Nonhygienic Behavior, Knowledge, and Attitudes among Interactive Splash Park Visitors
Nett, Randall J., Toblin, Robin, Sheehan, Annora, Huang, Wan-Ting, Baughman, Andrew, Carter, Kris, Journal of Environmental Health
Interactive zero-depth splash parks are youth-oriented recreational water attractions with features that spray or pour water on visitors. Splash parks are popular recreational water venues because they are typically free, easily accessible, and often located within municipal parks. They have also been associated with recreational water illness (RWI) outbreaks (Centers for Disease Control and Prevention [CDC], 2000, 2009; Hoebe, Vennema, de Roda Husman, & van Duynhoven, 2004; Jones et al., 2006; Liang et al., 2006; Schaffzin et al., 2006). Water, often initially supplied by a municipal source, might be treated and recirculated through the splash park, usually passed through a high-flow sand filtration system, chlorinated, and in certain parks, treated with ultraviolet disinfection systems. In the majority of states, splash parks are unregulated and not subject to construction review or routine inspection by public health (Kebabjian, 2003; Schaffzin et al., 2006). Therefore, no consistent requirements for water treatment, educational signage, or supervision at splash parks exist in the majority of states. In contrast with swimming pools, splash parks operate with a smaller volume of water and consequently have substantially larger bather densities (gallons of water per bather), perhaps increasing the risk for RWI outbreaks (Kebabjian, 2003). Certain RWI outbreaks (e.g., Shiga toxin-producing E. coll) that have been associated with splash parks have the potential for causing severe, life-threatening illness, particularly among groups at high risk (i.e., young children) (Castor & Beach, 2004; Gilbert & Blake, 1998).
Nonhygienic behaviors (e.g., exposing buttocks to splash feature water or placing an open mouth to splash park water) likely contributed to three RWI outbreaks in Idaho in 2007 (Carter, unpublished data, 2007 and Jue, unpublished data, 2007) (CDC, 2009). In response, operators of two separate splash parks where RWI outbreaks occurred posted educational signage adjacent to the splash pads advising visitors that diapered children must wear swim diapers and that visitors should not drink the splash park water. Additionally, both of these splash park operators hired a hygiene attendant, either part-time or full-time, to limit nonhygienic behaviors. We identified no published studies reporting the effectiveness of any public health interventions at splash parks or reporting adult supervisor knowledge of splash park-associated RWI.
To assess the effectiveness of selected interventions and to provide baseline information on nonhygienic behavior, knowledge, and attitudes among splash park visitors, we conducted a behavioral observation study at four Idaho splash parks, two of which had educational signage and hygiene attendants.
The research protocol was reviewed by the Idaho Department of Health and Welfare Institutional Review Board Committee and granted an exempt status.
Our study had two primary components: structured observation of the behavior of children visiting splash parks and administration of questionnaires to their adult supervisors. A four-person research team was trained in both observation and interviewing. During each two-hour study session and on a rotating basis, three team members performed disguised observation while a fourth administered questionnaires. Seven two-hour observational sessions were completed at each of the four busiest Idaho splash parks that were located in municipal parks and free for the public. Two splash parks employed hygiene attendants and had signage with messages advising visitors not to drink the splash park water and stating that diapered children must wear swim diapers.
Participants were children playing in the splash park during observational sessions.
Before each observational session, the splash park was photographed to allow for a cross-sectional count of total number of visitors (adults and children). …