Exposure to disinfection by-products in swimming pools and biomarkers of genotoxicity and respiratory damage – The PISCINA2 Study
Open accessAbstract
BACKGROUND: Swimming in pools is a healthy activity that entails exposure to disinfection by-products (DBPs), some of which are irritant and genotoxic. OBJECTIVES: We evaluated exposure to DBPs during swimming in a chlorinated pool and the association with short-term changes in genotoxicity and lung epithelium permeability biomarkers. METHODS: Non-smoker adults (N = 116) swimming 40 min in an indoor pool were included. We measured a range of biomarkers before and at different times after swimming: trihalomethanes (THMs) in exhaled breath (5 min), trichloroacetic acid (TCAA) in urine (30 min), micronuclei in lymphocytes (1 h), serum club cell protein (CC16) (1 h), urine mutagenicity (2 h) and micronuclei in reticulocytes (4 days in a subset, N = 19). Several DBPs in water and trichloramine in air were measured, and physical activity was extensively assessed. We estimated interactions with polymorphisms in genes related to DBP metabolism. RESULTS: , respectively. Creatinine-adjusted urinary TCAA increased by 3.1 μmol/mol. Micronuclei in lymphocytes and reticulocytes, urine mutagenicity and serum CC16 levels remained unchanged after swimming. Spearman correlation coefficients showed no association between DBP exposure and micronuclei in lymphocytes, urine mutagenicity and CC16. Moderate associations were observed for micronuclei in reticulocytes and DBP exposure. CONCLUSIONS: The unchanged levels of the short-term effect biomarkers after swimming and null associations with personal estimates of exposure to DBPs suggest no measurable effect on genotoxicity in lymphocytes, urine mutagenicity and lung epithelium permeability at the observed exposure levels. The moderate associations with micronuclei in reticulocytes require cautious interpretation given the reduced sample size.
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In a cross-sectional study of healthy adult nonsmokers in Spain, levels of CC16 were unchanged after swimming.
“Levels of CC16 were unchanged after swimming.”
From Inorganic chloramines: a critical review of the toxicological and epidemiological evidence as a basis for occupational exposure limit setting (2020) · cites this paper as Font-Ribera et al. (2019)
Competitive swimmers have been shown to suffer from high rates of asthma and airway hyperresponsiveness attributed to HOCl and volatile DBP exposure.
“For example, competitive swimmers have been shown to suffer from high rates of asthma and airway hyperresponsiveness attributed to HOCl and volative DBP exposure (149, 150).”
From Hypochlorous Acid: From Innate Immune Factor and Environmental Toxicant to Chemopreventive Agent Targeting Solar UV-Induced Skin Cancer (2022) · cites this paper as [150]
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Cites
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Snell, J. A., Jandova, J., & Wondrak, G. T. (2022) · Frontiers in Oncology · doi:10.3389/fonc.2022.887220 · Cited by 37 · see citing works
Wastensson, G., & Eriksson, K. (2020) · Critical Reviews in Toxicology · doi:10.1080/10408444.2020.1744514 · Cited by 30 · see citing works
- Authors
- Font-Ribera, L., Marco, E., Grimalt, J. O., Pastor, S., Marcos, R., Abramsson-Zetterberg, L., Pedersen, M., Grummt, T., Junek, R., Barreiro, E., Heederik, D., Spithoven, J., Critelli, R., Naccarati, A., Schmalz, C., Zwiener, C., Liu, J., Zhang, X., Mitch, W., Gracia-Lavedan, E., Arjona, L., de Bont, J., Tarès, L., Vineis, P., Kogevinas, M., & Villanueva, C. M.
- Affiliations
- Universitat Pompeu Fabra (ES)
- Consejo Superior de Investigaciones Científicas (ES)
- Universitat Autònoma de Barcelona (ES)
- National Food Administration (SE)
- University of Copenhagen (DK)
- German Environment Agency (DE)
- Utrecht University (NL)
- Italian institute for Genomic Medicine (IT)
- University of Tübingen (DE)
- Hong Kong University of Science and Technology (HK)
- Stanford University (US)
- Imperial College London (GB)
- ORCID
- Venue
- Environment International
- Publisher
- Elsevier BV
- Published
- 2019-10
- Volume
- 131
- Pages
- 104988
- ISSN
- 0160-4120 (ISSN-L)
- OpenAlex
- W2959808631
- Cited by
- 38
- References
- 7
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 5 · 2023: 9 · 2022: 8 · 2021: 5 · 2020: 5 · 2019: 1
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Environment International (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by-nc-nd)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (publishedVersion, cc-by-nc-nd)
- Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, cc-by-nc-nd)
- DIGITAL.CSIC (Spanish National Research Council (CSIC)) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Rare & Special e-Zone (The Hong Kong University of Science and Technology) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion, other-oa)
- Funders
- Instituto de Salud Carlos III
- European Commission
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Water Treatment and Disinfection
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Carcinogens and Genotoxicity Assessment
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Keywords
- disinfection by-products, swimming pools, chlorinated water, trihalomethanes, trichloroacetic acid, genotoxicity, micronuclei, trichloramine, biomarkers of exposure
- MeSH terms
- Adult, Disinfectants, DNA Damage, Female, Humans, Male, Polymorphism, Genetic, Spain, Swimming Pools, Water Pollutants, Chemical, Biomarkers, Respiratory Mucosa, Young Adult
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