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The Model Aquatic Health Code (MAHC)

International Pool Spa Patio Expo

November 2, 2016; New Orleans, LA

Douglas Sackett

Executive Director, CMAHC

MAHC/CMAHC and Other Acronyms

Who knows about the Model Aquatic Health Code (MAHC)?

Who knows about the Council for the MAHC (CMAHC)?

Who is a member of the CMAHC?

AGENDA

Intro to MAHC and CMAHC

Selected MAHC Design and Operation Requirements-implications & impact on pool service and maintenance

Questions & Answers

Why Create the MAHC?

No federal regulatory agency responsible for

aquatic facilities

68% of state and local health departments regulate, inspect, or license public swimming pools1

Significant variability in standards and requirements exist that are often outdated

Significant time and resources spent by individual jurisdictions to create and update codes

1. National Association of County and City Health Officials, 2013.

MAHC Core Work Strategies

The core work strategies used for MAHC development included:

Use an “Evolution NOT Revolution” approach

Build a strong partnership between public health and the aquatics sector

Actively seek, listen to, and incorporate public input

Rationale

Incremental change is most likely to be adopted by state and local jurisdictions

Partnership will yield the best product, greatest buy-in, and will be most likely to be adopted

Incorporating public input improves overall quality and national buy-in

Code Development Process with the MAHC

MAHC was developed by expert consortia of national and international stakeholders

Substantial industry participation in the process

Results in better acceptance by industry

72% of >4400 public comments accepted

Annex is a valuable tool that provides the data and other supporting evidence for the code requirements

Updated every two years through the Council for the Model Aquatic Health Code (CMAHC)

MAHC Scope

All areas of public health concern

Illness, injury, drowning

Public venues

Water, air, & facility exposures that impact the health of swimmers and facility users

Leave other areas to building codes, etc.

Facility types

Man-made, treated, recirculated water venues

Health care-based pools

Therapy pools

MAHC is Intended to Make Pools Safer: Risk Management Approach

Understanding & identifying risk Drowning

Disease

Injury

Developing methods to manage the risk Physical methods (DESIGN)

Operational methods (TRAINING)

Management methods (PLANNING & AUDITING)

Assessing compliance

What’s Inside?

1) Preface

2) User Guide

3) Glossary, Acronyms, Initialisms

4) Design and Construction

5) Operation and Maintenance

6) Policies and Management

7) MAHC Resources

8) Appendices

MAHC in Context

Document type? Model code, not a law

Creation Process?CDC led, with substantial input from state and local

public health, aquatics sector, and academiaEvolution NOT revolution

Public comment?Yes, two public comment periods plus 3rd comment

period when users choose to adopt

Can be updated?Yes, improvements based on data and expertise

from public health and aquatics

Enforceable? Must be adopted by state or local authority first

All pools?No, only public facilities in adopting jurisdictions. Also, design and construction provisions mostly

apply to new and remodeled construction

MAHC and Aquatics Industry Partnership

Keeping Pools Safe

and

Keeping Pools Open

are shared motivators for the MAHC and aquatics industry

The Conference for the Model Aquatic Health Code (CMAHC)

What is CMAHC ?

501c(3) non-profit organization

Why does it exist ?

Established in 2013 to manage updates to the MAHC

Administration & Operation

Bylaws, Board of Directors, Executive Director

Committees include Technical Review Committee and Ad Hoc Committees

The Conference for the Model Aquatic Health Code (CMAHC)

Role

Conduit for funneling advice and data-driven, science-based information from public health and aquatic industry experts to CDC

Support use of MAHC

Vision

To keep the MAHC up-to-date, science-based, sustainable, easily understood and implemented by pool programs across the U.S. so as to support healthy and safe aquatic experiences for everyone.

The Conference for the Model Aquatic Health Code (CMAHC)

Mission

Collect, assess, and relay input on MAHC revisions back to CDC for final acceptance

Provide advocacy and needed support to health departments and other partners on using the MAHC

Solicit, coordinate, and prioritize research needs

CMAHC Biennial Conference

CMAHC Biennial Conference will be hosted every two years

Revised MAHC will be launched to coincide with Recreational Water Injury and Illnesses Week (Memorial Day) the following year

Biennial CMAHC meetings: 2015, 2017, 2019, 2021, 2023, 2025, 2027, 2029

New MAHC Edition launches at CDC: 2016, 2018, 2020, 2022, 2024, 2026, 2028, 2030

Improving CR Submission Quality

CMAHC sponsoring listening posts

Encourage group discussion on CRs to get ideas and improvements made before submission

Look at 2015 CRs that didn’t pass but still have merit Can they be improved and marketed better to improve chance of

passage

Improving CR Review and Member Comment Changes

TRC to serve like MAHC development steering committee

TRC to be backed up by 7 Technical Committees modeled after MAHC development process Design/construction, Bather supervision, etc

Can reach out to tech committees for assistance with technical reviews

TRC reviews to be open for members to hear discussion not open for two way conversation vs. member comment

submission

SELECTED DESIGN/OPERATION REQUIREMENTS

Selected Design, Operation & Maintenance Items

Plan submittal/approval

Equipment and materials standards

Air handling system operating manuals

maintenance

Flow turn down system

Chemical feed equipment interlock controls

Staff training

Qualified operators

Contamination response

Design

Plan Submittal & Approval Must be submitted to and approved by AHJ before beginning

construction

• New construction or substantial alteration

• Prepared by licensed/registered design professional

Substantial Alteration means the alteration, modification, or renovation of an aquatic venue

(for outdoor aquatic facilities) or indoor aquatic facility (for indoor aquatic facilities) where the total cost of the work exceeds 50% of the replacement cost of the aquatic venue (for outdoor aquatic facilities) or indoor aquatic facility (for indoor aquatic facilities).

• Thoughts/suggestions for revised definition? If so, please consider submitting a Change Request (CR)

Design

Non-Substantial Alteration Contact AHJ to review proposal prior to starting work

• To determine if new or modified plans need to be submitted for review/approval

Replacements

• Submit technical verification that replacement equipment is equivalent/equal to original prior to replacement

• New or altered plans do not need to be submitted for replacement in-kind

• In emergencies, replacement can be made prior to AHJ’s approval

o Owner has responsibility for subsequent and immediate proper replacement if equipment deemed not equivalent by AHJ

Equipment & Materials

Equipment Must be listed and labeled to an ANSI accredited certification

organization

Materials Vinyl liners acceptable

• If damaged, must shut-down until repaired

Air Handling Systems

Operating manuals must be provided Manual from manufacturer

Supplied to owner by installation contractor

Air Handling Systems

Manual content Startup and shutdown procedures;

PURGING and other SAFETY procedures;

Cleaning procedures;

General maintenance requirements with parts listings and frequency of maintenance (i.e., filter cleaning frequencies, motor bearing maintenance);

Pressure differential specifications for filter replacement, filter replacement type, and frequency of cleaning or replacement;

Troubleshooting processes;

Frequency of required calibration of equipment;

Descriptions of general operating schemes; and

Contact information for the manufacturer.

Recirculation System Turnover Times/Flowrates

Continuous operation 24 hrs/day

Reduced flowrates may be acceptable No more than 25% lower

Only when pool unoccupied

Flow turndown system requirements must be met

• Maintain clarity and disinfectant levels

Chemical Feeder Interlock Controls

Required for all new or existing aquatic facilities

Automatic Deactivation of chemical feeders for no or low flow conditions

Staff Training – Storage, Use, or Handling of Chemicals

Training required prior to access to chemicals All qualified operators, maintenance staff, qualified lifeguards, or

others

Annual review of procedures Storage and handling

Personal protective equipment procedures

Spill procedures

OSHA requirements

Chemical & safety data sheets lists

Training plan

Qualified Operator

Means an individual responsible for the operation and maintenance of the water and air quality systems and the associated infrastructure of the aquatic facility and who has successfully completed an AHJ-recognized operator training course to operate an aquatic facility offered by an AHJ-recognized training agency and holds a current certificate for such training.

Qualified Operator

Required for all aquatic facilities On-site

Contracted off-site

On-site Qualified Operator

On-site Must be on-site or immediately available within 2 hrs during

hours of operation

Where/when required Size & Use

• More than two AQUATIC VENUES; or

• An AQUATIC VENUE of over 50,000 gallons of water; or

• AQUATIC VENUES that include AQUATIC FEATURES with recirculated water; or

• An aquatic venue used as a therapy pool; or

• An AQUATIC VENUE used to provide swimming training.

On-site Qualified Operator

On-site Must be on-site or immediately available within 2 hrs during

hours of operation

Where/when required Bathers & Management

• Permitted BATHER COUNT is greater than 200 BATHERS daily; or

• Operated by a municipality; or

• Operated by a school.

On-site Qualified Operator

On-site Must be on-site or immediately available within 2 hrs during

hours of operation

Where/when required Compliance history

• A QUALIFIED OPERATOR shall be available on-site or immediately available within two hours during all hours of operation at an AQUATIC FACILITY that has a history of CODE violations which in the opinion of the permit issuing official require one or more on-site QUALIFIED OPERATORS.

Contracted Off-site Qualified Operator

Off-site All other AQUATIC FACILITIES shall have an on-site QUALIFIED

OPERATOR immediately available within two hours or a contract with a QUALIFIED OPERATOR for a minimum of weekly visits and assistance whenever needed.

Aquatic Venue Water Contamination Response

Formed-Stool With or without chlorine stabilizers

Diarrheal-Stool With or without chlorine stabilizers

Vomit-Contamination With or without chlorine stabilizers

Blood-Contamination

Procedures for Brominated Pools

Aquatic Venue Water Contamination Response

Close Venue

Physical Removal and disposal of contaminating material

Treat venue water (when contaminated by feces or vomit) Check to ensure that the water’s pH is 7.5 or lower and adjust if

necessary;

Verify and maintain water temperature at 77°F (25°C) or higher;

Operate the filtration/RECIRCULATION SYSTEM while the POOL reaches and maintains the proper free CHLORINE concentration during the remediation process;

Test the CHLORINE residual at multiple sampling points to ensure the proper free CHLORINE concentration is achieved throughout the POOL for the entire DISINFECTION time; and

Use only non-stabilized CHLORINE products to raise the free CHLORINE levels during the remediation.

Aquatic Venue Water Contamination Response

Formed-Stool without chlorine stabilizers Formed-stool contaminated water shall have the FREE CHLORINE

RESIDUAL checked and the FREE CHLORINE RESIDUAL raised to 2.0 mg/L (if less than 2.0 mg/L) and maintained for at least 25 minutes (or an equivalent time and concentration to reach the CT INACTIVATION VALUE) before reopening the AQUATIC VENUE.

Formed-Stool with chlorine stabilizers In AQUATIC VENUE water that contains CYA or a

stabilized CHLORINE product, water shall be treated by doubling the inactivation time required under MAHC 6.5.3.1.

Aquatic Venue Water Contamination Response

Diarrheal-Stool without chlorine stabilizers Check the FREE CHLORINE RESIDUAL and then raise the FREE

CHLORINE RESIDUAL to 20.0 mg/L and maintain for at least 12.75 hours (or an equivalent time and concentration to reach the CT INACTIVATION VALUE) before reopening the AQUATIC VENUE, or

Circulate the water through a SECONDARY DISINFECTION SYSTEM to theoretically reduce the number of Cryptosporidium OOCYSTS in the AQUATIC VENUE below one OOCYST/100 mL as outlined in MAHC 4.7.3.3.2.4.

Aquatic Venue Water Contamination Response

Diarrheal-Stool with chlorine stabilizers• HYPERCHLORINATION accomplished by:

o Following the preparatory guidance outlined in MAHC 6.5.2.3;

o Lowering the CYA concentration to less than or equal to 15 ppm by draining, if necessary;

o Raising the FREE CHLORINE RESIDUAL to 20 mg/L for at least 28 hours; 30 mg/L for at least 18 hours; 40 mg/L for at least 8.5 hours;

o Measurement of the inactivation time required shall start when the AQUATIC VENUE reaches the intended FREE CHLORINE RESIDUAL level or;

• Circulating the water through a SECONDARY DISINFECTION SYSTEM to theoretically reduce the number of Cryptosporidium OOCYSTS in the AQUATIC VENUE below one OOCYST/100 mL as outlined in MAHC 4.7.3.3.2.4 or;

• Draining the AQUATIC VENUE completely.

Aquatic Venue Water Contamination Response

Procedures for brominated pools** Formed-stool, diarrheal-stool, or vomit-contaminated water in a

brominated AQUATIC VENUE shall have CHLORINE added to the AQUATIC VENUE in an amount that will increase the FREE CHLORINE RESIDUAL to the level specified for the specific type of contamination for the specified time.

**There are no inactivation data for Giardia or Cryptosporidium for bromine or any developed protocols for how to hyperbrominate a swimming POOL and inactivate pathogens that may be present in fecal matter or vomit.

QUESTIONS ?

MEMBERSHIP:

HOW TO BECOME A CMAHC MEMBER

MAHCMore Information: Search on

“CDC MAHC” or visit the Healthy Swimming MAHC

Website: www.cdc.gov/mahcEmail: mahc@cdc.gov

CMAHCMore Information: Search on “CMAHC” or visit the CMAHC

Website: www.cmahc.orgEmail: info@cmahc.org

Contact Information

Doug Sackett

Executive Director, CMAHC

E-mail: info@cmahc.org

Phone: 678-221-7218

APSP Membership

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