[Swimming pool warts. Treatment of so-called swimming pool warts without recurrence and without complications].
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The swimming pool granuloma is a chronic granulomatous skin disease, caused by atypical quick growing mycobacteria in areas of minor injuries with high self-healing rate.
BACKGROUND: A microbiological and physiochemical analysis has been made from 60 samples of water from two swimming pools in Santa Cruz de Tenerife in order to know the hygienic condition and to establish the most adequate microbiological indicators. The water of the two swimming pools has a different origin: sea water (Swimming pool B) and public supply (Swimming pool A), and so, different processings are used. METHODS: The analytical methodology was based on the Spanish current day regulations for the control of drinkable waters for public use, as well as on the methods the American Public Health Association recommends. RESULTS: There have been found differences between one swimming pool and the other, depending basically on the water characteristics and the processings used to treat it; there exists a greater microbiological contamination in the samples from the swimming pool B. It has been proved that medium R2A is better than medium P.C.A. to recount total mesophilic aerobes in both swimming pools. CONCLUSIONS: The isolation of St. aureus species in samples from the swimming pool B makes of it a possible microbiological indicator for the hygienic control of swimming pool waters of marine origin. Likewise, the presence of mycobacterium species in samples of the swimming pool A confirms its resistance to concentrations of growth inhibitors of free chlorine.
During the year 1977 we examined 2226 samples of swimming pool waters for colony counts, Escherichia coli and coliforms according to the German standards for drinking water. In addition, Pseudomonas aeruginosa was isolated out from 180 of those samples. This microorganism was found in 4.7% of samples from public municipal swimming pools, in 4.1% from swimming pools in schools, in 13.1% from swimming pools in hotels, boarding-houses, hydropathic establishments, sanatoria, blocks of flats and private dwellings as well as in 38% (!) from swimming pools in hospitals. P. aeruginosa could rarely be isolated together with E. coli or coliforms. However, it was often found in samples, which were faultless according to the bacteriological standards for drinking water. Its necessity as an additional important hygienic parameter will be discussed.
An analysis of a consecutive series of 66 swimming pool immersion accidents is presented; 74% of these occurred in in-ground swimming pools. The estimated accident rate per pool is five times greater for in-ground pools compared with above-ground pools, where pools are inadequately fenced. Backyard swimming pools account for 74% of pool acidents. Motel and caravan park pools account for 9% of childhood immersion accidents, but the survival rate (17%) is very low. Fifty per cent of pool accidents occur in the family's own backyard pool, and 13.6% in a neighbour's pool; in the latter the survival rate is still low at only 33%. In only one of the 66 cases was there an adequate safety fence; in 76% of cases there was no fence or barrier whatsoever. Tables of swimming pool accidents by age, season, site and outcome are presented.
The rate of childhood drowning and near-drowning accidents in home swimming pools has doubled over the last five years. A study has been undertaken to determine whether this is due simply to an absolute increase in the number of home swimming pools, or whether pools themselves are becoming intrinsically more dangerous, or both. Direct measurement of pool-house ratios has been undertaken by means of aerial photography. Supportive data have been obtained from municipal records. Pool-home ratios for the cities of Canberra and Brisbane are compared (estimated 1: 10.7, and 1:13.3 respectively). It is suggested that swimming pools are not becoming intrinsically more dangerous to children; the data suggest that effective pool legislation will prevent childhood drownings in spite of increasing trends in home pool ownership.
An ozone/activated charcoal stage in the water treatment also lends itself extremely well to improving the quality of sea water in swimming pools. This improvement is typically reflected in the low content of organic substances and nitrogen compounds (ammonia, urea) and, as a result, in the high redox potentials in the swimming-pool water which are even likely to bring about a rapid inactivation of the viri. A small percentage of the bromide in the sea water is oxidised to free bromide which passes through the activated charcoal filter, counteracts the growth of germs, keeps the filtrate largely free from germs and contributes to the disinfection of the swimming pool.
About 90% among 44 water samples executed in 9 swimming-pools of Lyon contained amoebae. From these prelevements, 85 strains have been separated. In spite of the great diversity of the species isolated, the strains belonging to genus Acanthamoeba and Hartmannella prevail. In return, the genus Naegleria seems to be rare: it has been isolated only one time directly from water of swimming-pools.
An inquiry was held to determine the occurrence and quantitative importance of "Limax" amoebae in 8 swimming-pools of the North of France. The influence of water flow system, filters and water disinfectants was studied. The connections with the bacterial flora growing at 37 degrees C and the presence of strains able to grow at 41 degrees were analyzed. The significance of their presence in the swimming-pools is discussed from the obtained results.
German Standards Specification DIN 19,643 is at present under revision for health reasons and because of both negative and positive experiences gathered in practice. To enable adaptation of the standards specification to future developments, a Part I of the specification is being created comprising the demands to be made on the quality of the water and general demands on the construction and operation of swimming pools and tubs and basins in bath houses, e.g. in spas or municipal swimming pools. The subsequent parts of the new specification (Part 2 to Part n) concern the demands to be made on individual combinations of processes; these can be supplemented at any time in accordance with technical progress without requiring revision of the entire standards specification. Essential innovations are the reformulation of the required efficiency of disinfection, the introduction of the parameters Legionella pneumophila, trihalogen methane (THM) and the reduction of the limit value for chloramines. Technically speaking, the new features concern the automatic measurement of the auxiliary parameters of hygiene such as redox potential, pH value and free chlorine, automatic control of disinfectant additions, automatic filter rinsing with fluidization of the filter-bed to a prescribed minimum bed expansion, and the sight-glas at the filter container. The demands made on Jacuzzi and warm water spouted bed besins are integrated into the specification, thus obviating the need for German Standards Specification DIN 19,644.
An investigation of maintenance, usage, and coliform status of water in 104 domestic swimming pools in 13 Brisbane suburbs was made in January, 1978. The results showed that domestic pools are often imperfectly serviced, and are potential infection sources. The need for health education of pool owners, and for more reliable methods of pool sanitization is emphasized.
During a short term investigation, 1 outdoor and 15 indoor swimming pools were examined for the presence of amoebae. Of all isolates from 13 pools, 43.6% belonged to the genus Acanthamoeba. The genus Naegleria accounted for 7.3% of the isolates, but none belonged to the pathogenic N. fowleri. A high percentage (70%) of the Acanthamoeba strains tested showed virulence for mice.
A bacteriological study was carried out on the first Leisure Centre swimming pools in the United Kingdom to be disinfected with ozone/chlorine. Results suggested that a free chlorine concentration of approximately 0.8 mg/l was necessary to maintain the pools in a bacteriologically satisfactory condition. This amount of free chlorine was similar to that required when the pool was disinfected with chlorine alone. However, the associated amount of combined chlorine was much lower when disinfection was by ozone/chlorine and this gave more acceptable bathing conditions. Implications for the manamgement of pools disinfected by this method are discussed.
A reservoir of pathogenic Naegleria fowleri has been located in the cracked wall of a swimming pool where repeated outbreaks of primary amoebic meningoencephalitis were observed between 1962 and 1965.
The author evaluated conditions necessary for the development of the most common intestinal helminths in swimming pools and emphasizes provisions which prevent their development. The author recommends helminthological examinations only in indicated cases.
An outbreak of otitis externa was observed to affect one third of 230 swimmers using a new swimming pool within three weeks of its opening. Pseudomonas aeruginosa was grown from the water and from all of the nine swabs taken from the infected ears of the swimmers. During the same period only six other cases of otitis externa were seen in the local general practice serving 4,000 patients. The disinfection procedures were found to be defective and after they were corrected the outbreak subsided.
During the summer of 1973 cultures of Pseudomonas aeruginosa and other fluorescent pseudomonads capable of growth at 41 C were obtained from swimming pool waters at a training center for the mentally retarded. Isolates were subjected to selected physiological tests, pyocine typing, and immunotyping. High counts of P. aeruginosa or other fluorescent pseudomonads consisted mainly of single predominant types. Both P. aeruginosa strains and unidentified fluorescent Pseudomonas strains predominated in pool waters at different times.