Ocular and Respiratory Symptoms Among Lifeguards at a Hotel Indoor Waterpark Resort

Dang, Bich N.; Chen, Lilia; Mueller, Charles; Dunn, Kevin H.; Almaguer, D.; Roberts, Jennifer; Otto, Charles

doi:10.1097/jom.0b013e3181cf00d5

Cited by 26 publications

(44 citation statements)

References 14 publications

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“…In general, the levels of trichloramine found in this study (about 0.2 mg/m 3 in the 9 facilities) are relative low compared to several other studies, which have shown levels about 0.5 mg/m 3 (Dang et al 2010;Jacobs et al 2007;Thickett et al 2002). Almost all of the facilities in this study had baths are believed to generate higher trichloramine levels .…”

Section: Discussioncontrasting

confidence: 40%

“…In addition to trichloramine, microbial growth in the damp pool environment with release of proinflammatory bacterial products such as endotoxins has been suggested as a cause of airway symptoms (Dang et al 2010). We have previously identified a novel endotoxin-binding protein, SPLUNC1 (also known as BPI fold-containing family A member 1), in the upper airways as a possible biomarker for environmental-induced airway irritation (Ghafouri et al 2002;Ghafouri et al 2006;Ghafouri et al 2004).…”

Section: Discussionmentioning

confidence: 99%

“…The main cause of airway irritation related to swimming pools is believed to be exposure to trichloramine (Massin et al 1998;Dang et al 2010). It is also likely that the levels of trichloramine are related to factors such as number of visitors, ventilation, water temperature, the size of the pools and type of pools.…”

Section: Discussionmentioning

confidence: 99%

“…However, people frequently being in the environment often experience airway, eye or dermatological problems (WHO 2006;Nemery et al 2002). Several studies have showed that personnel, like lifeguards and pool attendants, suffer from nasal and throat symptoms, often together with eye irritation (Massin et al 1998;Demange et al 2009;Dang et al 2010;Fantuzzi et al 2010;Jacobs et al 2007). There are also studies indicating that children frequently visiting indoor swimming pools have an increased risk to develop asthma and allergy (Bernard et al 2005;Bernard et al 2006), although the opposite has also been found (Font-Ribera et al 2011).…”

Section: Introductionmentioning

confidence: 99%

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Airway irritation among indoor swimming pool personnel: trichloramine exposure, exhaled NO and protein profiling of nasal lavage fluids

Fornander

Ghafouri

Lindahl

et al. 2012

Int Arch Occup Environ Health

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Purpose Occurrence of airway irritation among indoor swimming pool personnel was investigated.The aim was to assess trichloramine exposure levels and exhaled nitric oxide in relation to the prevalence of airway symptoms in swimming pool facilities and to determine protein effects in the upper respiratory tract. MethodsThe presence of airway symptoms related to work were examined in 146 individuals working at 46 indoor swimming pool facilities. Levels of trichloramine, as well as exhaled nitric oxide, were measured in five facilities with high prevalence of airway irritation and four facilities with no airway irritation among the personnel. Nasal lavage fluid was collected and protein profiles were determined by a proteomic approach.Results 17 % of the swimming pool personnel reported airway symptoms related to work. The levels of trichloramine in the swimming pool facilities ranged from 0.04-0.36 mg/m 3 . There were no covariance between trichloramine levels, exhaled nitric oxide and prevalence of airway symptoms.Protein profiling of the nasal lavage fluid showed that, alpha-1-antitrypsin and lactoferrin, were significantly higher, and S100-A8 was significantly lower in swimming pool personnel.Conclusions This study confirms the occurrence of airway irritation among indoor swimming pool personnel. Our results indicate altered levels of innate immunity proteins in the upper airways that may pose as potential biomarkers. However, swimming pool facilities with high prevalence of airway irritation could not be explained by higher trichloramine exposure levels. Further studies are needed to clarify the environmental factors in indoor swimming pools that cause airway problems and affect the immune system.

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Section: Discussioncontrasting

confidence: 40%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Airway irritation among indoor swimming pool personnel: trichloramine exposure, exhaled NO and protein profiling of nasal lavage fluids

Fornander

Ghafouri

Lindahl

et al. 2012

Int Arch Occup Environ Health

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“…However, during the same period, there were 17 reports of eye, throat, and respiratory irritation among the government food inspectors with whom these employees work side-by-side. [NIOSH 2003[NIOSH , 2006Dang et al 2010]. …”

Section: Other Measurements and Observationsmentioning

confidence: 99%

Evaluation of eye and respiratory symptoms at a poultry processing facility - Oklahoma.

2012

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Disinfection of herbal spa pool using combined chlorine dioxide and sodium hypochlorite treatment

Hsu

Huang

2015

Environ Monit Assess

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The presence of pathogenic microorganisms in public spa pools poses a serious threat to human health. The problem is particularly acute in herbal spas, in which the herbs and microorganisms may interact and produce undesirable consequences. Accordingly, the present study investigated the effectiveness of a combined disinfectant containing chlorine dioxide and sodium hypochlorite in improving the water quality of a public herbal spa in Taiwan. Water samples were collected from the spa pool and laboratory tests were then performed to measure the variation over time of the microorganism content (total CFU and total coliforms) and residual disinfectant content given a single disinfection mode (SDM) with disinfectant concentrations of 5.2 × 10, 6.29 × 10, 7.4 × 10, and 11.4 × 10(-5) N, respectively. Utilizing the experience gained from the laboratory tests, a further series of on-site investigations was performed using three different disinfection modes, namely SDM, 3DM (once every 3 h disinfection mode), and 2DM (once every 2 h disinfection mode). The laboratory results showed that for all four disinfectant concentrations, the CFU concentration reduced for the first 6 h following SDM treatment, but then increased. Moreover, the ANOVA results showed that the sample treated with the highest disinfectant concentration (11.4 × 10(-5) N) exhibited the lowest rate of increase in the CFU concentration. In addition, the on-site test results showed that 3DM and 2DM treatments with disinfectant concentrations in excess of 9.3 × 10 and 5.5 × 10(-5) N, respectively, provided an effective reduction in the total CFU concentration. In conclusion, the experimental results presented in this study provide a useful source of reference for spa businesses seeking to improve the water quality of their spa pools.

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Ocular and Respiratory Symptoms Among Lifeguards at a Hotel Indoor Waterpark Resort

Abstract: Indoor waterparks need to control water chemistry and ensure adequate air movement and distribution to control air contaminants and reduce health symptoms.

Cited by 26 publications

References 14 publications

Airway irritation among indoor swimming pool personnel: trichloramine exposure, exhaled NO and protein profiling of nasal lavage fluids

Airway irritation among indoor swimming pool personnel: trichloramine exposure, exhaled NO and protein profiling of nasal lavage fluids

Evaluation of eye and respiratory symptoms at a poultry processing facility - Oklahoma.

Disinfection of herbal spa pool using combined chlorine dioxide and sodium hypochlorite treatment

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