Swimming and other water-related activities are great ways to stay physically fit, but they are not without their risks.
For swimmers, boaters and water skiers to enjoy a safe recreational water experience, it is important for them to know how to protect themselves and others from potential health hazards, including recreational water illnesses (RWIs), sunburn and drowning that can occur.
Below you will find more information on ways to reduce your risks for injury or illnesses when you participate in water-related activities.
Recreational Water Illnesses
Recreational water illnesses (RWIs) can be caused by germs spread by swallowing, breathing in mists or aerosols of, or having contact with contaminated water in swimming pools, hot tubs, water parks, water play areas, interactive fountains, lakes, rivers, or oceans.
RWIs include a wide variety of infections, such as gastrointestinal, skin, ear, respiratory, eye, neurologic, and wound infections. The most common include:
- Crypto (short for Cryptosporidium)
- E. coli O157:H7.
- Hot Tub Rash (Pseudomonas Dermatitis / Folliculitis)
Swallowing even a small amount of recreational water that has been contaminated with feces containing germs can make you sick. In addition, lakes, rivers, and the ocean can be contaminated with germs from sewage spills, animal waste, and water runoff following rainfall. Some common germs can also live for long periods of time in salt water.
Children, pregnant women, and people with weakened immune systems (for example, people living with AIDS, individuals who have received an organ transplant, or people receiving certain types of chemotherapy) can suffer from more severe illness if infected.
To ensure that most germs are killed, it’s important that chlorine or other disinfectant levels in pools are used properly and checked regularly. The high water temperatures in most hot tubs make it hard to maintain the disinfectant levels needed to kill germs which is why it’s important to check disinfectant levels in hot tubs even more regularly than in swimming pools.
To help protect yourself and other swimmers from germs, here are a few other easy and effective steps all swimmers should take:
- Keep the poop, germs, and pee out of the water. Don’t swim when you have diarrhea. Shower with soap before you start swimming. Take a rinse shower before you get back into the water. Take bathroom breaks every 60 minutes. Wash your hands after using the toilet or changing diapers.
- Check the free chlorine level and pH before getting into the water. Pools: Proper free chlorine level (1–3 mg/L or parts per million [ppm]) and pH (7.2–7.8) maximize germ-killing power. Hot tubs/spas: Proper disinfectant level (chlorine [2–4 parts per million or ppm] or bromine [4–6 ppm] and pH [7.2–7.8]) maximize germ-killing power. Pool and spa chlorine test strips are available at local home improvement stores, discount retailers and pool supply stores.
- Don’t swallow the water you swim in.When someone is ill with diarrhea, their stool can contain millions of germs. This means that just one person with diarrhea can easily contaminate the water in a large pool or water park. Swallowing even a small amount of recreational water that has been contaminated with feces containing germs can make you sick.
Parents of young children should take a few extra steps:
- Take children on bathroom breaks every 60 minutes or check diapers every 30–60 minutes. Change diapers in the bathroom or diaper-changing area and not at poolside where germs can rinse into the water.
The Department of Health also inspects swimming pools and spas for chemical hazards to ensure correct chemistry and adequate disinfection is occurring.
For more information on our inspection program, visit our Public Swimming Pool & Spa page.
Drowning ranks fifth among the leading causes of unintentional injury death in the United States. About one in five people who die from drowning are children 14 and younger.
Some of the factors that affect drowning risk include lack of swimming ability, lack of barriers to prevent unsupervised water access, lack of close supervision while swimming, failure to wear life jackets and alcohol use.
Some tips to help you stay safe in the water:
- Supervise when in or around water. Designate a responsible adult to keep an eye on children at all times, as kids can drown in seconds and in silence.
- Learn to swim. Formal swimming lessons can protect young children from drowning. However, even when children have had formal swimming lessons, constant, careful supervision when children are in the water, and barriers, such as pool fencing to prevent unsupervised access, are still important.
- Don’t use air-filled swimming aids (such as “water wings”) with children in place of life jackets or life preservers. These toys are not life jackets and are not designed to keep swimmers safe
- Inspect the pool and its surroundings. Pool water should be clean and clear. You should be able to clearly see any painted stripes and the bottom of the pool. No odor; a well-chlorinated pool has little odor. A strong chemical smell indicates a maintenance problem. Pool equipment working; pool pumps and filtration systems make noise and you should hear them running.
- Protect against sunburn by using a sunscreen with at least SPF 15 and both UVA and UVB protection, and be sure to re-apply it after swimming.
- Always swim with a buddy. Select swimming sites that have lifeguards when possible.
- Avoid alcohol. Avoid drinking alcohol before or during swimming, boating, or water skiing. Do not drink alcohol while supervising children.
- Learn cardiopulmonary resuscitation (CPR). In the time it takes for paramedics to arrive, your CPR skills could save someone’s life.
If you have a swimming pool at home:
- Install four-sided fencing. Install a four-sided pool fence that completely separates the pool area from the house and yard. The fence should be at least 4 feet high. Use self-closing and self-latching gates that open outward with latches that are out of reach of children. Also, consider additional barriers such as automatic door locks and alarms to prevent access or alert you if someone enters the pool area.
- Clear the pool and deck of toys. Remove floats, balls and other toys from the pool and surrounding area immediately after use so children are not tempted to enter the pool area unsupervised.
If you are in and around natural water settings:
- Use U.S. Coast Guard approved life jackets. This is important regardless of the distance to be traveled, the size of the boat, or the swimming ability of boaters; life jackets can reduce risk for weaker swimmers too.
- Know the meaning of and obey warnings represented by colored beach flags. These may vary from one beach to another.
- Watch for dangerous waves and signs of rip currents. Some examples are water that is discolored and choppy, foamy, or filled with debris and moving in a channel away from shore.
- If you are caught in a rip current, swim parallel to shore. Once free of the current, swim diagonally toward shore.
The sun’s ultraviolet (UV) rays can damage your skin in as little as 15 minutes. Your best bet to protect your skin is to use sunscreen or wear protective clothing when you’re outside—even when you’re in the shade.
To reduce your risk of skin damage or skin cancer:
- When possible, long-sleeved shirts and long pants and skirts can provide protection from UV rays. If wearing this type of clothing isn’t practical, at least try to wear a T-shirt or a beach cover-up. Keep in mind that a typical T-shirt has an SPF rating lower than 15, so use other types of protection as well. A wet T-shirt offers much less UV protection than a dry one, and darker colors may offer more protection than lighter colors.
- Wear a hat with a brim all the way around that shades your face, ears, and the back of your neck. A tightly woven fabric, such as canvas, works best to protect your skin from UV rays. Avoid straw hats with holes that let sunlight through. A darker hat may offer more UV protection.
- Wear sunglasses that block both UVA and UVB rays. Most sunglasses sold in the United States, regardless of cost, meet this standard. Wrap-around sunglasses work best because they block UV rays from sneaking in from the side.
- Apply a broad spectrum sunscreen with at least SPF 15 before you go outside, even on slightly cloudy or cool days. Don’t forget to put a thick layer on all parts of exposed skin. Get help for hard-to-reach places like your back. And remember, sunscreen works best when combined with other options to prevent UV damage. Be sure to reapply if you stay out in the sun for more than two hours and after swimming, sweating, or toweling off.
- How sunscreen works. Most sun protection products work by absorbing, reflecting, or scattering sunlight. They contain chemicals that interact with the skin to protect it from UV rays. All products do not have the same ingredients; if your skin reacts badly to one product, try another one or call a doctor.
- SPF. Sunscreens are assigned a sun protection factor (SPF) number that rates their effectiveness in blocking UV rays. Higher numbers indicate more protection. You should use a broad spectrum sunscreen with at least SPF 15.
- Expiration date. Check the sunscreen’s expiration date. Sunscreen without an expiration date has a shelf life of no more than three years, but its shelf life is shorter if it has been exposed to high temperatures.
- Cosmetics. Some makeup and lip balms contain some of the same chemicals used in sunscreens. If they do not have at least SPF 15, don’t use them by themselves.
It’s also important to know that indoor tanning is not safer than tanning in the sun. Indoor tanning is designed to give you high levels of UV radiation in a short time,which can damage your skin and increase the risk of cataracts and potentially blinding eye diseases.
- Healthy Swimming [En español] (CDC)
- Basics of Recreational Water Illnesses (CDC)
- Healthy Swimming-Fact Sheet for Swimmers (CDC)
- Healthy Swimming: Fact Sheet for Hot Tub Users (CDC)
- Healthy Swimming Brochure (CDC)
- Basics of Recreational Water Illnesses (CDC)
- Six Steps for Healthy Swimming Poster (CDC)
- Educational Posters on Pool Safety (CDC)
- Pool User Information: Protect Yourself from Recreational Water Illnesses by Remembering to Swim Your LAAPS! (CDC)
- Aquatic Health & Safety Infographic (NEHA)
- Beaches (EPA)
- Before You Go to the Beach Brochure (EPA)
- Local Beach Information (EPA)
- Keep Kids Safe in Pools Poster (SafeKids)
- Pool Safety Poster (AAP)
- Sunscreen: the Burning Facts (EPA)
View CDC’s healthy swimming video below.