Spa pools (also commonly called hot tubs, whirlpool spas, Jacuzzi™, etc.) have been shown to cause outbreaks of disease such as pseudomonas folliculitis and Legionnaires disease (LD). Legionnaires disease is a life threatening pneumonia with a mortality rate of between approximately 12-40%. Poor design and management of these pools, whether on display or in recreational use, have been identified as risk factors for causing illness and death of users. Following a Health Protection Agency / Local Authority Environmental Health Department study into the quality of water in spa pools in commercial premises eg. hotels, leisure centres, sport facilities, the existing UK guidelines were updated and published as joint guidance by the Health Protection Agency with the UK health and Safety Executive. The new guideline contains the requirements not only for managers/operators but also includes the legal duties for designers, manufacturers and importers together with Legionella testing on a quarterly basis. The study identified several risk factors for causing illness in users relating to poor spa pool management and design. The survey findings will be presented together with an overview of the guidelines. Dr. Susanne Surman-Lee is the Director of the Health Protection Agency London Regional Food, Water and Environmental Microbiology Laboratory. She has a long association with Legionella and Legionnaires disease. Her Ph.D. was on the growth of Legionella in biofilms and for the last 13 years, she has worked in the public health sector investigating outbreaks of food and waterborne disease particularly Legionnaires disease. She was a member of the HPA/HSE working group which produced the new guidelines for the “Management of Spa Pools – controlling the risk of infection” and co-editor / author of the new WHO book Legionella and the Prevention of Legionellosis.” Her research interests include novel treatments for cooling towers and spa pools to control the risk of infection and the quality of recreational water with respect to its impact on health of users. She is lead investigator into a survey of spa pools in England and also into the microbiological quality of river Thames which is heavily used for recreational activities such as rowing, etc.
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