Prevalence of ocular, respiratory and cutaneous symptoms in indoor swimming pool workers and exposure to disinfection by-products (DBPs)

International Journal of Environmental Research and Public Health

Volumn 7, Issue 4, 2010, Pages 1379-1391

  Fantuzzi, Guglielmina ^a   Righi, Elena ^a   Predieri, Guerrino ^a   Giacobazzi, Pierluigi ^a   Mastroianni, Katia ^a   Aggazzotti, Gabriella ^a  

^a UNIVERSITY OF MODENA AND REGGIO EMILIA   (Italy)

Author keywords

Irritative symptoms; Occupational exposure; Ocular and cutaneous symptoms; Respiratory; Swimming pools; Trihalomethanes

Indexed keywords

DISINFECTANT AGENT; TRIHALOMETHANE;

ADULT; AIR SAMPLING; ARTICLE; ASTHMA; COMMON COLD; CONTROLLED STUDY; CROSS-SECTIONAL STUDY; DYSPNEA; ECZEMA; EYE DISEASE; FEMALE; HEALTH STATUS; HOARSENESS; HUMAN; ITALY; LUNG ALVEOLUS; MAJOR CLINICAL STUDY; MALE; MYCOSIS; NOSE CONGESTION; OCCUPATIONAL EXPOSURE; OCULAR PRURITUS; PREVALENCE; QUESTIONNAIRE; RASH; RESPIRATORY TRACT DISEASE; RHINORRHEA; RISK ASSESSMENT; SELF REPORT; SKIN DISEASE; SNEEZING; SWIMMING POOL; SYMPTOM; VERRUCA VULGARIS; EYE DISEASES; GAS CHROMATOGRAPHY; RESPIRATORY TRACT INFECTIONS; SKIN DISEASES;

EMILIA;

ADULT; CHROMATOGRAPHY, GAS; CROSS-SECTIONAL STUDIES; DISINFECTANTS; EYE DISEASES; FEMALE; HUMANS; MALE; OCCUPATIONAL EXPOSURE; PREVALENCE; RESPIRATORY TRACT INFECTIONS; SKIN DISEASES;

EID: 77954558668     PISSN: None     EISSN: 16604601     Source Type: Journal    
DOI: 10.3390/ijerph7041379     Document Type: Article

References (32)

1. Massin, N.; Bohadana, A.B.; Wild, P.; Hery, M.; Toamain, J.P.; Hubert, G. Respiratory symptoms and bronchial responsiveness in lifeguards exposed to nitrogen trichloride in indoor swimming pools. Occup. Environ. Med. 1998, 5, 258-263.
2. Thickett, K.M.; McCoach, J.S.; Gerber, J.M.; Sadhra, S.; Burge, P.S. Occupational asthma caused by chloramines in indoor swimming-pool air. Eur. Respir. J. 2002, 19, 827-832.
3. Nemery, B.; Hoet, P.H.; Nowak, D. Indoor swimming pools, water chlorination and respiratory health Eur. Respir. J. 2002, 19, 790-793.
4. Levesque, B.; Duchesne, J.; Gingras, S.; Lavoie, R.; Prud'Homme, D.; Bernard, E.; Boulet, L.P.; Ernst, P. The determinants of prevalence of health complaints among young competitive swimmers. Int. Arch. Occup. Environ. Health. 2006, 80, 32-39.
5. Jacobs, J.H.; Spaan, S.; van Rooy, G.B.; Meliefste, C.; Zaat, V.A.; Rooyackers, J.M.; Heedrik, D. Exposure to trichloramine and respiratory symptoms in indoor swimming pool workers. Eur. Respir. J. 2007, 29, 690-698.
6. Weisel, C.P.; Richardson, S.D.; Nemery, B.; Aggazzotti, G.; Baraldi, E.; Blatchley, E.R., III; Blount, B.C.; Carlsen, K.H.; Eggleston, P.A.; Frimmel, F.H.; Goodman, M.; Gordon, G.; Grinshpun, S.A.; Heederik, D.; Kogevinas, M.; LaKind, J.S.; Nieuwenhuijsen, M.J.; Piper, F.C.; Satta, S.A. Childhood asthma and environmental exposures at swimming pools: State of the science and research recommendations. Environ. Health. Perspect. 2009, 117, 500-507.
7. Lazarov, A.; Nevo, K.; Pardo, A.; Froom, P. Self-reported skin disease in hydrotherapists working in swimming pools. Contact Dermatitis 2005, 53, 327-331.
8. WHO (World Health Organization). Guidelines for Safe Recreational-Water Environments, Vol. 2: Swimming Pools, Spas and Similar Recreational-Water Environments; World Health Organization: Geneva, Switzerland, 2006.
9. Hery, M.; Hecht, G.; Gerber, J.M.; Gendre, J.C.; Hubert, G.; Rebuffaud, I. Exposure to chloramines in the atmosphere of indoor swimming pools. Ann. Occup. Hygiene. 1995, 39, 427-439.
10. Kaydos-Daniels, S.C.; Beach, M.J.; Shwe, T.; Magri, J.; Bixler, D. Health effects associated with indoor swimming pools: a suspected toxic chloramines exposure. Public Health 2008, 122, 195-200.
11. Li, J.; Blatchley, E.R., III. Volatile disinfection by-product formation resulting from chlorination of organic-nitrogen precursors in swimming pools. Environ. Sci. Technol. 2007, 41, 6732-6739.
12. Aggazzotti, G.; Fantuzzi, G.; Righi, E.; Predieri, G. Environmental and biological monitoring of chloroform in indoor swimming pools. J. Chromatogr. A 1995, 710, 181-190
13. Fantuzzi, G.; Righi, E.; Predieri, G.; Ceppelli, G.; Gobba, F.; Aggazzotti, G. Occupational exposure to trihalomethanes in indoor swimming pools. Sci. Total Environ. 2001, 264, 257-265.
14. Chu, H.; Nieuwenhuijsen, M.J. Distribution and determinants of trihalomethanes concentrations in indoor swimming pools. Occup. Environ. Med. 2002, 59, 243-247.
15. Erdinger, L.; Kühn, K.P.; Kirsch, F.; Feldhues, R.; Fröbel, T.; Nohynek, B.; Gabrio, T. Pathways of trihalomethanes uptake in indoor swimming pools Int. J. Hyg. Environ. Health 2004, 207, 571-575.
16. Aggazzotti, G.; Fantuzzi, G.; Righi, E.; Predieri, G. Blood and breath analyses as biological indicators of exposure to trihalomethanes in indoor swimming pools. Sci. Total Environ. 1998, 217, 155-163.
17. Nieuwenhuijsen, M.J.; Toledano, M.B.; Elliott, P. Uptake of chlorination disinfection by-products; a review and a discussion of its implications for exposure assessment in epidemiological studies. J. Expo. Anal. Environ. Epidemiol. 2000, 10, 586-599.
18. Nuckols, J.R.; Ashley, D.L.; Lyu, C.; Gordon, S.M.; Hinckley, A.F.; Singer, P. Influence of tap water quality and household water use activities on indoor air and internal dose levels of trihalomethanes. Environ Health Perspect. 2005, 113, 863-870.
19. Caro, J.; Gallego, M. Alveolar air and urine analyses as biomarkers of exposure to trihalomethanes in an indoor swimming pool. Environ. Sci. Technol. 2008, 42, 5002-5007.
20. Lee, J.; Ha, K.T.; Zoh, K.D. Characteristics of trihalomethane (THM) production and associated health risk assessment in swimming pool waters treated with different disinfection methods. Sci. Total Environ. 2009, 407, 1990-1997.
21. Lindstrom, A.B.; Pleil, J.D.; Berkoff, D.C. Alveolar breath sampling and analysis to assess trihalomethane exposures during competitive swimming training. Environ. Health Persp. 1997, 105, 636-642.
22. Palin, A. T. The determination of free and combined chlorine in water by the use of diethyl-p- phenylene diamine. J. Am. Water. Works Assoc. 1957, 49, 873.
23. SPSS (Statistical Package for Social Sciences) version 16.0 (SPSS/PC). SPSS Inc.: Chicago, IL, USA, 1986.
24. Pardo, A.; Nevo, K.; Vigiser, D.; Lazarov, A. The effects of physical and chimical properties of swimming pool water and its close environment on the development of contact dermatitis in hydrotherapists. Am. J. Ind. Med. 2007, 50, 122-126.
25. Cimitiere, N.; De Laat, J. Henry's law constant of N,N-dichloromethylamine: application to the contamination of the atmosphere of indoor swimming pools. Chemosphere 2009, 77, 465-470.
26. Centers for Disease Control and Prevention (CDC). Respiratory and ocular symptoms among employees of a hotel indoor water park resort-Ohio, 2007. MMWR Morb. Mortal. Wkly. Rep. 2009, 58, 81-85.
27. Carbonelle, S.; Francaux, M.; Doyle, I.; Dumont, X.; de Burbure, C.; Morel, G.; Michel, O.; Bernard, A. Changes of serum pneumoproteins caused by short term exposures to nitrogen trichloride in indoor chlorinated pools. Biomarkers 2002, 7, 464-478.
28. Bernard, A.; Carbonelle, S.; Michel, O.; Higuet, S.; de Burbure, C.; Buchet, J.P.; Herman, C.; Dumont, X.; Doyle, I. Lung hyperpermeability and asthma prevalence in schoolchildren: unexpected associations with the attendance of indoor chlorinated pools. Occup. Environ. Med. 2003, 60, 385-394.
29. Bernard, A.; Carbonelle, S.; Dumont, X.; Nickmilder, M. Infant swimming practice, pulmonary epithelium integrity, and the risk of allergic and respiratory diseases later in childhood. Pediatrics 2007, 6, 1095-1103.
30. Font-Ribeira, L.; Kogevinas, M.; Zock, J.P.; Nieuwenhuijsen, M.J.; Heederik, D.; Villanueva, C.M. Swimming pool attendance and risk of ashma and allergic symptoms in children. Eur. Respir. J. 2009; 34, 1304-1310.
31. Uyian, Z.S.; Carraro, S.; Piacentini, G. and Baraldi, E. Swimming pool, respiratory health and childhood asthma: should we change our beliefs? Pediatric Pneumology 2009, 44, 31-37.
32. Goodman, M.; Hays, S. Asthma and swimming: a meta-analysis. J. Asthma 2008, 45, 639-647.