Protection of public health from microbial and chemical hazards in swimming pool environments; Dissertation, Utrecht University and IHE Delft Institute for Water Education

This thesis describes the occurrence of microbial and chemical contaminants in swimming pools and the investigation of an alternative disinfection technology, UVOX Redox® that could reduce reliance on chlorine and the formation of chlorinated disinfection byproducts (DBPs) in swimming pools. This technology was effective in inactivation of chlorine resistant microorganisms, represented by Bacillus subtilis spores, and in combination with chlorine generated lower concentrations of chlorinated DBPs compared to chlorination alone. It enhanced the removal of pharmaceuticals and personal care products (PPCPs), which were frequently present in indoor, outdoor and spa pools. Carbamazepine and 1H-benzotriazole were the most frequently detected PPCPs, while hydrochlorothiazide and 4-methylbenzylidene camphor were detected at the highest concentration. An investigation of seven different swimming pool facilities showed that clinically relevant fungi were omnipresent. Floors at the sites where the pool visitors converge, such as the exit leading to shower rooms, showed the highest fungal concentrations. The distribution of fungi inside the swimming pool facilities highlighted potential transmission pathways and a possible risk of fungal infections. Future swimming pool water guidance should include raising awareness among swimmers, pool operators and managers about hygienic behaviour and better hygiene measures, and application of alternative disinfection technologies such as UVOX