Chlorine, chlorination by-products and their allergic and respiratory health effects

Current Respiratory Medicine Reviews

Volumn 3, Issue 1, 2007, Pages 39-47

  Kohlhammer, Yvonne ^a   Heinrich, Joachim ^a  

^a INSTITUTE OF EPIDEMIOLOGY   (Germany)

Author keywords

Allergic health; Chlorination by products; Respiratory health; Swimming pool attendance

Indexed keywords

CHLORINE; EOSINOPHIL PEROXIDASE; LIPOCALIN; SURFACTANT PROTEIN A; SURFACTANT PROTEIN B;

AIRWAY OBSTRUCTION; ALLERGIC REACTION; ASTHMA; ATHLETE; ATOPIC DERMATITIS; BRONCHOSPASM; CHILD HEALTH; CHLORINATION; DISINFECTION; ENVIRONMENTAL EXPOSURE; FORCED EXPIRATORY VOLUME; HAY FEVER; HEALTH HAZARD; HUMAN; LUNG FUNCTION; MEDICAL RESEARCH; MEDLINE; OCCUPATIONAL EXPOSURE; PEAK EXPIRATORY FLOW; PNEUMONIA; PRIORITY JOURNAL; RECREATION; RESPIRATORY TRACT DISEASE; REVIEW; SAFETY; SWIMMING; SWIMMING POOL; WATER TREATMENT;

EID: 33847646760     PISSN: 1573398X     EISSN: None     Source Type: Journal    
DOI: 10.2174/157339807779941839     Document Type: Review

References (44)

1. Kohlhammer Y, Doring A, Schafer T, Wichmann HE, Heinrich J. Swimming pool attendance and hay fever rates later in life. Allergy 2006; 61(11): 1305-1309.
2. Bernard A, Carbonnelle S, De Burbure C, et al. Lung hyperpermeability and asthma prevalence in schoolchildren: Unexpected associations with the attendance at indoor chlorinated swimming pools. Occup Environ Med 2003; 60(6): 385-394.
3. Carbonnelle S, Dumont X, De Burbure C, et al. Changes in serum pneumoproteins caused by short-term exposures to nitrogen trichloride in indoor chlorinated swimming pools. Biomarkers 2002; 7(6): 464-478.
4. Bernard A, Nickmilder M. Respiratory health and baby swimming. Arch Dis Child 2006; 91(7): 620-621.
5. Bernard A, Carbonnelle S, De Burbure C, Michel O, Nickmilder M. Chlorinated Pool Attendance, Atopy, and the Risk of Asthma during Childhood. Environ Health Perspect 2006; 114(10): 1567-1573.
6. Lagerkvist BJ, Forsberg B, Lundstrom NG, et al. Pulmonary epithelial integrity in children: Relationship to ambient ozone exposure and swimming pool attendance. Environ Health Perspect 2004; 112(17): 1768-1771.
7. Nickmilder M, Bernard AM. Ecological association between childhood asthma and availability of indoor chlorinated swimming pools in Europe. Occup Environ Med 2006; Published Online First: 17 July 2006. doi:10.1136/oem.2005.025452.
8. Nystad W, Nja F, Magnus P, Nafstad P. Baby swimming increases the risk of recurrent respiratory tract infections and otitis media. Acta Paediatrica, Int J Paediat 2003; 92(8): 905-909.
9. Momas I, Brette F, Spinasse A, et al. Health effects of attending a public swimming pool: follow up of a cohort of pupils in Paris. J Epidemiol Commun Health 1993; 47(6): 464-468.
10. Helenius IJ, Rytila P, Metso T, et al. Respiratory symptoms, bronchial responsiveness, and cellular characteristics of induced sputum in elite swimmers. Allergy 1998; 53(4): 346-352.
11. Helenius I, Rytila P, Sarna S, et al. Effect of continuing or finishing high-level sports on airway inflammation, bronchial hyperresponsiveness, and asthma: a 5-year prospective follow-up study of 42 highly trained swimmers. J Allergy Clin Inummol 2002; 109(6): 962-968.
12. Varraso R, Massin N, Hery M, et al. Not only training but also exposure to chlorinated compounds generates a response to oxidative stimuli in swimmers. Toxicol Ind Health 2002; 18(6): 269-278.
13. Levesque B, Duchesne JF, Gingras S, et al. The determinants of prevalence of health complaints among young competitive swimmers. Int Arch Occup Environ Health 2006; 80(1): 32-39.
14. Mustchin CP, Pickering CAC. 'Coughing water': bronchial hyper-reactivity induced by swimming in a chlorinated pool. Thorax 1979; 34(5): 682-683.
15. Small M, Murray JA. Nasal changes following immersion in chlorinated water. Rhinology 1987; 25(3): 153-157.
16. Zwick H, Popp W, Budik G, Wanke T, Rauscher H. Increased sensitization to aeroallergens in competitive swimmers. Lung 1990; 168(2): 111-115.
17. Thickett KM, McCoach JS, Gerber JM, Sadhra S, Burge PS. Occupational asthma caused by chloramines in indoor swimming-pool air. Eur Respir J 2002; 19(5): 827-832.
18. Massin N, Bohadana AB, Wild P, et al. Respiratory symptoms and bronchial responsiveness in lifeguards exposed to nitrogen trichloride in indoor swimming pools. Occup Environ Med 1998; 55(4): 258-263.
19. Rose CS, Martyny JW, Newman LS, et al. "Lifeguard lung": endemic granulomatous pneumonitis in an indoor swimming pool. Am J Public Health 1998; 88(12): 1795-1800.
20. Penny PT. Swimming pool wheezing. Br Med J (Clin Res Ed) 1983; 287(6390): 461-462.
21. Seki T, Morimatsu S, Nagahori H, Morohashi M. Free residual chlorine in bathing water reduces the water-holding capacity of the stratum corneum in atopic skin. J Dermatol 2003; 30(3): 196-202.
22. Stav D, Stav M. Asthma and whirlpool baths [7]: N Eng J Med 2005; 353(15): 1635-1636.
23. Bonetto G, Corradi M, Carraro S, et al. Longitudinal monitoring of lung injury in children after acute chlorine exposure in a swimming pool. Am J Respir Crit Care Med 2006; 174(5): 545-549.
24. Di Napoli A, Agabiti N, Ancona C, et al. Respiratory effects of exposure to chlorine vapors during a swimming pool accident in a recreational center in Rome. Epidemiol Prev 2002; 26(5): 240-247.
25. Agabiti N, Ancona C, Forastiere F, et al. Short term respiratory effects of acute exposure to chlorine due to a swimming pool accident. Occup Environ Med 2001; 58(6): 399-404.
26. Jones RN, Hughes JM, Glindmeyer H, Weill H. Lung function after acute chlorine exposure. Am Rev Respir Dis 1986; 134(6): 1190-1195.
27. King BS, Page EH, Mueller CA, et al. Eye and respiratory symptoms in poultry processing workers exposed to chlorine by-products. Am J Ind Med 2006; 49(2): 119-126.
28. Wood BR, Colombo JL, Benson BE. Chlorine inhalation toxicity from vapors generated by swimming pool chlorinator tablets. Pediatrics 1987; 79(3): 427-430.
29. Parimon T, Kanne JP, Pierson DJ. Acute inhalation injury with evidence of diffuse bronchiolitis following chlorine gas exposure at a swimming pool. Respir Care 2004; 49(3): 291-294.
30. Decker WJ, Koch HF. Chlorine poisoning at the swimming pool: an overlooked hazard. Clin Toxicol 1978; 13(3): 377-381.
31. Kilburn KH. Effects of chlorine and its cresylate byproducts on brain and lung performance. Arch Environ Health 2003; 58(12): 746-755.
32. Leroyer C, Malo JL, Girard D, Dufour JG, Gautrin D. Chronic rhinitis in workers at risk of reactive airways dysfunction syndrome due to exposure to chlorine. Occup Environ Med 1999; 56(5): 334-338.
33. Bernard A, Carbonnelle S, Nickmilder M, De Burbure C. Non-invasive biomarkers of pulmonary damage and inflammation: Application to children exposed to ozone and trichloramine. Toxicot Applied Pharmacol 2005; 206(2): 185-190.
34. Steiner D, Jeggli S, Hilfiker S, et al. Clara cell protein and surfactant protein B in garbage collectors and in wastewater workers exposed to bioaerosols. Int Arch Occup Environ Health 2005; 78(3): 189-197.
35. Preller L, Doekes G, Heederik D, et al. Disinfectant use as a risk factor for atopic sensitization and symptoms consistent with asthma: An epidemiological study. Eur Respir J 1996; 9(7): 1407-1413.
36. Medina-Ramon M, Zock JP, Kogevinas M, et al. Asthma, chronic bronchitis, and exposure to irritant agents in occupational domestic cleaning: a nested case-control study. Occup Environ Med 2005; 62(9): 598-606.
37. Levesque B, Ayotte P, Tardif R, et al. Evaluation of the health risk associated with exposure to chloroform in indoor swimming pools. J Toxicol Environ Health A 2000; 61(4): 225-243.
38. King WD, Marrett LD. Case-control study of bladder cancer and chlorination by-products in treated water (Ontario, Canada). Cancer Causes Control 1996; 7(6): 596-604.
39. Shusterman D, Balmes J, Avila PC, Matovinovic E, Murphy MA. Chlorine inhalation produces nasal congestion in allergic rhinitics without mast cell degranulation. Eur Respir J 2003; 21(4): 652-657.
40. Powis B, Hazzard A. Effects of swimming on health. Med J Aust 1984; 141(4): 235-236.
41. Tatsumi T, Fliss H. Hypochlorous acid and chloramines increase endothelial permeability: possible involvement of cellular zinc. Am J Physiol 1994; 267(4 Pt 2): H1597-H1607.
42. Broeckaert F, Clippe A, Knoops B, Hermans C, Bernard A. Clara cell secretory protein (CC16): Features as a peripheral lung biomarker. Annals of the New York Academy of Sciences 2000; 923: 68-77.
43. Miyake Y, Yokoyama T, Yura A, Iki M, Shimizu T. Ecological association of water hardness with prevalence of childhood atopic dermatitis in a Japanese urban area. Environ Res 2004; 94(1): 33-37.
44. Drobnic F, Freixa A, Casan P, Sanchis J, Guardino X. Assessment of chlorine exposure in swimmers during training. Med Sci Sports Exerc 1996; 28(2): 271-274.