Respiratory, ocular and skin health in recreational and competitive swimmers: Beneficial effect of a new method to reduce chlorine oxidant derivatives

Abstract

Background: Chlorine by-products may irritate the eyes, nose, skin and airways of swimmers and may cause chronic airway inflammation.

Objective: To assess the salutary effects on swimmers health of a new method of water disinfection.

Methods: Recreational (n=320) and competitive swimmers (n=53) participated in the study. The first part of the study (Phase A) was carried out while using the current standard method. The second part (Phase B) began 8 weeks after the new method had been introduced. Total oxidants in air and chlorine species in water were assessed by standard methods. All swimmers completed a questionnaire on health complaints. Exhaled breath condensate (EBC) was used to monitor the levels of leukotriene B4 (LTB₄) and cysteinyl leukotrienes (CysLTs) in airway from competitive swimmers.

Results: The new system resulted in a 75% and 39% reduction in the concentration of total oxidants and of nitrogen trichloride respectively in the air of the swimming pool. With the new system recreational swimmers experienced fewer symptoms of cough and irritation of the eyes, nose and skin. A decrease in eye irritation symptoms was also noted by competitive swimmers. The baseline concentration of CysLTs in EBC decreased significantly in Phase B with respect to Phase A.

Conclusions: The new method markedly reduced the levels of irritant oxidant substances in the pool atmosphere that resulted in a reduction of eye, nose, skin and cough complaints in recreational swimmers, and eye irritation in competitive swimmers. It was also associated with reduced CysLT levels in the airways of competitive swimmers.

Keywords: Chloramines; Chlorine; Chlorine by-products; Exercise; Exhaled breath condensate; Health; Leukotrienes; Nitrogen trichloride; Oxidants; Swimmers; Swimming pool; Water disinfection.