Baby and toddler swimming in warm hydrotherapy pools

PWTAG Technical notes are updates or new material for the standards and guidance given in the PWTG book, Swimming Pool Water and the PWTAG Code of practice and should be read in association with these publications.

A previous technical note on this subject appears to have caused some confusion. PWTAG’s experts have reviewed the evidence and this is our considered advice.

PWTAG still recommends that hydrotherapy pools in hospitals should not be used for baby and toddler swimming classes. Infections, including from Cryptosporidium, have resulted from this type of use.

Both patients and children are potential sources of infection, and both groups may also be vulnerable to infection, as may be hospital staff who spend many hours each day in the pool.

Hydrotherapy pools in other settings, including special schools, may be considered for baby and toddler swimming classes. But pool providers and operators, as well as those hiring the pools, should first do a formal risk assessment. This should take into account the potential infectious risk from – and the susceptibility of – all the people who use and work in the pool, both outside and within these classes.

The characteristics of the pool itself should be included in that risk assessment. That means considering what the pool was designed for, as well as its hydraulics, bather load, filtration, primary and secondary disinfection etc.

Hydrotherapy pools in hospitals are routinely tested microbiologically once a week. So too should hydrotherapy pools in other healthcare settings where staff or patients are vulnerable.

The risk assessment of other hydrotherapytype pools for baby and toddler swimming should consider the possibility that weekly testing is necessary there also. This may apply, for example, to some special schools.

Detailed guidelines for the water treatment of hydrotherapy and other pools can be found in PWTAG’s book, Swimming Pool Water: treatment and quality standards for pools and spas.