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Applying the Model Aquatic Health Code to Grade Swimming Pool Safety in a Large Metropolitan Area

Abstract

The Model Aquatic Health Code (MAHC) provides voluntary guidelines that reduce the risk of disease, injury, and drowning at aquatic facilities. Its use varies across state and local jurisdictions. We sought to develop a swimming pool safety grading system in a metropolitan area by applying the MAHC to city swimming pool inspection data. We conducted a cross-sectional study that involved routine inspections of commercial aquatic venues in Houston, Texas, during 2016. We calculated the overall percentage of items in compliance with the MAHC. Next, we graded swimming pools by assigning points based on the MAHC to corresponding swimming pool violations and assigning a letter grade: A = 95–100%; B = 85–94%; C = 75–84%; and fail (F) = <75%. Graded pools were projected onto a map of Houston to geographically sort and visualize their location.

There were 3,100 commercial aquatic venues in Houston that were inspected. Venues were graded for safety as: A = 40.2%; B = 0.5%; C = 0%; and F = 59.3%. Swimming pool enclosure violations were most frequent (18.0%). Most swimming pools, irrespective of the degree of pool safety violations, were located in the Southwest section of Houston. Overall, the MAHC can be applied to grade swimming pool safety in jurisdictions where it has not been adopted. The degree of safety violations can be spatially demonstrated to inform injury-prevention measures. 

Publication: Journal of Environmental Health 
Volume: 86
Number: 1
Pages: 8-16
Published: July/August 2023

Authors

  • Miguel A. Arroyo, Jr., MD, Division of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital
  • Jennifer L. Jones, MS, Division of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital
  • Antoine Nguyen, University of Houston
  • Rohit P. Shenoi, MD, Division of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital 

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