Public Health England (PHE) and NHS England have temporarily advised expectant mothers “Against the home use of birthing pools with built-in heaters and recirculation pumps, potentially filled up to 2 weeks in advance of the birth” (17th June 2014 – www.gov.uk) . “This follows a single case of Legionnaires’ disease identified in a baby born in this specific type of birthing pool at home. The baby is currently receiving intensive care treatment in hospital”.
(Public Health England (June 2014) Alert after Legionnaires’ disease case in baby [Press Release] Sourced from: https://www.gov.uk/government/news/alert-after-legionnaires-disease-case-in-baby)
The alert comes after a case of Legionnaires ‘disease was identified in a baby born in a home birth in one of the pools. Water samples confirmed the presence of Legionella bacteria. This is the first reported case of Legionnaires’ disease linked to a birthing pool in England, although there have been 2 cases reported internationally some years ago.
Prof. Nick Phin, PHE’s expert on Legionnaires’ disease, a severe form of pneumonia, said: “This is an extremely unusual situation, which we are taking very seriously. As a precaution, we advise that heated birthing pools, filled in advance of labour and where the temperature is then maintained by use of a heater and pump, are not used in the home setting, while we investigate further and until definitive advice on disinfection and safety is available.
“We do not have concerns about purchased or hired pools that are filled from domestic hot water supplies at the onset of labour, provided that any pumps are used solely for pool emptying.
“PHE and relevant local authorities are investigating the infection control measures required for this type of birthing pool and local authorities will be working with the small number of companies who supply these heated birthing pools for use at home.”
In light of the current warning, BISHTA, the Trade Association for the British and Irish Spa and Hot Tub industry, would like to highlight these potential safety considerations when using, purchasing, hiring and maintaining spa products for home birthing purposes.
BISHTA formed in 2001 following the outbreak of Legionnaires’ disease in the Netherlands and Belgium in 1999 that killed a number of people visiting flower shows where hot tubs were on display (filled with water, but not treated with chlorine). BISHTA is the only Trade Association anywhere in Europe totally dedicated to solely representing the Spa and Hot Tub Industry, with published Standards.
The key message from BISHTA has always been about promoting safe spa water. By providing water hygiene management training, both BISHTA and its Members can ensure that the rest of the industry is aware of their responsibilities, for maintaining spa water with an appropriate level of sanitiser (bromine, chlorine or PHMB) to reduce to a minimum the risk of having the Legionella bacteria developing into the potential danger of Legionnaires’ disease.
BISHTA’s Technical Adviser, Howard Gosling said: “BISHTA estimates there are at least 100,000 hot tubs and swim spas in the British Isles, and given the isolated number of incidents each year, this demonstrates that by following the simple rules needed for water hygiene management, these spa pools can be safely maintained and used.”
It is vital that companies selling or hiring out products that will contain heated water for the purpose of bathing follow the advice of the relevant public health agency and the Health and Safety Executive to ensure that they are adequately maintained. This advice is contained within a range of publications, such as ‘Management of Spa Pools – Controlling the Risk of Infection’ and also ‘Legionnaires’ Disease – The Control of Legionella Bacteria in Water Systems – Approved Code of Practice and Guidance (This HSE Code of Practice is also referred to as “L8”) and the PWTAG Swimming Pool Water Book (p.16). Every business in this industry should have a copy of these publications. Businesses that provide spa facilities on their premises and/or sell or hire out these products should also carry out a Risk Assessment, in accordance with BS 8580, which should be reviewed annually.
BISHTA provides advice on water hygiene management to its 100+ members around Britain and Ireland, and expects them to abide by a Code of Ethics for responsible trading. Staff should be vigilant about their personal health and should inform colleagues and family of the symptoms in case they become unwell, especially with pneumonia.
Through the vigilance of BISHTA and its members, customers can be sure that they are receiving the correct advice on how to safely maintain their spas. BISHTA would strongly urge customers to buy or hire from BISHTA members, as companies that are not members of BISHTA may not be suitably trained in water hygiene management and sadly, in some cases, the products being sold or hired by non-members are not always of a suitable quality.
BISHTA welcomes applications for membership from anyone involved in manufacturing, importing, distributing, retailing or utilising hot tubs in a business setting. An approved Water Training course is a pre-requisite for BISHTA Membership.
BISHTA works alongside The Swimming Pool and Allied Trades Association (SPATA); both trade associations offer advice and guidance, providing resources for customers along with an easy to use ‘Find a Member’ postcode search facility.
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