A study by the Centers for Disease Control and Prevention finds that nearly 5,000 emergency room visits in the US during 2012 were caused by injuries from pool chemicals.

For almost a century, chemicals have been added to pools, hot tubs, spas and interactive fountains to kill any pathogens that might affect the health of people using these recreational water venues. But these chemicals can also cause injuries if they are not handled or stored properly.

The Centers for Disease Control and Prevention (CDC) analyzed data from the US Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS) to estimate the number of emergency department visits for pool chemical-associated injuries during 2003-2012.

Although no deaths were recorded during the study period, the CDC report says that in 2012, 4,900 people visited an emergency department for pool chemical injuries. Almost half of the patients with pool chemical injuries in the NEISS survey were aged under 18, and more than a third of injuries occurred at home.

The most frequent diagnosis of these injuries was poisoning, stemming from inhalation of vapors, fumes or gases.

Patients were also injured when handling pool chemicals without using protective equipment, such as goggles, when chemicals were added to water shortly before the patient entered the water and when chemicals were not secured away from children.

However, the NEISS survey did not record some basic characteristics of the patients and their injuries – such as patient race – and it did not contain complete information on pool chemical-related injuries that did not lead to an emergency room visit.

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Almost half of the patients with pool chemical injuries in the NEISS survey were aged under 18, and more than a third of injuries occurred at home.

The authors also admit that some of the injuries could have been misclassified – such as dermatitis that is inflamed by water-dwelling bacteria rather than pool chemicals. Also, the chemistry of the water can change quickly, making it difficult to discern the exact cause of a pool-related injury.

The report explicitly states that “pool chemical-associated health events are preventable.”

As an example of a preventable pool chemical injury, the report mentions an event that occurred in Minnesota in 2013, where seven children and one adult were sent to an emergency department. The Minnesota Department of Health conducted an investigation into the event and determined the cause to be poor monitoring of pool chemistry.

The report nominates the CDC’s Model Aquatic Health Code as a resource that state and local agencies can use to prevent these types of injuries.

The authors include some pointers for avoiding injuries related to pool chemicals. They say before using pool chemicals:

  • Get trained in pool chemical safety (i.e. during an operator training course)
  • Ask for help if you are not trained for specific tasks
  • Read entire product label or Safety Data Sheet before using.

And, to use pool chemicals safely:

  • Keep young children away when handling chemicals
  • Dress for safety by wearing appropriate safety equipment (i.e. safety goggles, gloves and respirator)
  • Handle in a well-ventilated area
  • Open one product container at a time and close it before opening another
  • Minimize dust, fumes and splashes
  • Measure carefully
  • Never mix chlorine products with acid or different pool chemicals with each other or with any other substance
  • Only pre-dissolve pool chemicals when directed by product label
  • If product label directs pre-dissolving, add pool chemical to water; never add water to pool chemical because a potentially explosive reaction can occur.

Additional information on pool chemical safety can be found on the CDC’s website.