Allergic and non-allergic rhinitis in swimmers: clinical and cytological aspects

Abstract

A neutrophilic rhinitis occurs in a large proportion of swimmers. This seems to be irritative in its nature and can be prevented by avoiding the direct contact with chlorinated water.

Effects of indoor swimming pools on the nasal cytology of pool workers

“…19 In our study, all subjects with a positive skin prick test had eosinophils in their nasal smear; thus, allergic rhinitis was more prevalent in indoor pool workers than neutrophilic rhinitis, even though neutrophilic rhinitis has been previously reported in swimmers. 8 In the skin prick test, 29.6 per cent of subjects in the study group and 18.4 per cent in the control group tested positive. Indoor pool workers had a high prevalence of allergies (as determined by comparing the skin prick test and eosinophil count results with the control group).…”

“…Gelardi et al reported predominantly neutrophilic inflammation and allergic rhinitis in symptomatic swimmers and suggested that this could be prevented by avoiding direct contact with chlorinated pool water. 8 Unlike other reports, in our study, we evaluated the nasal cytology of indoor pool workers who had no direct contact with the swimming pool to assess the indirect effect of the evaporation of airborne chlorine. In contrast to Gelardi et al 8 we did not find significant numbers of neutrophils in the nasal smears, and considered that this was likely due to the lack of contact between the nasal mucosa and the pool water.…”

“…8,[14][15][16][17] Hypersensitivities to fungus and mites are aggravated by the time spent within the pool area, which leads to cytological changes. The concentrations of chlorine by-products in indoor air, such as trihalomethanes and trichloramine, have been found to be correlated with the concentrations found in the pool water.…”

“…A number of studies of swimmers have been performed, but fewer studies have focused on pool workers. [8][9][10][11][12] In one study, swimmers had poorer nasal functions compared to runners, but only the post-nasal drip was significantly different between the two groups. The authors concluded that the results supported the existence of swimming-induced rhinitis independent of the atopic status of the athlete.…”

“…7 Sodium and calcium hypochlorite, which are commonly used as disinfectants in swimming pools, cause irritation of the nasal mucosa and exacerbate the symptoms of rhinitis. 8 Rhinitis is common among athletes, especially swimmers. 9 However, pool workers spend more time in and around swimming pools compared to swimmers and are also exposed to sodium and calcium hypochlorite.…”