Posting Regulations for Vendors of Alcoholic Beverages (Chapter 1) - Requirement of the Breath-Holding Warning Signage at swimming pools

Proposed Rules: Closed to Comments (View Public Comments Received:1)

Comment By: 
Tuesday, November 24, 2015
Download Copy of Proposed Rule (.pdf): 


Statement of Basis and Purpose


Repetitive or prolonged underwater swimming or breath-holding can be deadly. During these activities the levels of oxygen and carbon dioxide in the body can drop, delaying the breathing reflex. Coupled with the lack of oxygen to the brain, a swimmer can lose consciousness and drown. This risk is heightened when breath-holding is coupled with intentional hyperventilation caused by repeatedly taking deep breaths, or when done as a competitive activity.


The Department has identified four drowning incidents in New York City and 12 other incidents in New York State between 1988 and 2011 that were confirmed or suspected to have been caused by a loss of consciousness underwater due to lack of oxygen caused by intentional hyperventilation or by competitive, repetitive or prolonged underwater swimming or breath-holding. Four of the sixteen swimmers involved died in incidents associated with intentional hyperventilation. Yet, many swimmers are unaware of the risks associated with these activities.[1]

 The Department has also studied relevant policies, practices and guidance of multiple jurisdictions and organizations with respect to these specific swimming behaviors. Several jurisdictions require pool operators to post signs regarding the risks associated with prolonged breath-holding activities and extended underwater swimming. These signage requirements can be found in the rules of local governmental jurisdictions that regulate pool facilities and in the policies of large governmental entities and non-governmental organizations that own and operate pool facilities. Additionally, governmental agencies and safety awareness organizations have developed guidance and educational materials that promote swimming behavior rules and signage requirements to reduce the risks associated with these activities.

 Article 165 of the New York City Health Code regulates bathing establishments, including swimming pools, spa pools and spray grounds. Health Code §165.41(u)(2)(K) was added by the Board of Health on September 10, 2013, and authorizes the Department to design and mandate posting of a pictogram that informs swimmers of the dangers of underwater breath-holding behaviors—taking deep breaths, one after the other, before swimming underwater—and of breath-holding contests, to warn and prevent swimmers from engaging in these deadly swimming activities.

 Proposed Changes

             The Department is proposing to amend Chapter 1 of Title 24 of the Rules of the City of New York to require pool operators to post signs warning of the dangers of prolonged underwater breath-holding behaviors. Chapter 1 currently only requires signage about the risks of drinking alcohol during pregnancy in food service establishments. The Department is proposing to reorganize this Chapter so that its provisions will apply to various signs required by the Department in various settings. The requirement for a sign warning of use of alcohol in pregnancy is proposed in section 1-01 of the Chapter, and the requirements for the new underwater breathing sign are proposed in section 1-02 of the Chapter.  The Department is proposing minor changes in section 1-01 of the Chapter regarding alcohol use warning signs to make the section more consistent and readable, though the substantive requirements will remain unchanged from the current Chapter 1.

 Pool operators will be required to post signs with the specific design and warning text indicated in the proposed rule. 

 Statutory Authority

 New York City Charter (“Charter”) §§ 556 and 1043 authorize these amendments.  Pursuant to § 556 of the Charter, the Department has jurisdiction to regulate all matters affecting health in the City of New York. Section1043 of the Charter gives the Department rulemaking powers. Section 165.41(u)(2)(K) of the New York City Health Code authorizes rulemaking related to posting warning signs at pools of the dangers of repetitive or prolonged underwater swimming or breath-holding.


[1] C. Boyd, et al., Fatal and nonfatal drowning outcomes related to dangerous underwater breath-holding behaviors – New York State, 1988-2011, CDC MMWR, May 22, 2015, 64, 19, 518-521.


Public Hearing

Proposed resolution to amend Chapter 1 (Posting Regulations for Vendors of Alcoholic Beverages) of Title 24 of the Rules of the City of New York to require signage at swimming pools that indicates competitive breath holding is prohibited and warns swimmers of the risks involved.

Public Hearing Date: 
Tuesday, November 24, 2015 - 10:00am

Svetlana Burdeynik at

New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street 14th Floor, Room 14-31 Queens
New York, NY 11101-4132