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[Poisoning caused by a paint stripping agents containing dichloromethane].
It is widely known that inhalation of the solvent dichloromethane can lead to severe intoxication. We report on a fatal accident of a 29-year-old painter. He had to remove the old chlorocaoutchoucpaint of two overflow pools adjoining an empty swimming pool by sand-blasting. After obviously having finished his work in the first pool the painter was found dead, lying on the floor of the second pool. Later an almost empty 10-kg-canister of a paint stripper (macerating agent) the main component of which was dichloromethane was found in the car of the painter. Blood samples of the corpse measured by head space gas chromatography and electron capture detection showed dichloromethane levels in the range of 513-773 micrograms/ml.
Effects of NMDA antagonists on memory processes in a novel two-trial swimming test.
Rats were placed in a circular swimming pool for two 3-min swims separated by 3 days. In the first swim control rats swam initially around the perimeter of the pool and later spent more time in the central region and swam more slowly. The time spent in the centre during min 1 was much higher in the second swim than in the first. This alteration of behaviour by the previous experience suggests that a memory of the first swim was formed. The NMDA antagonists, CPP (10-20mg/kg) or MK-801 (50-100µg/kg), administered before the first swim attenuated or reversed the decline in swimming speed and attenuated the intra-trial increase in the time spent in the centre. The alteration of swimming pattern between the two swims was also reduced. Administering the antagonists immediately after the first swim did not have this effect. Drug administration shortly before the second swim prevented the within-trial decline of swimming speed, but did not significantly reduce the high proportion of time spent in the central region during min 1. The results suggest that in this paradigm NMDA receptors are involved in within-trial habituation of swimming activity and in the initial stages of long-term memory formation, but are not involved in memory consolidation or retrieval.
Giardiasis associated with the use of a water slide.
Although Giardia lamblia cysts are an important contaminant of surface water supplies, only one swimming pool outbreak, involving an infant and toddler swim class, has been reported. We describe an outbreak of giardiasis associated with a hotel's new water slide pool which was cleansed by both bromination and sand filtration. Among the 107 hotel guests and their visitors surveyed, 29 probable and 30 laboratory-confirmed cases of Giardia infection were found. Cases ranged from 3 to 58 years of age, with a mean age of 21 years. The 5-year modal age grouping was 5 to 10 years of age. Symptoms in the 59 cases included: diarrhea (48), cramps (38), foul smelling stools (29), loss of appetite (23), fatigue (20), vomiting (18), greasy stools (15), fever (11) and weight loss (10). Four children and 2 adults were hospitalized. Significant associations were found for staying at the hotel, using the water slide pool and swallowing pool water. A possible contributing factor was the emptying of an adjacent toddlers' wading pool, a potential source of fecal material, into the water slide pool. Transmission of Giardia can occur in water slide pools and therefore should be considered in cases of protracted diarrhea among users of such pools.
Profile of pediatric drowning victims in a water-oriented society.
Drowning accounts for 32% of all pediatric accidental deaths in Dade County, Florida. Swimming pools, primarily home pools, are the most common site, 38%; followed by canals, 27%; lakes, ponds and rockpits, 13%; and the ocean and bay, 11%. The majority of drowning victims could not swim and were dead at the scene of the accident. Most pool victims were white, male, and 3 years old. Most victims were thought to be engaged in a non-pool related activity before the accident. Children who drowned in lakes, ponds, and rockpits, canals, and the ocean and bay were usually of school age and unsupervised. Black children had a higher rate of drowning than white children in these sites. Recommendations to prevent drowning: 1) Community education programs; 2) Safety fence around the perimeter of swimming pool; 3) Higher water levels in pools; 4) Investigation of "drown-proofing" instructions for preschool children; 5) Mandatory swimming and water safety instructions in public schools; 6) More supervised public swimming sites.
Pool fencing for preventing drowning in children.
BACKGROUND: In most industrialized countries, drowning ranks second or third behind motor vehicles and fires as a cause of unintentional injury deaths to children under the age of 15. Death rates from drowning are highest in children less than five years old. Pool fencing is a passive environmental intervention designed to reduce unintended access to swimming pools and thus prevent drowning in the preschool age group. Because of the magnitude of the problem and the potential effectiveness of fencing we decided to evaluate the effect of pool fencing as a drowning prevention strategy for young children. OBJECTIVES: To determine if pool fencing prevents drowning in young children. SEARCH STRATEGY: We used Cochrane Collaboration search strategy of electronic databases, searched reference lists of past reviews and review articles, Cochrane International Register of RCT's, studies from government agencies in the United States and Australia, and contacted colleagues from International Society for Child and Adolescent Injury Prevention, World Injury Network, and CDC funded Injury Control and Research Centers. SELECTION CRITERIA: In order to be selected a study had to be designed to evaluate pool fencing in a defined population and provide relevant and interpretable data which objectively measured the risk of drowning or near drowning or provided rates of these outcomes in fenced and unfenced pools. The completed studies meeting selection criteria employed a case-control design. No randomized controlled studies have been identified. DATA COLLECTION AND ANALYSIS: Three published studies met selection criteria. Data were extracted by two reviewers using standard abstract form. Odds ratios with 95% CI, and incidence rates, were calculated for drowning and near-drowning. Attributable Risk percent (AR%) was calculated to report the reduction in drowning due to pool fencing. MAIN RESULTS: Case control studies which evaluate pool fencing interventions indicate that pool fencing significantly reduces the risk of drowning. Odds ratio for the risk of drowning or near drowning in a fenced pool compared to an unfenced pool is 0.27 95%CI (0.16, 0.47). Isolation fencing (enclosing pool only) is superior to perimeter fencing (enclosing property and pool) because perimeter fencing allows access to the pool area through the house. Odds ratio for the risk of drowning in a pool with isolation fencing compared to a pool with three sided fencing is 0.17 95%CI (0.07, 0.44) REVIEWER'S CONCLUSIONS: Pool fences should have a dynamic and secure gate and isolate (i.e., four-sided fencing) the pool from the house. Legislation should require isolation fencing with secure, self-latching gates for all pools, public, semi-public and private.
[How long do dermatophytes survive in the water of indoor pools?].
Trichophyton rubrum, Trichophyton mentagrophytes and Candida albicans were shown to survive at least 123 days in chlorinated swimming-pool water of 28-30 degrees, at least 18 days in ozonized water at 34-35 degrees, and at least 25 days in pipe water at room temperature of 23-25 degrees. Concentrations of chlorine and ozone normally used to inhibit bacterial contamination did not devitalize the fungi used in the experiment.
Water ingestion during swimming activities in a pool: a pilot study.
Chloroisocyanurates are commonly added to outdoor swimming pools to stabilize chlorine disinfectants. The chloroisocyanurates decompose slowly to release chlorine and cyanuric acid. Studies conducted to determine if the chloroisocyanurates might be toxic to swimmers showed that they were not and that ingested cyanuric acid passed through the body unmetabolized. This fact was used to determine the amount of water swallowed during swimming activity. Fifty-three recreational swimmers, using a community swimming pool disinfected with cyanuric acid stabilized chlorine, participated in the study. The participants did not swim on the day before or after the test swim. The swimmers were asked to actively swim for at least 45 minutes and to collect their urine for the next 24 hours. Cyanuric acid was measured in pool water using high performance liquid chromatography and porous graphitic carbon columns with UV detection. The urine sample assay required a clean-up procedure to remove urinary proteins and interfering substances. Results of the study indicate that non-adults ingest about twice as much water as adults during swimming activity. The average amount of water swallowed by non-adults and adults was 37 ml and 16 ml, respectively. The design for this study and the analytical methodology used to assay cyanuric acid in swimming pool water and human urine were effective for measuring the volume of water swallowed during swimming activity.
Enhancement of swimming endurance in mice by highly branched cyclic dextrin.
We investigated the ergogenic effect in mice of administering highly branched cyclic dextrin (HBCD), a new type of glucose polymer, on the swimming endurance in an adjustable-current swimming pool. Male Std ddY mice were administered a HBCD, a glucose solution or water via a stomach sonde 10 min before, 10 min after or 30 min after beginning swimming exercise, and were then obliged to swim in the pool. The total swimming period until exhaustion, an index of the swimming endurance, was measured. An ergogenic effect of HBCD was observed at a dose of 500 mg/kg of body weight, whereas it had no effect at a dose of 166 mg/kg of body wt (p < 0.05). The mice administered with the HBCD solution 10 min after starting the exercise were able to swim significantly longer (p < 0.05) than the mice who had ingested water or the glucose solution. The rise in mean blood glucose level in the mice administered with HBCD, which was measured 20 min after starting swimming, was significantly lower (p < 0.05) than that in the mice administered with glucose, although it was significantly higher (p < 0.05) than that in the mice administered with water. The mean blood insulin rise in the mice given HBCD was significantly lower (p < 0.05) than that in the mice given glucose. The mice administered with HBCD 30 min after starting the exercise swam significantly longer (p < 0.05) than the mice who had ingested water, although the enhancement of swimming time was similar to that of the glucose-ingesting mice. The gastric emptying rate of the HBCD solution was significantly faster (p < 0.05) than that of the glucose solution. However, this glucose polymer must have spent more time being absorbed because it has to be hydrolyzed before absorption, reflecting a lower and possibly longer-lasting blood glucose level. We conclude that the prolongation of swimming endurance in mice administered with HBCD depended on its rapid and longer-lasting ability for supplying glucose with a lower postprandial blood insulin response, leading to a delayed onset of fatigue.
Antifatigue effect of fresh royal jelly in mice.
We investigated the antifatigue effect of royal jelly (RJ), which had been stored at -20 degrees C from immediately after collection, in male Std ddY mice. The mice were accustomed to swimming in an adjustable-current swimming pool, then subjected to forced swimming five times during 2 wk, and the total swimming period until exhaustion was measured. They were separated into three groups with equal swimming capacity, which were administered RJ, RJ stored at 40 degrees C for 7 d (40-7d RJ), or the control solution including casein, cornstarch, and soybean oil before swimming. All mice were forced to swim for 15 min once; then the maximum swimming time to fatigue was measured after a rest period. The swimming endurance of the RJ group significantly increased compared with those of the other groups. The mice in the RJ group showed significantly decreased accumulation of serum lactate and serum ammonia and decreased depletion of muscle glycogen after swimming compared with the other groups, whereas there was no significant difference between the 40-7d RJ group and the control group in these parameters after swimming. A quantitative analysis of constituents in RJ showed that 5 7-kDa protein, which we previously identified as a possible freshness marker of RJ, was specifically degraded in RJ stored at 40 degrees C for 7 d, whereas the contents of various vitamins, 10-hydroxy-2-decenoic acid, and other fatty acids in RJ were unchanged. These findings suggest that RJ can ameliorate the physical fatigue after exercise, and this antifatigue effect of RJ in mice seems to be associated with the freshness of RJ, possibly with the content of 5 7-kDa protein.
An outbreak of otitis externa in competitive swimmers due to Pseudomonas aeruginosa.
Pseudomonas aeruginosa was isolated from the ears of 18 of the 25 members of a team of competitive swimmers who complained of painful discharging ears. This group of swimmers trained twice daily in the pool, in the early morning and late afternoon. In contrast swabbing of the ears of a similar group of 54 competitive swimmers who used the pool only in the afternoon revealed only one swimmer with P. aeruginosa. Investigation of the swimming pool revealed that chlorination was often inadequate when the first group of swimmers were training in the early morning. Strains of P. aeruginosa were isolated from various sites around the pool and from the bag of a vacuum used to clean the pool. Pyocin typing, serotyping and phage typing were performed on all isolates. The dominant strain recovered from the swimmers' ears was found to be almost identical to that from the vacuum bag and belonged to serotype 0--11 which has been particularly associated with outbreaks of P. aeruginosa infection in whirlpools in the United States. These results support the hypothesis that there is a direct correlation between the development of otitis externa and swimming in water contaminated with P. aeruginosa.
Update on recreational water illnesses.
Swimming is a popular exercise activity in the United States, but swimming pools and other recreational venues may serve as settings for infectious disease transmission. Adopting healthy swimming habits can protect you and your family and prevent disease transmission for everyone.
[Hydrotherapy pools, microbiological and chemical results (author's transl)].
The results of microbiological and chemical examinations of water samples collected from hydrotherapy pools for non incontinent patients proved that the officially agreed parameters for the surveillance of public swimming pools (Osterr. Bäderhygiene-Gesetz and Verordnung) have to be extended to meet the requirements of epidemiology. Similarly the requirements for treatment and operating conditions of those waters should be more rigorous. Minimal requirements for the treatment of water in hydrotherapy pools are recommended. The results of the study indicated also that the microbicide action of chlorine (chlorine gas, hypochlorite solution) was superior to those of DIHALO (chlorine-bromine-hydantoine). Suggestions are made for proper handling of waters which would lose their therapeutical potencies by any kind of treatment.
Cholinergic effects on spatial exploration and its memory.
In their first swim in an unfamiliar circular swimming pool, control rats showed declines in average swimming speed and in the time spent in the perimeter of the pool. Both declines were antagonized by the muscarinic antagonist scopolamine, but not by methylscopolamine, a muscarinic antagonist that crosses the blood-brain barrier only poorly, indicating that these declines depend upon central cholinergic activity. In the first minute of a second swim 3 days later, control rats spent a much longer time in the central region of the pool than in the first minute of the first swim. This modification of behaviour by previous experience suggests that a long-term memory of the first swim was formed. Scopolamine, but not methylscopolamine, administered before the first swim attenuated this modification of behaviour. Pilocarpine, administered shortly after scopolamine before the first swim, significantly normalized all the scopolamine-induced changes, whereas oxotremorine and arecoline normalized only habituation of perimeter preference; agonists administered alone decreased swimming speed and perimeter preference without affecting their rates of decline. The results suggest that in this test, different cholinergic mechanisms are involved in habituation of swimming speed and habituation of perimeter preference.
[Treatment of thermal pool waters].
No laws currently exist regarding the treatment of spa pool water, since it is not completely logical that these should have the same requirements as normal swimming pools. The problem arises especially with regards to the use of chlorine as a disinfectant, which may actually annulate the therapeutic effects of spring waters by altering their physical-chemical characteristics. Possible choices may be represented by frequent replacement of pool water, which may be easily achievable for small pools but more difficult to implement for larger pools, or by alternative disinfection methods such as ozone or ultraviolet rays. The efficacy of these methods must be shown through frequent chemical and microbiological analyses and future, to be hoped-for laws or guidelines, will need to be aimed at defining safety performance standards rather than prescribing analytical intervention and control methods. Beyond the choice of disinfection method, it is extremely important to highlight some relevant hygienic measures that bathers should take and that play a fundamental role in preventing infectious diseases which may be acquired in pools. The most important of these include: showering before entering the pool, wearing slippers around the pool, not urinating in the pool, not bathing if affected by diarrhea, wearing a bathing cap, avoiding the use of contact lenses while bathing and avoiding exchanging towels. Pool managers have the important role of avoiding overcrowding of the facilities and ensuring that all technological systems function properly.
Preventing drowning through design--the contribution of human factors.
A number of routes can be followed towards the prevention of drowning, such as educating on water safety, installing barriers between non-intended users and water, mitigating the consequences of submersion incidents, and design. The human factor approach to safety is that design should always be the primary route. Human factors can be applied to the design of personal protective equipment such as buoyancy aids, barriers such as pool fencing, ancillary equipment such as swimming pool covers through to information and organisational factors such as safety signs and swimming campaigns. Design should consider all potential drowning scenarios and accommodate the characteristics of those at risk. A framework is presented with examples on how human factor principles can be applied to the design of potential drowning sites and products, with suggestions for methods and techniques that can be used in the key stages of predicting potential hazards and assessing risk.
[Suitability of thermal selection for the primary culture of Pseudomonas aeruginosa].
It could be shown by quantitative methods that growing P. aeruginosa suspensions at 42 degrees C without any loss is possible only in a medium without any inhibitory additives--when suspensions of unimpaired organisms are used. The addition of inhibitors e.g. malachite green without influence to the growth rate of P. aeruginosa at 37 degrees C leads to a marked reduction of growth at temperatures only slightly higher e.g. 38 degrees C. This can also be observed when poor media like Drake's medium 10 are used. The method of thermic selection was the most inappropriate for the culture of P. aeruginosa organisms impaired by chlorine. Germs which showed good growth at 37 degrees C could be grown only at a very reduced rate at 42 degrees C even though a rich medium free of inhibitory additives was used. Thermic selection is not suited to the cultivation of P. aeruginosa from samples of water which as a rule is chlorinated e.g. swimming pool water.
Increasing incidence of childhood immersion injury in Brisbane.
The incidence of childhood immersion injury in a defined population is reported. The data were drawn from this Hospital's Child Injury Surveillance programme and cover the period July 1, 1984 to June 30, 1985. The overall rate of immersion injury was 26.8 per year per 100 000 children at risk and the rate for fresh-water immersions was 25.3. The magnitude of this public health problem is revealed by an annual fresh-water immersion rate of 70.2 per 100 000 at risk for the critical 0 to four years' age group. Eighty per cent of all immersions occurred in swimming-pools and the rate of pool immersion is three times that reported in the Brisbane Drowning Study (1971-1975). Eighty per cent of immersions in back yard pools were potentially avoidable by the provision of an effective safety barrier. Only 25% of the families that were involved could be described as being familiar with their pool.