NEHA July | Page 10

ADVANCEMENT OF THE SCIENCE
These changes would involve training current safety inspectors and using an incremental approach to allow regulatory and industry partners to adapt to changing MAHC guidelines . CDC ( 2023b ) provides resources for public health officials and aquatic staff to implement MAHC recommendations or strengthen their aquatic health and safety programs . The advantages of incorporating MAHC guidelines would be use of the most effective water safety inspection criteria , which could translate into reduced RWIs . Furthermore , inspection results could be compared with other jurisdictions that use similar inspection criteria .
A promising aspect of our study is the ability to illustrate the distribution of swimming pools in Houston based on their safety grade . This mapping has potential use in injury prevention . This approach has been used in playground safety , where the safety scores of playgrounds in need of maintenance were spatially mapped in Chicago to effect improvements in fall surfacing and equipment maintenance ( Allen et al ., 2013 ).
The same approach could be applied to swimming pool safety in Houston . Currently , Houston maintains an up-to-date listing of all pool violations by property that is accessible to the public ( Houston Health Department , 2023b ). The City of Plano , Texas , employs a similar scoring system that allows the public to look up swimming pools with color-coded scores that show the results of the swimming pool inspection ( Plano Health Department , n . d .).
Data from our study demonstrate that the swimming pools that failed safety inspections were predominantly concentrated in Southwest Houston , which has a larger percentage of residents belonging to a lower socioeconomic status ( City of Houston Planning & Development Department , 2016a ) and racial and ethnic minority groups ( City of Houston Planning & Development Department , 2016b ). The rate of unintentional drownings is higher in children belonging to racial and ethnic minorities ( Felton et al ., 2015 ; Gilchrist & Parker , 2014 ), which could serve as a focus for injury prevention efforts to reduce drowning .
Limitations There are several limitations to our study . First , our findings are not generalizable to other jurisdictions that have other types of
TABLE 4 continued from page 13 Frequency of Observed Swimming Pool Violations
Item From the Model Aquatic Health Code ( MAHC ) Inspection Form Observed by the City of Houston
Observed Violations # (%)
Water chemicals
Approved NSF / ANSI Standard 50 DPD test kit
2 ( 0.05 )
Proper disinfectant level
516 ( 12.7 )
pH between 7.2 and 7.8
449 ( 11.1 )
Equipment and chemical room
Automated feeder operable
99 ( 2.4 )
Piping and valves identified and marked
238 ( 5.9 )
Flow meter present and operating
126 ( 3.1 )
Recirculation pump : approved , in good repair , operating
38 ( 0.9 )
Filter : approved , in good repair , operating
8 ( 0.2 )
Pump strainer : baskets in good condition , not clogged
1 ( 0.02 )
Filter gauges operable : filter inlet and outlet , strainer ; sight glass
74 ( 1.8 )
Chemicals : labeled , stored safely , secured
1 ( 0.02 )
Records room
Lifeguard training certification available on-site
2 ( 0.05 )
Note . Bolded items represent critical code items in the MAHC .
FIGURE 1
Location of Swimming Pools in the City of Houston That Received A Grades
Note . Shaded area indicates the City of Houston .
14 Volume 86 • Number 1