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 Most of the symptoms improved after the lifeguards left work,
suggesting that chemicals used to maintain indoor pools may be
triggering the symptoms, the study authors report in the
International Journal of Environmental Health Research.
“In the past years, in the province of Quebec as well as in other
jurisdictions, lifeguards’ and competitive swimmers’ awareness of
potential irritative effects related to indoor swimming pools
increased,” lead author Gabrielle Bureau told Reuters Health in an
email.
“However, this study clearly highlights the fact that indoor
swimming pool environments may have adverse health effects on the
respiratory system and suggest a relationship between respiratory
symptoms and the time spent in this environment as a lifeguard,”
said Bureau, a researcher at the Department of Social and Preventive
Medicine of Laval University in Quebec City.
The researchers surveyed current and former licensed lifeguards
using online questionnaires to assess their exposure to swimming
pool environments and certain symptoms such as cough, sputum,
shortness of breath, wheezing, lung congestion, sneezing, throat or
eye irritation, hoarseness, stuffy nose and ear pain.
In addition, the lifeguards were asked if they had been diagnosed
with asthma or used asthma medications.
Of the 870 respondents, 601 were currently working as lifeguards and
three quarters were women. Their ages ranged from 18 to 64 years,
with an average age of 22 for current lifeguards and 29 for former
lifeguards.
About 78 percent of the lifeguards reported having at least one
respiratory symptom in the previous year and 23 percent reported
having physician-diagnosed asthma.
Lifeguards exposed to the pool more than 500 hours during the
previous year were about two and a half times more likely to have a
cough or sore throat than those exposed less than 50 hours. They
were also over four times more likely to have eye irritation.
Among lifeguards with asthma, those exposed more than 500 hours a
year were six times more likely to have asthma attacks than those
with little or no exposure to the indoor pool environment.
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“We found that the most exposed lifeguards in the past 12 months
were more susceptible to have a cough, hoarseness and throat and eye
irritation during this period. Furthermore, we found that most
exposed lifeguards over their lifetime had significantly more
chances of suffering from various symptoms while on duty,” Bureau
said.
“Most of the swimming pools worldwide are disinfected with
chlorine-based disinfectants,” she noted.
The reaction between free chlorine and organic matter such as
sloughed skin cells, cosmetics, urine, sunscreen and sweat in water
generates a high number of contaminants called
disinfection-by-products (DBP), Bureau said.
“One of those DBPs is the trichloramine (NCl3), a highly volatile
contaminant that gives indoor swimming pools their characteristic
‘chlorine smell,’” she said, and NCl3 is the most likely contaminant
to cause irritative symptoms.
“The present findings underscore the need to implement and respect
preventive measures. To that extent, it is important to limit the
entry of organic matter into the water to decrease the amount of
disinfection-by-products generated,” she said.
Taking specific hygiene measures such as using the toilet and
showering with soap before swimming, using swimming caps, taking
children to the toilet frequently, using diapers specially designed
for swimming would be important, Bureau said.
“Moreover, measures like adequate filtration, tight chlorination
control, regular monitoring of chlorination parameters, adequate
ventilation at all times are essential to improve water and air
quality in indoor swimming pools and prevent the occurrence of
irritative and respiratory symptoms,” she said.
SOURCE: http://bit.ly/2t8mF0o International Journal of Environmental
Health Research, online June 25, 2017.
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