ool Hygiene

Notice there’s no “P” in there

By Dr. Chris Thurber

Most camps have worked hard for decades to get kids and staff to wash their hands after using the bathroom and before meals. Now both groups do it almost instinctively. I still see people cough and sneeze into their palms, but most people now blow their droplets into an elbow.

© Can Stock Photo / EpicStockMedia

Better personal and public hygiene are the upsides to the COVID-19 pandemic. But peeing in a pool might be a habit that’s harder to change. As a psychologist with an aquatic background, I thought it was time to address this—ehem … somewhat nasty—issue. If your camp has a pool, this will be a transformative article, but you can stop here if you’re confident your pool is perfectly clean.

The Quick And Dirty

© Can Stock Photo / lakmaljz

The Water Quality & Health Council is an independent group of scientific experts, health professionals, and consumer advocates whose mission is to “promote science-based practices and policies to enhance water quality and health by advising industry, health professionals, policymakers, and the public.”[1] The Council’s most recent survey of more than 3,000 adults revealed that between 30 and 40 percent admitted to urinating in a pool once or more in the previous year.[2]  (Surprisingly, respondents said they were more likely to pee in their own pools than in a community or friend’s pool.) Although children were not surveyed, it’s probably safe to double those percentages.

Who cares? Pools have chlorine, or sometimes bromide or salt chlorine generators, to sanitize the water. But we should all care, according to Dr. Chris Wiant, chair of the Water Quality & Health Council. He writes: 

Swimmers’ unhealthy swimming habits can make loved ones sick. We all share the water we swim in. And although chlorine and other pool chemical disinfectants are effective at disinfecting pools, they might be used up by contaminants, such as pee, sweat, and dirt from swimmers’ bodies. Chlorine mixing with these contaminants is what makes swimmers’ eyes red, not chlorine in and of itself. Protect yourself and loved ones by showering before going in the pool and don’t pee in the water.[3]

To truly appreciate the importance of this interesting fact and its sound advice, we need to dial back the clock more than 200 years and start sniffing around southern Sweden for some stinky gas.

Yellow And Green Make It Clean

Carl Wilhelm Scheele was born in 1742 in Stralsund, northern Germany, across the Baltic Sea from Sweden. After a two-year career as a pharmacist in Stockholm, he moved 40 miles north to Uppsala to direct the Locke Laboratory, which supplied chemicals to pharmacies and other labs in the region. Besides manufacturing chemicals, Scheele loved to experiment with them. He and his chemistry professor friend, Torbern Bergman, were actually the first scientists to discover oxygen and describe it as an element.4 (English chemist Joseph Priestly usually gets the credit because he published his findings first, but Scheele isolated oxygen at least two years before Priestly.)

Scheele had fun making candle flames bigger and brighter in the presence of oxygen, which he described as colorless and odorless. His next great discovery was neither. Scheele dissolved crystals of manganese dioxide (the same substance some Neanderthals used to draw on cave walls and perhaps to make fire) in hydrochloric acid, and then warmed the mixture up. What bubbled out was a yellowish-green gas with a strong odor. Scheele did not understand that this gas was the element chlorine, but he wrote all about its power to bleach fabric, kill insects, and oxidize metals.5 (Another English chemist, Sir Humphry Davy, was the first to recognize this gas was an element. Davy also named it chlorine, from the Greek word, khloros, which means “pale green.”)

The Magic of Oxidation

To understand chlorine’s disinfecting properties requires a brief chemistry lesson on a process called oxidation. Oxidation occurs when a molecule, atom, or ion loses electrons. As you might guess, the word oxidation comes from oxygen, the first known oxidizing agent. (Thank you, Carl Scheele.) However, oxidation reactions do not have to involve oxygen; they merely have to involve the loss of electrons. And losing electrons, as it turns out, can seriously degrade a substance, whether it’s organic, like a bacterium, or inorganic, like a metal.

A common example of oxidation isiron being exposed to oxygen, perhaps in the air or maybe dissolved in water. Oxygen takes electrons away from iron. And when iron loses electrons, it becomes a brittle, flaky, brownish-orange substance called iron oxide, also known as rust. Anyone who spends time around a camp waterfront or swimming pool can tell which equipment is prone to oxidizing. I spent the better part of 30 consecutive Junes replacing rusty mooring chains so Camp Belknap’s sailboats would stay put. Personal rust grievances aside, the point to remember is that oxidation is destructive.6

Now, back to chlorine, the oxidizing substance used to destroy bad stuff in pools. You may be wondering, If chlorine is a gas, what am I putting in my pool? Well, if you use chlorine tablets, they are calcium hypochlorite; if you use chlorine liquid, those bottles contain sodium hypochlorite. Both of these chlorine derivatives are easier to store and handle than a pressurized canister of pure chlorine gas, so they are much safer for the average consumer.

When either calcium hypochlorite or sodium hypochlorite is mixed with water, the reaction makes hypochlorous acid. At that point, the magic of oxidation unfolds. As an oxidizer, hypochlorous acid “steals” electrons from the cell walls of bacteria and viruses (yup, even from COVID-19!), thus destroying them. It also prevents the cell’s DNA and RNA from replicating, so a pool can’t become a breeding ground for germs. In your pool—in the right concentration—hypochlorous acid is good stuff. 

Although hypochlorous acid is a weak acid, it’s a strong disinfectant. Its oxidizing power wreaks havoc on all types of germs, rendering them harmless. Human white blood cells even contain a bit of hypochlorous acid, as part of their defense against bodily infection. Most of the other fiddling done with pool chemistry, such as adjusting hardness, alkalinity, and pH, is designed to help hypochlorous acid do its job by not degrading into another chemical.

The Power of Pee

Urine is sterile, but who wants to swim in it? Besides the yuck factor, urine contains urea and uric acid, both of which break down to form ammonia. And ammonia—you guessed it—reacts with hypochlorous acid, breaking it down and diminishing its sanitizing power. Human sweat also contains urea and uric acid, adding even more ammonia and ammonia-derived compounds to a pool.

When ammonia breaks down hypochlorous acid, the resulting chemical reactions are harmful for two reasons: less hypochlorous acid is available to oxidize bacteria and viruses, and two poison byproducts are created: chloramines and cyanogen chloride. You know why bacteria and viruses are bad, but what about chloramines and cyanogen chloride?

Chloramines provide that characteristic pool smell. Fun fact, sure. Yet, instead of reassuring one that the pool is chlorinated, that smell indicates that chlorine levels (actually hypochlorous acid) are too low. Chloramines wouldn’t be in the air unless the hypochlorous acid desired in pool water had been degraded. Worse still, chloramines irritate the respiratory system and eyes. And that’s no fun.

Cyanogen chloride is far more toxic than chloramines. Fortunately, very little is produced, even when plenty of swimmers mistake a pool for a potty. In fact, it would take a pool that is one part chlorine and one part water, plus more urine than the entire volume of this hypothetical (cess)pool, to produce dangerous amounts of cyanogen chloride. Despite the tragic fact that cyanogen chloride is among a dozen or so toxic substances that have been weaponized over the last century in chemical warfare,7 the levels of cyanogen chloride typical for a public pool are lower than the U.S. government’s standards for what is tolerable in drinking water. Nevertheless, even minimal levels of cyanogen chloride can irritate the eyes, nose, and throat with prolonged exposure. Again, that’s no fun.

I Don’t Swim In Your Toilet; Please Don’t Pee In My Pool

You’ve read this witticism before, maybe even seen it posted on a sign. This is why it matters. Urine and sweat reduce chlorine’s power to disinfect a pool, plus the byproducts of chlorine’s reacting with urine and sweat cause physical irritation.

The best way to keep a pool safe this summer is vigilant lifeguarding, as I’ve written about often in this column. And the best way to keep a pool clean is to ensure participants use it only for swimming, playing, and cooling off. However, that’s easier said than done, as anyone who has jumped into a pool can tell you … and that’s, well, everyone.

When a pool’s water temperature is cooler than a body’s internal temperature, there is a physiological phenomenon known as the shell-core effect. Blood vessels near the surface of the skin (the “shell”) constrict to conserve heat and shunt blood to internal organs (the “core”). Then, because a body needs to filter more blood through the core in order to keep warm, the kidneys have to work overtime. This creates more urine, which increases the urge to go. Doctors (who also pee in pools from time to time) call this “cold diuresis.” The rest of us just think, A minute ago, I didn’t have to go. But now that I’m in the pool, I gotta pee.

Where does all this science leave us? Peeing in a pool is common, but unhealthy. As if that weren’t bad enough, the body’s response to refreshing dips in the water is often an increased urge to urinate. The social, chemical, and physiological cards are stacked against anyone who wants a clean pool.

João Rabelo / Pexels

In order for pool water to be healthier, I recommend upgrading pre-pool procedures with these four steps:

1. Anyone who is feeling ill or has recently had diarrhea should not use a pool. Intentionally introducing viruses and bacteria, especially the E. coli, Salmonella, Shigella, and Vibrio bacteria in human feces, is asking for trouble. Likewise, babies and anyone else who is periodically incontinent should wear a clean swim diaper that fits snugly around the waist and legs. If any swimmer has an accident in a diaper, that person should immediately exit a pool. If any feces have leaked out of the diaper, or out of a swimmer not wearing a diaper, everyone should exit the pool and take a soapy shower while the lifeguards decontaminate the pool.

2. In cases where feces are not an issue, pool use should begin with all swimmers taking a warm (not hot) shower, ideally around 85° F / 30° C. Even without soap, this practice removes most of the dirt and sweat on a body (Urea/Uric Acid Dump 1). As a bonus, anyone who might have thought the pool is a substitute for a bathtub or shower will now have experienced this important distinction.

3. Next, everyone should visit the restroom and attempt to urinate, even if they don’t feel like going. Rinsing off under a warm shower first will help empty the bladder, thanks to the reliable shell-core effect. If a camp’s showers and restrooms are nowhere near the pool, that’s inconvenient, but, again, hitting the showers before the restrooms will always make that second stop more, um, productive (Urea/Uric Acid Dump 2).

4. Finally, add signage around a pool that reminds participants not to pee in the pool. The signs pointing to restrooms can be humorous, serious, or both, as long as participants get the message.

So, there you have it—more than you ever wanted to know about the most common, and most invisible, behavior problem at camps with pools. Fortunately, the solution is clear (both puns intended).

Christopher Thurber, PhD, is a clinical psychologist and faculty member at Phillips Exeter Academy. He created Prep4Camp.com, the only evidence-based homesickness prevention program, and co-authored the best-selling Summer Camp Handbook with Dr. Jon Malinowski. His newest book, The Unlikely Art of Parental Pressure, includes eight ways adults can transform harmful pressure to healthy pressure. Learn more about the work that Chris does with schools, camps, and companies on DrChrisThurber.com.

Resources

[1] https://waterandhealth.org

[2] Water Quality & Health Council (2020). Healthy Pools Survey. https://waterandhealth.org/wp-content/uploads/2020/05/Healthy-Pools-2020-Survey-Results-FINAL.pdf (Retrieved Dec. 9, 2022)

[3] Water Quality & Health Council (2018). Would you know if your local pool failed its health inspection? https://waterandhealth.org/healthy-pools/would-you-know-if-your-local-pool-failed-its-health-inspection-unlikely-survey-reveals/ (Retrieved Dec. 9, 2022)

4 https://www.britannica.com/biography/Carl-Wilhelm-Scheele (Retrieved Dec 9, 2022)

5 West, J. B. (2014). Carl Wilhelm Scheele, the discoverer of oxygen, and a very productive chemist. American Journal of Physiology-Lung Cellular and Molecular Physiology, 7(11): 811-816

6 In case you’re wondering, antioxidants are substances that can give some of their extra electrons to any unstable molecule that lacks a full complement of electrons. Our body produces these unstable molecules, also called “free radicals,” as a natural part of metabolism, exercise, and aging. As oxidizers, these free radicals help our body destroy harmful bacteria and viruses, just like the hydrochlorous acid in your pool. However, too many free radicals, from exposure to tobacco smoke, ultraviolet rays, and air pollution, increases our risk for cancer and other diseases. A well-rounded diet that includes colorful fruits and vegetables has enough antioxidants, such as vitamins C and E, to help your body maintain a healthy level of free radicals.

7 Tragically, cyanogen chloride is among the dozen or so toxic substances that have been weaponized over the last century in chemical warfare. See Black, R. (2016). Development, Historical Use and Properties of Chemical Warfare Agents. Chemical Warfare Toxicology: Volume 1: Fundamental Aspects, pp. 1-28.