Skin rashes are an all too frequent consequence of exposure to poorly managed water. Disinfection byproducts can induce rapid and clinically significant dermal reactions in some individuals. The best documented cases of this type of contact dermatitis are among health professionals working in aquatic therapy tanks. Less documented cases are noted among life guards and the general public. Microbial dermal infections have longer incubation periods than chemical allergic reactions. Pseudomonas aeruginosa is the most frequently reported bacterial infection in all aquatic venues. Inflammation of hair follicles (folliculitis) is the most common complaint resulting from contact with P aeruginosa. Victims and occasionally medical professionals describe this rash as a “burn” or “chemical burn”. Documented cases of swimmer’s ear and infections of the respiratory tract, urinary tract, wounds and cornea caused by P aeruginosa have been linked to the use of hot tubs. Informal surveys of frequent recreational water users indicate that infections caused by this bacterium are very widespread and may repeatedly attack some individuals. Prior to the mid 1980’s and the advent of the portable modern spa most microbiologists focused on Staphylococcus aureus as the primary cause of rashes from aquatic venues. An outbreak in 2003 among collegiate athletes in Connecticut and the increase in community acquired Methicillin-resistant Staph aureus (ca-MRSA) may be heralding the emergence of a new and more serious bacterial rash agent. Less understood and poorly reported is the role that viruses play in recreational water rashes. While chemically induced dermatitis and P aeruginosa rashes are not serious health threats, their wide spread occurrence is a strong indication that poor water quality is common and pervasive. Continuous adequate sanitizer residuals in the water coupled with routine oxidation is critical in managing water quality, and limiting the potential for rash outbreaks. This presentation will focus on how and why the mismanagement of aquatic venues can lead to dermal infections and contact dermatitis. Case studies will be used to illustrate the mechanism of outbreaks. Roy D. Vore, Ph.D. is currently a Senior Research Microbiologist at DuPont Chemical Solutions Enterprise in Wilmington, Delaware. He has 29 years of work experience in manufacturing and applied product development and 15 years of industry experience in the management of microbiological issues, including recreational water. Dr. Vore has participated in numerous product launches from concept to technical support in the market. He has worked extensively with regulatory agencies including the EPA, California Department of Pesticide Regulations and the Canadian Pesticide Management Agency. His professional industry activity includes relationships with the Association of Pool and Spa Professionals and the National Swimming Pool Foundation®. He is the author of 40 technical articles and presentations on microbiology, microbial physiology, the preservation of aqueous systems, and the protection of human health in recreational water. Dr. Vore is the co-inventor on four patents on the use of antimicrobials in recreational water. He received his Master of Science in Microbiology and his M.B.A. from Pittsburg State University in Pittsburg, Kansas. He received his Doctor of Philosophy in Microbiology from the University of Arkansas.
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