The Middlesex-London Health Unit aims to achieve excellence in aquatic facility management

by Sally Bouorm | December 1, 2014 9:54 am

By Anne-Maria Quin and Fatih Sekercioglu

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The relationship between the local public health department and the owners, operators, and staff of public pools, spas/hot tubs, wading pools, splash/spray pads, and waterparks can best be described as multi-dimensional. With a role that ranges from inspection and enforcement to training and support, the relationship between public health inspectors and those who operate recreational water facilities is critical to the safety of their patrons as well as to the prevention and reduction of waterborne illnesses.

Aquatic facilities are used for recreation and therapy by people of all ages and states of health. If not operated or maintained properly, they can pose numerous risks for bathers, including the potential exposure to waterborne illnesses and minor to life-threatening injuries.

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As the recent recipient of the Association of Pool & Spa Professionals’ (APSP’s) Dr. Neil Lowry Award, the first time it has been presented to a Canadian winner, the Middlesex-London Health Unit (MLHU) has developed an approach that aims to achieve those goals while creating an environment that encourages operators to make their facilities the best they can be.

Located in London, Ont., the MLHU is a key partner in the local health system. As part of its mandate, the health unit conducts routine, unannounced inspections of local recreational water facilities, as well as any re-inspections that are necessary in an effort to ensure any issues of concern that are identified are brought into compliance. Public health inspectors from the MLHU also ensure bather and client safety by conducting complaint-related investigations when concerns are raised about possible waterborne illnesses, or conditions at recreational water facilities that could lead to injury. In addition to this inspection and enforcement role, these inspectors also work closely with owners and operators, guiding them through regulatory requirements, and ensuring their facilities are operated in a safe and sanitary manner.

General pool safety introduction

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In Ontario, public health inspectors conduct assessments of local public pools and spas to ensure operators are following the regulations outlined for them under the Ontario Ministry of Health’s Health Protection and Promotion Act. In addition, under the Ontario Public Health Standards Recreational Water Protocol 2014, Ontario’s local boards of health are required to have their staff inspect seasonal public pools and spas at least twice a year, while indoor public pools and spas must be inspected at least once every three months while in operation. Non-regulated recreational water facilities, like wading pools, splash and/or spray pads and waterslide receiving basins at waterparks are to be inspected using the Operating Procedures for Non-Regulated Recreational Water Facilities Guidance Document at least once a year. While the owners and operators are legally responsible for ensuring facilities are operated and maintained in accordance with the regulations contained in provincial legislation, public health inspectors are considered partners in achieving these goals. This speaks to the training and support role inspectors have with owners and operators, in addition to their inspection and enforcement role.

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The MLHU currently has a team of eight inspectors assigned to conduct more than 650 recreational water facility inspections each year as part of the Safe Water and Rabies Prevention and Control programs’ overall activities.

The inspectors use a software-based program to enter the inspection data they observe, and based on those observations, issue a report for the facility operator that details their findings at the time of the visit. Any items found to be in non-compliance are noted and must be corrected within a prescribed time. The inspectors also educate the operators on site, as required, to increase their knowledge by addressing any specific non-compliance issues head-on. It is sometimes necessary to close a facility when a health hazard that cannot be addressed immediately, is found. In such cases, facilities are allowed to reopen once all non-compliance items are corrected.

Training of public health inspectors

In Canada, public health inspectors are certified under the Canadian Institute for Public Health Inspectors (CIPHI). To become a certified inspector, a candidate must first graduate from a CIPHI-accredited university program, then complete a comprehensive 12-week practicum, before successfully fulfilling the board of certification requirements, which include completing two written reports and taking an oral exam. In addition to this rigorous certification process, most of the MLHU’s inspectors are also National Swimming Pool Foundation (NSPF) Certified Pool Operators® (CPO®). Each inspector also receives ongoing education through in-service training sessions as needed.

Current public pool/spa operator information sessions

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Educating owners and operators has long been a valued and vital component of a process that ensures safe, healthy recreational water facilities for bathers and patrons. On occasion, the inspectors will provide some guidance and regulatory information during their inspections; however, a detailed poolside discussion about regulatory requirements is not appropriate. This is why the MLHU has been providing regulatory-specific training for public pool and spa owners, operators, and lifeguards since 2008, with approximately 100 participants each year. The training involves lecture-style teaching sessions supported by copies of the MLHU’s Public Pool and Public Spa Operator Guide and various handouts, including daily log sheets and pamphlets on water safety, for participants. The vision behind the sessions and operator guide is to assist public pool and spa operators to be fully compliant with Ontario’s public pool and spa regulations.

[6]It is important to note, the training process used by the MLHU is not intended to replace the NSPF’s CPO course, where participants receive more detailed information regarding the operation of recreational water facilities. Instead, attendees receive basic knowledge of regulatory requirements in a consistent manner, e.g. what is expected before opening, and what an operator’s roles and responsibilities are during facility operation.

In 2012, a newly-revised and enhanced version of the Public Pool and Public Spa Operator Guide was designed, resulting in a higher number of owners, operators, and lifeguards attending information sessions over the last two years. An analysis of the MLHU’s previous information sessions has shown these sessions have been effective in increasing knowledge, reducing barriers, and changing some attitudes about the operation of pools and spas. Even with this feedback, through more recent informal discussions between owners, operators, lifeguards, and the inspectors who lead information sessions, it appears there is a growing need for new teaching and training methods which will increase participation. In short, attendees are looking for something that uses more exciting, interactive, and engaging teaching methods.

To address these challenges, the MLHU plans to engage its audiences in focus groups prior to revisiting the program. It is hoped these groups will assist in determining what recreational water[7] facility owners, operators, and lifeguards expect and need from a training program offered by the local public health department. It is planned that participants will also discuss and provide feedback about their preferred and effective teaching methods.

[8]The MLHU will gather information from those who have attended, or have never attended previous sessions to understand how the MLHU can make its program more attractive, accessible, beneficial, and effective in obtaining wider compliance with provincial regulations. The goal would be to make this future training program available to as many owners, operators, and lifeguards as possible in an effort to meet the ultimate goal of preventing and reducing waterborne illnesses and injuries associated with recreational water use.

Planning activities for future regulatory training program

With the generous support of the Dr. Neil Lowry Award, the MLHU would like to create this new, enhanced, evidence-informed, and comprehensive regulatory training program.

The MLHU plans to achieve this goal by designing training that is based on best methods supported by literature, which takes into account the experiences of owners, operators, lifeguards of recreational water facilities, and public health inspectors.

The steps the MLHU plans to follow include:

1. Comprehensive needs assessment:

a) Undergo an inspection report audit.
i. To determine the most commonly occurring non-compliance issues observed during recreational water facility inspections over the last three years.

b)Complete focus groups with owners, operators, and lifeguards who have previously attended and who have never attended the MLHU’s public pool and spa operator information sessions.
i. To determine what is expected and needed from a health unit provided regulatory training program. Anecdotally, it appears there are facilities who continue to experience non-compliance issues despite attending previous sessions.

c) Conduct in-depth interviews with public health inspectors.
i. To identify knowledge gaps and perceived barriers to compliance. Questions to ask could be: What have public health inspectors experienced in the field? What are their perceptions as to what will be effective to improve compliance?

2. Identification of effective intervention methods:

a) Design and engage in an environmental scan of pool and spa training programs among other public health units or regions across Canada.
i. To determine what types of pool and spa training programs are being offered by other public health units or regions.

b) Complete a literature review of legislative compliance training programs.
i. To identify features of other programs shown to be effective.

c) Complete a literature review of effective adult learning principles.
i. To enhance the delivery of evidence-informed material.

3. Assess the effectiveness of an enhanced training program:

a) Design and engage in a post-training survey.
i. To determine whether training increased knowledge about the relevant legislation.

b) Undergo a pre- and post-comparison assessment of compliance items.
i. To determine whether the training improved compliance of pool and spa premises.

Looking towards a future regulatory training program

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By engaging owners, operators, and those who work in roles that support recreational water facilities, and incorporating their feedback, it is anticipated the MLHU’s future training program will become a product that adds value to the recreational water facility landscape. The goal of this proposed new training program will be to provide those who are in positions of responsibility with the skill set necessary to operate their facilities in accordance with the respective regulations. Ideally, this will allow them to fulfil their roles and responsibilities with respect to maintaining safe and sanitary recreational water facilities. The ultimate goal will be to decrease the number of non-compliance items observed at each location, reducing the risks that lead to recreational waterborne illnesses and injuries. The Dr. Neil Lowry Award will allow the MLHU to enhance its current training program, which could become the foundation for a system that other public health agencies could adopt and use for their own training purposes.

 

Anne-Maria Quin, B.Sc. is a public health inspector on the Safe Water and Rabies Prevention and Control Team at the Middlesex-London Health Unit. Quin is the recreational water program lead and can be reached via e-mail at anne-maria.quin@mlhu.on.ca[10].

 

 

Fatih Sekercioglu is an environmental health manager for the Middlesex-London Health Unit and has more than 10 years of public health experience. He is currently enrolled in the PhD program at Western University. Sekercioglu can be reached via e-mail at fatih.sekercioglu@mlhu.on.ca[11].

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