,000 ppm as CaCO3, and ideally between 200 ppm – 400 ppm. The acceptable range for hot tub/spa water is 100 ppm – 800 ppm as CaCO3, and ideally between 150 ppm – 250 ppm.

4.1.7. Total Dissolved Solids (TDS). TDS is a measure of all the dissolved ions in the water. TDS can decrease efficacy of sanitizers and cause water to become cloudy or hazy.

The TDS level in pool/spa shall not exceed 1,500 ppm above the TDS level of pool startup concentration.

The Association of Pool and Spa Professionals. ANSI/APSP-11 2009. American National Standard for Water

Quality in Public Pools and Spas, 15 June 2009.

14 AFI48-114 7 MARCH 2012

4.1.8. Clarity. Water clarity is important to identify swimmers in distress, and so that swimmers can see potential underwater hazards. In addition, particulates can negatively interfere with the disinfection process. Clarity is measured by using a Secchi disk, as described in Table 4.1

4.1.9. Cyanuric Acid. Cyanuric acid, if used, should be maintained between 25-50 ppm.

100 ppm is the maximum allowable. Use of stabilized chlorine products (e.g. di-chlor or tri-chlor) in an erosion feeder will eventually lead to exceeding approved levels. If using a chlorinated isocyanurate to maintain FAC, cyanuric acid levels should be checked weekly.

4.1.10. Oxidation reduction potential (ORP). The oxidation–reduction potential (also known as ORP or redox) can also be used in the operational monitoring of disinfection efficacy. ORP measures the effectiveness of disinfectant in the swimming pool water by providing an indication of the capacity of the disinfectant to oxidize or sanitize organic contaminants. ORP is measured in units of millivolts (mV) with a handheld meter. The ORP value corresponds to an approximate level of oxidizing sanitizer such as chlorine or bromine.

In general terms for swimming pools and similar environments, levels in excess of 720 mV

(measured using a silver/silver chloride electrode) or 680 mV (using a calomel electrode) suggest the water is in good microbial condition. However, measuring ORP does not eliminate the need for testing sanitizer levels with standard test kits.

4.1.11. Temperature. The temperature of swimming pool and hot tub/spa water must never exceed 104°F.

4.1.12. Bacteria. Because the deterioration of water conditions is difficult to measure through regular monitoring, water quality parameters must be maintained in accordance with this instruction. This will ensure safe quality water while avoiding the expense of unnecessary continuous bacteriological sampling.

4.1.13. Algae. Algae can affect the health and safety of swimmers by harboring disease-causing organisms, causing slippery pool floors, and raising the turbidity in a pool. Algae can be very difficult to eliminate once it gets established in a pool. Maintaining proper sanitizer levels is the best method of prevention. There is no requirement to perform testing for algae, but if it is observed, immediate action should be taken to remove it.

4.1.14. Combined chlorine. Combined chlorine, also known as chloramines, can form when free chlorine reacts with amine-containing compounds, e.g., proteins and ammonia from perspiration and urine. These compounds can cause eye, mucous membrane, and skin irritation and have strong objectionable chlorine-type odors. Combined chlorine concentrations are obtained by subtracting the measured FAC from the measured total chlorine concentration. The maximum level for combined chlorine is 0.2 ppm in pools and

0.5 ppm in spas.

4.1.15. 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 spas, water replacement is generally the only practical way to correct for excessive contaminants, calcium hardness, TDS, and cyanuric acid. Water replacement can be accomplished by

AFI48-114 7 MARCH 2012 15

periodic draining or continuous dilution; however, continuous dilution does not preclude the need for periodic draining and thorough cleaning of the pool or spa.

4.1.15.1. Monitoring. Measure the TDS concentration in pools, spas, and hot tubs every two weeks. When the TDS concentration exceeds the startup concentration by 1,500 ppm or more, partially drain and refill the pool to reduce it to acceptable levels.

4.2. Turnover Rate.

4.2.1. 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

Turnover rate shall not exceed 6 hours, or 360 minutes.

4.2.2. The turnover rate for wading pools/baby pools shall be one hour.

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

Parameter Acceptable Range Applicability Monitoring

Frequency

Responsible

Organization

Free available chlorine

(FAC)*

1.0 – 4.0 ppm Pools Every 2 hours Bathing facility manager or lifeguard

2.0 – 5.0 ppm Spas & Hot Tubs Every hour

Bromine 1.0 – 8.0 ppm Pools Every 2 hours Bathing facility manager or lifeguard

2.0 – 8.0 ppm Spas & Hot Tubs Every hour pH 7.2 -7.8 Pools, Spas, & Hot Tubs Every two hours Bathing facility manager or lifeguard

Total alkalinity

60 – 180 ppm Pools Once per week Bathing facility manager or lifeguard Spas & Hot Tubs Daily

Calcium hardness

150 – 1,000 ppm as

CaCO3

Pools Every 2 weeks CE

100 – 800 ppm as

CaCO3

Spas & Hot Tubs

Total

Dissolved

Solids (TDS)

NTE 1500 ppm above the concentration at startup

Pools, Spas, & Hot Tubs Every 2 weeks CE

16 AFI48-114 7 MARCH 2012

Parameter Acceptable Range Applicability Monitoring

Frequency

Responsible

Organization

Clarity

An 8-inch diameter black and white

Secchi disc or the main drain located on 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 from the disc or main drain.

Pools Daily Bathing facility manager or lifeguard

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.

Spas & Hot Tubs Bathing facility manager or lifeguard

Cyanuric

Acid

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

100 ppm

Pools, Spas, & Hot Tubs using cyanuric acid as a stabilizer

Monthly;

however if a chlorinated isocyanurate is used, monitor weekly

CE, if used

Oxidation

Reduction

Potential

(ORP)

Greater than 720 mV if using a silver/silver chloride electrode; Greater than 680 mV if using a calomel electrode

Not a required parameter;

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

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

CE, if used

Temperature 78°F - 82°F Pools Every two hours Bathing facility manager or lifeguard 78°F - 80°F Competitive events/training

Maximum 104°F Pools, Spas, & Hot Tubs

Algae No visible algae when open to swimmers

Pools, Spas, & Hot Tubs Continuous Bathing facility manager or lifeguard

Combined chlorine

0.2 ppm Pools Every hour Bathing facility manager or lifeguard

0.5 ppm Spas

AFI48-114 7 MARCH 2012 17

Parameter Acceptable Range Applicability Monitoring

Frequency

Responsible

Organization

*It is important to note the differences in FAC levels for responding to diarrheal vs. formed stool and vomit incidents. A diarrheal incident has a higher risk of Cryptosporidium and requires a more robust response, as described in Attachment 6.

4.3. Test Kits. Diethyl-p-phenylene diamine (DPD) and orthotolidine (OTO) are the most commonly used reagents for measuring levels of sanitizer in pool and spa water. OTO is very acidic and is a suspected carcinogen and should not be used.

18 AFI48-114 7 MARCH 2012

Chapter 5

GENERAL OPERATION AND MAINTENANCE OF POOLS AND SPAS

5.1. Safety.

5.1.1. Rules. FSS, PH, and SEG shall jointly establish a set of rules that will be clearly posted in a location where pool patrons will pass before entering the pool area. Rules should include, but are not limited to the rules in Attachment 4. Post a copy of these rules which can be clearly read by personnel while sitting in the spa or hot tub. In addition, a copy of these rules and this instruction shall be posted at the facilities for the bathing facility staff, pool operator, and patrons.

5.1.2. Pool Closure. The bathing facility manager shall immediately close the pool or spa if any of the following water quality conditions occur:

5.1.2.1. The water fails clarity test;

5.1.2.2. The sanitizer or ORP level is below minimum standard;

5.1.2.3. The pH is outside the acceptable range;

5.1.2.4. The water temperature exceeds 104° F;

5.1.2.5. Fecal or vomit accident.

5.1.3. Emergency Preparedness. The bathing facility manager shall prepare for emergencies by implementing the following requirements.

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

110.

5.1.3.2. Clearly post a sign in the immediate vicinity of the pool area stating the location of the nearest telephone and indicating emergency telephone numbers.

5.1.3.3. When feasible, ensures the availability of an Automatic External Defibrillator

(AED). Location of the AED should be clearly marked and readily available for use in the event of emergency.

5.1.4. Adverse Weather Conditions. Refer to AFOSH Standard 91-501, Air Force

Consolidated Occupational Safety Standard, for procedures to follow when lightning or other adverse weather conditions are present.

5.2. Sanitation. The bathing facility manager shall maintain a sanitary pool environment.

5.2.1. Drain and clean recirculation filter pools and hot tubs/spas in accordance with paragraph 4.1.15. Coordinate draining with the local wastewater authority or base wastewater treatment plant, or designated CE personnel, as appropriate.

5.2.2. Clean the pool daily with a suction cleaner or other bottom cleaning device.

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

AFI48-114 7 MARCH 2012 19

5.2.4. The bathing facility manager shall ensure pools and spas equipped with overflow gutters are overflowed each day to remove scum and surface debris. The water in pools equipped with only surface skimmers shall be maintained at a level such that the skimmer continuously operates.

5.2.5. Ensure pool deck/apron and area surrounding a spa/hot tub is 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), the surface will be routinely cleaned with a 50 ppm chlorine solution.

5.2.6. Ensure spas and hot tubs are shock treated weekly by raising the total chlorine to 10 ppm for 10 hours or according to manufacturer's guidelines for other disinfectants.

5.2.7. Clean toilet, shower facilities, and dressing rooms in accordance with AFI 48-117, Public Facility Sanitation.

5.3. Pool treatment plant operation.

5.3.1. CE shall maintain a piping diagram of water and sewer lines and post a copy near the pool chemical equipment.

5.3.2. Pool treatment plant operator shall shock treat (hyperchlorinate) the pool as necessary to correct poor water quality or kill algae. The contact time (CT) inactivation value is the concentration of free chlorine in ppm multiplied by time in minutes at a specific pH and temperature. See Table 5.1 for a list of CT inactivation values sufficient to inactivate some microorganisms commonly found in pool/spa water. Other CT values may be used as long as they are consistent with 40 CFR 141.74. For disinfectants other than chlorine, follow manufacturer’s guidelines. Cryptosporidium is a chlorine-resistant microorganism, and the recommendations provided by the CDC fact sheet ―Hyperchlorination to Kill

Cryptosporidium‖ should be reviewed prior to any hyperchlorination intended to inactivate it.

5.3.3. CE shall measure for those 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.

5.3.4. The bathing facility manager shall ensure the spa/hot tub operator is qualified in the operation of equipment and the procedures for performing the necessary water quality tests and safety checks.

Table 5.1. CT Inactivation Values

(Applicable for water conditions of 1 ppm FAC, pH 7.5 or less, and temperature 77°F or more)

Agent Disinfectant Times for Fecal Contaminants in Chlorinated Water

E. coli O157:H7 Less than 1 minute

Hepatitis A Approximately 16 minutes

Giardia Approximately 45 minutes

Centers for Disease Control and Prevention. Chlorine Disinfection Timetable.

http://www.cdc.gov/healthywater/swimming/pools/chlorine-disinfection-timetable.html http://www.cdc.gov/healthywater/swimming/pools/chlorine-disinfection-timetable.html

20 AFI48-114 7 MARCH 2012

Cryptosporidium Approximately 15,300 minutes (10.6 days)

Note: These values are only for pools that do not use a chlorine stabilizer such as cyanuric acid. Disinfection times would be longer in the presence of a stabilizer.

5.4. Measurements.

5.4.1. The bathing facility manager or life guard shall measure pH, temperature, and disinfectant residual level of spas/hot tubs prior to daily opening, and shall measure pH, temperature, and disinfectant residual at all corners of the pool at least once every two hours during operation, entering the average of the values on the AF Form 708. If results are outside the acceptable range indicated in Table 4.1, close the pool and contact BE and the pool treatment plant operator.

5.4.2. On a monthly basis, BE measures the pH and disinfectant residual levels, enters the results on the AF Form 708, and compares the results to the life guard's readings. If the readings differ significantly, BE shall determine the cause of the discrepancy and ensure the life guards are following the correct measurement procedures. BE shall determine the frequency of these measurements based on past performance history. Measurements should be made at times of heavy use.

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

5.5. Inspections.

5.5.1. Pre-season inspection. Representatives from CE, FSS, BE, PH, and SEG shall conduct a joint pre-season inspection approximately 30 calendar days prior to pool opening to ensure a safe and sanitary environment, and to allow time for corrective actions. For facilities operated continuously, perform an inspection about 30 days prior to heavy seasonal use. FSS shall coordinate the inspection.

5.5.2. Post-season inspection. Within 30 days after seasonal closure, the CE, FSS, BE, PH, and SEG representatives shall perform a joint post-season inspection to identify the extent of off-season maintenance needs. Early scheduling of maintenance will facilitate funding and completion of work in time for the next season. FSS shall coordinate the inspection. For facilities operated continuously, no special inspection is required. The facility manager should conduct a survey six months after the 30 day inspection to identify any special repairs needed prior to the next heavy use season.

5.5.3. Sanitary inspections. PH shall conduct periodic sanitary inspections of pool and spa/hot tub facilities. For facilities operated continuously, ensure a minimum of two inspections per year are conducted. The frequency of inspection may be more frequent if determined necessary by the Medical Group Commander based upon past performance history. Attachment 5 gives minimum inspection guidance.

5.5.4. Equipment inspections. During periods of operation, representatives from CE shall at least weekly perform an inspection of the filtration, recirculation, and disinfection equipment to ensure its adequate function.

AFI48-114 7 MARCH 2012 21

5.6. Chlorine Gas Safety. BE and SE shall determine the degree of protective equipment required when potential exposure to chlorine gas exists. The following summarize the minimum factors to consider when determining protective equipment requirements.

5.6.1. The potential for chlorine release exists whenever connecting and disconnecting containers to equipment. Occupational exposure to chlorine shall be evaluated for all tasks in accordance with AFMAN 48-153, Health Risk Assessment, and AFMAN 48-155, Occupational and Environmental Health Exposure Controls.

5.6.2. Chlorinator facilities shall be evaluated in accordance with AFOSH Standard 91-25, Confined Spaces, to determine applicability of requirements for a permit required confined space.

5.6.3. Chlorinator facilities shall be evaluated for chlorine leaks prior to entry. The characteristic odor of chlorine makes its presence known at concentrations well below those which might injure persons exposed for brief periods. Because the odor of chlorine in itself is an inadequate indicator of concentration, it is essential that some quantitative measure of exposure be determined.

5.6.4. Ideally, facilities will be equipped with appropriate equipment to determine the presence and magnitude of airborne chlorine levels. Without adequate chlorine monitoring equipment to sample air in the vicinity of potential leaks, the use of self-contained breathing apparatus (SCBA) equipped with full face piece and operated in pressure demand or other positive pressure mode is required. Entry into facilities with an unknown chlorine concentration requires the use of SCBA equipped with full face piece operated in pressure demand or other positive pressure mode.

5.6.5. Leak detection can also be performed with ammonia. A small piece of cloth soaked with ammonia and wrapped around the end of a short stick can be used to detect leaks.

Alternately, a polyethylene "squeeze bottle" filled with ammonia may be used to direct ammonia vapor (not liquid) at potential leaks. If chlorine gas is leaking, a white cloud of ammonium chloride will form. This method of detection is not a quantitative method of detection. A SCBA equipped with full face piece and operated in pressure demand or other positive pressure mode is required in the presence of a leak unless other quantitative measurements are obtained and can be used to support selection of other respiratory protection.

5.6.6. An escape respirator should be selected in accordance with AFOSH Standard 48-137, Respiratory Protection Program. The selected respirator shall be kept in a nearby controlled location, but not in the chlorinator equipment room.

22 AFI48-114 7 MARCH 2012

Chapter 6

NATURAL BATHING AREAS

6.1. Safety.

6.1.1. Approved areas. The Medical Group Commander shall approve all areas proposed for designated natural bathing facilities. The decision should be based on the following considerations:

6.1.1.1. Site Location. Ensure the bathing areas are free of the effects of point and nonpoint pollution sources. Sources of potentially dangerous contamination include waste discharges from communities, agriculture, industries, marine craft, local animal populations, and water fowl.

6.1.1.2. Type of Bottom. These areas should have bottoms which slope gently and uniformly toward deep water; have no holes or sudden step-offs; be free of hidden or submerged obstructions such as rocks, stumps, snags, and sunken logs; be composed of firm sand, small-sized gravel, or shale; have no silt, quicksand, shell patches, sharp and broken rock, or debris in depths of 5 ft (1.5 m) or less.

6.1.1.3. Physical Water Quality. Consider the depth and turbidity of the water, presence of currents, rip tides, and dangerous aquatic flora and fauna.

6.1.1.4. Common Diseases. Natural bodies of water located in areas where schistosomiasis (bilharziasis), leptospirosis, or primary amoebic meningoencephalitis are endemic shall not be approved for recreational purposes without the concurrence of the public health or preventive medicine officer. PH should be consulted to determine if there are threats from other microorganisms, including those endemic to the local area.

6.1.2. Rules and Signs. FSS, BE, PH, and SEG shall jointly establish safety and warning guidelines for hazards particular to the bathing area. For example, marine bathing beaches should 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. FSS shall clearly post signs with these safety and warning guidelines.

6.1.3. Emergency Preparedness.

6.1.3.1. If the area is to be guarded, comply with lifeguard requirements in accordance with AFI 34-110.

6.1.3.2. 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.

6.1.3.3. Post signs on offshore floats or rafts indicating whether or not diving is permitted.

6.1.3.4. Maintain the appropriate safety and rescue equipment in accordance with AFI

34-110.

AFI48-114 7 MARCH 2012 23

6.1.3.5. Ensure emergency phone numbers are clearly posted near a dedicated emergency phone at the facility.

6.1.3.6. If feasible, ensure the availability of an Automatic External Defibrillator (AED).

Location of the AED should be clearly marked and readily available for use in the event of emergency.

6.1.4. Adverse Weather Conditions. Refer to AFOSH Standard 91-501, Air Force

Consolidated Occupational Safety Standard, for procedures to follow when lightning or other adverse weather conditions are present.

6.2. Sanitation. The natural bathing facility manager shall maintain a clean and healthful environment in and around natural bathing areas by implementing the following requirements.

6.2.1. Establish and follow inspection, cleaning and maintenance (e.g., raking) schedules for managed beach areas.

6.2.2. Designate picnic areas near the beach and provide waste receptacles. Picnicking and bottles and cans for food and drink shall be prohibited on the beach proper.

6.2.3. Ensure all beach toilets, shower facilities, and dressing rooms are kept clean and sanitary in accordance with AFI 48-117, Public Facility Sanitation.

6.3. Water Quality.

6.3.1. 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, level of bathing area use, historical water quality data, and occurrence of sewage spills or other pollution events.