Health effects of attending a public swimming pool: follow up of a cohort of pupils in Paris.

Abstract

Objectives-This study aimed to determine the health effects of attending a well-kept school swimming pool maintained according to French public health regulations. Methods-This prospective month long study was carried out on a randomised sample of pupils aged 5 to 18 years who attended a private French school with two swimming pools. The children surveyed, helped by their parents, had to fill in questionnaires about their bathing habits and symptoms during the survey period. Inspections of the pool complex were made and these included physicochemical and bacteriological analyses of the pools' water. Participation-The response rates achieved were 70% at primary and middle school levels but only 25% in the high school pupils. Because of this older teenagers were excluded from the final analysis (of 246 children). Results-Compared with non-bathers, bathers experienced fatigue and eye irritation significantly more often (p<0001). The eyes were red (38% of bathers) and/or watery (16%) after swimming but this resolved spontaneously within 24 hours. Bathing behaviour (bath duration, head immersion, wearing swimming goggles) did not affect these incidence rates noticeably. There were no differences between bathers and non- To investigate this situation, a prospective decriptive survey was designed in one school. The study population was therefore young, well defined, easy to follow up and perhaps more susceptible to ailments. This investigation was carried out in a private school in Paris.The objectives of this one month study were to determine the incidence or the prevalence of different symptoms, especially ocular, otolaryngological, and cutaneous symptoms, and to examine whether these were more frequent in pool users than in those who did not swim. Methods STUDY POPUIATIONThe study was carried out on 600 children selected at random from the register of pupils attending College S during the 1990-91 academic year. This college was attended by approximately 3000 pupils aged between 5 and 20 years. The sample was stratified by age (children from 5 to 11 years old attending primary school, those from 12 to 15 years old attending middle school, and teenagers over 15 at high school). SWIMMING POOI.The swimming pool complex of this college comprised two large pools (12 5m by 25m) with different water depths. They were served by the same continuous treatment system: sand for filtration and chloro-isocyanurates for disinfection. The hydraulicity was classic. Inspection of the pool complex showed that it was operating properly. The maintenance was satisfactory: showers were cleaned three times a day and the pools in the evening. In addition to the college pupils, children from other schools and members of different clubs used the pools; thus about 10 000 'people were using the swimming facilities each week.Six

Skin irritation in users of brominated pools

“…The percentage of swimmers reporting 'any skin rash' over the study period (10.1%) was higher than non-swimmers in this study, or that of 7.7% of swimmers using a chlorinated pool in a French study (Momas et al 1993).…”

“…Chlorine-based disinfection systems have been shown to cause drying effects on the skin and hair in frequent swimmers in these pools (Hicks 1977), and skin rashes have also been reported (Momas et al 1993). There have been no published studies of ozonated systems.…”

Outdoor swimming pools and the risks of asthma and allergies during adolescence

“…First, upon oxidising organic substances originally from swimmers or other sources, hypochlorous acid generates a mixture of harmful breakdown products, which includes potent irritants, such as chloramines, haloacetic acids or haloacetonitriles [2,3]. Secondly, another frequent drawback is that hypochlorous acid is a nonselective biocide that inevitably also reacts with the organs of the bather in contact with pool water or aerosols, causing irritation of the skin, eyes and upper respiratory tract [4][5][6].…”

Indoor swimming pools, water chlorination and respiratory health

“…Although the issue of the chlorination of public water supplies has received considerable attention, mainly with regard to the presence of potentially carcinogenic or teratogenic chlorinated by-products [6,7], the respiratory hazards of chlorinated swimming water have been less well addressed. Thus, old [8,9] and even more recent [10] reports on indoor pollution do not deal with the air of chlorinated swimming pools, despite the generally obvious and readily noticeable irritant character of this type of environment, even in well-maintained pools [11].…”