Water holds pleasures, and lurking menaces
Personal Health: How swimmers and others can avoid "recreational water illness," the gastrointestinal, respiratory and nervous system infections or irritations caused by unseen pollutants. Plus, simple ways to prevent injuries and drownings
The New York Times
I learned to swim at age 3 at Brighton Beach, where each morning, June to October, my father swam freestyle back and forth between the rock jetties. Summering near water was a family essential as I was growing up, a pleasure I carried into adulthood. For more than 30 summers, I swam daily from Minnesota to Wisconsin and back against the current of the scenic St. Croix River. In my 40s, I joined the local YMCA so I could swim year-round.
Swimming is the second most popular sports activity in this country (after walking), replete with health benefits. Swimmers have about half the risk of death of inactive people. Swimming can improve both mental and physical well-being, and it is ideal for people with chronic ailments like arthritis, fibromyalgia, anxiety disorders and physical disabilities — not to mention the temporary relief from gravity it can bring to pregnant women.
For me, swimming is also a meditation exercise; with nothing but the water to distract me, I get some of my best ideas while swimming laps. Dr. Oliver Sacks, the neurologist and best-selling author, wrote in an autobiographical essay called "Water Babies" that the mind-altering properties of swimming can inspire as nothing else can.
But whether you swim in a river, lake, ocean or pool, the last thing you want afterward is what the Centers for Disease Control and Prevention calls a "recreational water illness," an infection or irritation caused by germs or chemicals contaminating the water.
These unseen pollutants can cause ailments of the ears, eyes, skin, nervous system, gastrointestinal and respiratory tracts, and any cut or scratch you may have. Five years ago, the centers examined 78 waterborne disease outbreaks in 31 states associated with recreational sports, a "substantial increase" in the number of reports from previous years. The outbreaks involved 4,412 cases of illness, 116 hospitalizations and five deaths.
And while you might expect otherwise, fully 94 percent of the cases resulted from swimming in treated water — pools and the like that were supposed to be sanitized. The usual culprit was a bacterium called Cryptosporidium, which is resistant to chlorine.
Fortunately, there are measures every swimmer can take to keep water play safe.
The most common problem is diarrhea from swallowing water contaminated with germ-laden feces. Should one swimmer have diarrhea, the millions of germs in that person's stool "can easily contaminate the water in a large pool or water park," the CDC reports.
Natural waters can become contaminated with fecal and other germs by sewage overflow, stormwater runoff, boating wastes and septic systems that malfunction. It is a myth that seawater quickly kills pathogens; coastal waters in particular are rich in nutrients that enable bacteria to survive despite the salt.
Viruses can be even more of a problem, because they live longer than bacteria in saltwater. In one study of beaches in Texas, intestinal viruses were found in more than 40 percent of waters listed as safe for recreational swimming based on bacterial standards.
Protection starts by following usual health department rules to shower before entering a pool — not just a superficial rinse but a full-body soak with special attention to germ-laden body parts. Respect fellow swimmers by staying out of the water if you have a diarrheal illness. Keep ill babies away, too — swim diapers are no guarantee that they won't sicken others.
Be sure pool water is tested regularly for proper chemical balance: twice a day in public facilities and two or more times a week in private ones. Concerned swimmers can invest in chlorine test strips (available at pool supply and home improvement stores) to check the level of disinfectant.
Inflatable and hard plastic kiddie pools are often breeding grounds for infectious organisms. Most are filled with tap water without added disinfectants. The CDC recommends that children be given "a cleansing soap shower or bath" before they use a kiddie pool, which should be emptied and scrubbed clean after each use.
Finally, stay out of water that has been closed by pool or health officials, whose job it is to make sure that water is safe for swimming.
But even a well-maintained swim site can result in inflammation of the ears and eyes. So-called swimmer's ear (acute otitis externa) results in pain, tenderness, redness and swelling of the external ear canal, usually caused by a bacterial infection in the outer ear canal.
Residual moisture is the primary culprit, and the best preventive is to keep the ear canals dry with earplugs or a tight-fitting cap. After swimming, tilt your ear first to one side then the other and shake out any water that got in. Then dry your ears thoroughly with a towel (or hair dryer set on low) and alcohol-based ear drops.
Eyes are even easier to protect. I use goggles wherever I swim, both to protect my eyes and help me see. Wear goggles that fit snugly and are your own. Borrowed goggles could be contaminated with germs that cause conjunctivitis (better known as pinkeye).
Without goggles, the chemicals used to disinfect pools can irritate your eyes, especially when combined with human urea or sunlight. The salt in ocean water can also be irritating.
In addition to polluting microbes, ocean waters sometimes have free-swimming organisms that cause swimmer's itch, as well as the stinging cells of jellyfish.
Swimmer's itch, or cercarial dermatitis, is a rash caused by an allergic reaction to microscopic parasites of birds and mammals that are released into both fresh water and saltwater by snails, their intermediate hosts.
Avoid swimming in areas where snails are common or where signs have been posted warning of this problem or the presence of jellyfish. To counter the effects of swimmer's itch, use a corticosteroid or anti-itch cream, and bathe in Epsom salts or baking soda.
If stung by jellyfish, try dabbing the skin with vinegar to neutralize the toxin and relieve the pain. People with a bee sting allergy should be especially careful to stay out of waters containing jellyfish. If you are allergic to one, you may well be allergic to the other.
SIMPLE WAYS TO PREVENT INJURIES AND DROWNINGS
Even more common than illness as an aftermath of swimming are injuries and drowning. Yet swimmers and their guardians can easily prevent an overwhelming majority of these accidents and tragedies.
According to the Consumer Product Safety Commission, more than 200,000 swimming-related injuries require medical treatment each year. And the Centers for Disease Control and Prevention reports that each day about 10 people die from unintentional drowning (not counting boating accidents), two of whom are children younger than 15. Drowning is the second most common cause of injury death among children under age 14.
Indicative of their propensity for risk-taking, nearly 80 percent of drowning victims are male.
The list of preventives starts with the obvious. Learn how to swim, preferably at an early age (3 or 4), though it is never too late.
If you have a private pool, make sure it is properly fenced and secured with a lock to keep out young children and uninvited guests. Make sure the pool has depth markers, and keep rescue equipment at poolside.
Never swim alone — always have a buddy who is an experienced swimmer — and swim only in supervised areas. Inexperienced swimmers should wear life jackets in the water and not depend on air-filled swimming aids. These can deflate at any time or, in some cases, float away and leave a weak swimmer stranded.
Children must be closely supervised in and around water by an adult who is a good swimmer. Teach children never to cry wolf, never to pretend they are drowning, lest they be ignored if they really get into trouble.
Never dive into shallow or murky water or where conditions on the bottom are unknown. Don't swim in a river unless you are a strong swimmer and familiar with the currents. Avoid river swimming after a storm, when the current may be a lot stronger and new hidden obstacles may be present.
Stay out of the water during an electric storm in the area; lightning can travel through water for up to a mile.
At the beach, check with the lifeguard before going in the water to find out the water temperature, how strong the waves are, and whether there is a strong undertow or current. Swimming in very cold water can shock your body and impair muscle movements, making it harder to swim.
The U.S. Lifesaving Association reports that 80 percent of rescues by ocean lifeguards involve people caught in rip currents that circulate water back to sea after it reaches the shore. Avoid swimming where there are rip currents; if you should get caught in one, swim parallel to the shore until the pull of the current stops. Alternatively, tread water and wave for assistance. Stay at least 100 feet from piers and jetties, where rip currents are more likely to occur.
Drinking and swimming is as dangerous as drinking and driving. Don't do it.
And don't swim in the dark, when you can easily lose track of where you are.
If, like me, you are a frequent lap swimmer, you can reduce the risk of shoulder injury by strengthening the muscles around the shoulders and in the upper back and taking a few minutes to warm up and stretch before getting into the water.
Even if you are an experienced swimmer, a few lessons to improve your technique can reduce the risk of repetitive stress injuries.
When swimming outdoors, protect yourself from sunburn. Use water-resistant sunscreen and reapply it after toweling off. Young children can be protected by special swim cover-ups, which are well worth their cost.
When swimming in natural waters, consider wearing something to protect your feet against injury from rocks, broken glass and other trash.
Finally, know your limits. Don't swim on a dare or try to swim where you are unsure of your ability or safety just because someone else is doing it.
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