Ingestion of swimming pool water by recreational swimmers

Abstract

The volume of water ingested by swimmers while swimming is of great interest to individuals who develop risk assessments using quantitative microbial risk assessment or epidemiological approaches. We have used chloroisocyanurate disinfected swimming pool waters to determine the amount of water swallowed by swimmers during swimming activity. The chloroisocyanurate, which is in equilibrium with chlorine and cyanuric acid in the pool water, provides a biomarker, cyanuric acid, that once swallowed passes through the body into the urine unchanged. The concentration of cyanuric acid in a 24 hour urine specimen and the concentration in pool water can be used to calculate the amount of water swallowed. Our study population of 549 participants, which was about evenly divided by gender, and young and adult swimmers, indicated that swimmers ingest about 32 mL per hour (arithmetic mean) and that children swallowed about four times as much water as adults during swimming activities. It was also observed that males had a tendency to swallow more water than females during swimming activity and that children spent about twice as much time in the water than adults.

Child environmental exposures to water and sand at the beach: Findings from studies of over 68,000 subjects at 12 beaches

“…Sample volumes per minute (mL/min) from Dufour et al (2017 ( 34 )) and Evans et al (2006) The volume of water swallowed during the swimming pool study was divided by the self-reported total time spent in the pool, to yield an estimated rate of water swallowed (. Sampling was conditional on age and sex.…”

“…This simulation was conducted for each age group using all participants, and for males and females separately, since evidence suggests males may swallow a greater volume compared to females ( 26 , 34 , 36 – 38 ). The simulation was also conducted separately based on beach water type (freshwater and marine), since behavior was expected to differ at different types of beaches ( 1 ).…”

Integrated preservation and sample clean up procedures for studying water ingestion by recreational swimmers via urinary biomarker determination

“…From the standpoint of broader application of the methodology presented, the results of a study of the volume of ingested water by a large group of volunteers from a broad range of age groups during recreational swimming activities, using the methodology described for the first time here, are presented in Refs. [12,46], which represent pilot-scale and full-scale studies, respectively. An additional broader application is that while the development of the methodology discussed was predicated on ingestion of water during swimming, the results may also have implications for other studies of ingestion of cyanuric acid through other means as has occurred, perhaps most notably through contamination or adulteration of animal feed or infant formula in the United States and China, respectively [47,48].…”

Maternal Swimming Pool Exposure during Pregnancy in Relation to Birth Outcomes and Cord Blood DNA Methylation among Private Well Users

“…The most commonly used biomarker for long term exposure in pregnancy is urinary trichloroacetic acid (Costet et al, 2012;Smith et al, 2013). However, this marker represents ingestion of chlorinated DBPs but not inhaled or absorbed DBPs through the skin as would occur from swimming pools (Dufour et al, 2017). Blood, urine or exhaled breath trihalomethanes only capture short term exposures (inhalation and dermal absorption) and in some cases chronic drinking water exposure (Backer et al, 2008;Rivera-Núñez et al, 2012;P.…”

“…Swimming, as a physical activity, has benefits for cardiovascular health, fitness, and respiratory function. Swimming pools also contain microbes and potential toxicants such as disinfection by-products (DBP) (De Filippis et al, 2017;Dufour et al, 2017;Ekowati et al, 2017;Manasfi et al, 2017). DBPs are a complex mixture of organic chemicals formed from reactions of the brominated or chlorinated compounds used in pool disinfection with organic matter such as microbes (Manasfi et al, 2017;Richardson et al, 2010).…”