Respiratory, ocular and skin health in recreational and competitive swimmers: Beneficial effect of a new method to reduce chlorine oxidant derivatives
Abstract
Background Chlorine by-products may irritate the eyes, nose, skin and airways of swimmers and may cause chronic airway inflammation.Objective To assess the salutary effects on swimmers health of a new method of water disinfection.Methods Recreational (n=320) and competitive swimmers (n=53) participated in the study. The first part of the study (Phase A) was carried out while using the current standard method. The second part (Phase B) began 8 weeks after the new method had been introduced. Total oxidants in air and chlorine species in water were assessed by standard methods. All swimmers completed a questionnaire on health complaints. Exhaled breath condensate (EBC) was used to monitor the levels of leukotriene B4 (LTB 4) and cysteinyl leukotrienes (CysLTs) in airway from competitive swimmers.Results The new system resulted in a 75% and 39% reduction in the concentration of total oxidants and of nitrogen trichloride respectively in the air of the swimming pool. With the new system recreational swimmers experienced fewer symptoms of cough and irritation of the eyes, nose and skin. A decrease in eye irritation symptoms was also noted by competitive swimmers. The baseline concentration of CysLTs in EBC decreased significantly in Phase B with respect to Phase A.Conclusions The new method markedly reduced the levels of irritant oxidant substances in the pool atmosphere that resulted in a reduction of eye, nose, skin and cough complaints in recreational swimmers, and eye irritation in competitive swimmers. It was also associated with reduced CysLT levels in the airways of competitive swimmers.
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Indiscriminate HOCl-dependent induction of chlorination stress might be associated with adverse irritant effects.
“Also, in the context of balancing HOCl-related organ toxicity and therapeutic effects, it should be mentioned that the indiscriminate HOCl-dependent induction of chlorination stress might be associated with adverse irritant effects (51, 141–144).”
From Hypochlorous Acid: From Innate Immune Factor and Environmental Toxicant to Chemopreventive Agent Targeting Solar UV-Induced Skin Cancer (2022) · cites this paper as [143]
In human skin, irritation and disruption of barrier function, alteration of the commensal microbiome, allergy, and contact hypersensitivity are expected outcomes of inappropriate topical HOCl product use not compliant with standard of care.
“In human skin (as a function of concentration, pH, and exposure time), irritation and disruption of barrier function, alteration of the commensal microbiome, allergy, and contact hypersensitivity are expected outcomes of inappropriate topical HOCl product use not compliant with standard of care ( Figure 5D ) (142, 143).”
From Hypochlorous Acid: From Innate Immune Factor and Environmental Toxicant to Chemopreventive Agent Targeting Solar UV-Induced Skin Cancer (2022) · cites this paper as [143]
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- Authors
- Gomà, A., de Lluis, R., Roca-Ferrer, J., Lafuente, J., & Picado, C.
- Affiliations
- Universitat Autònoma de Barcelona (ES)
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES)
- Corresponding author
- Picado, César
- Venue
- Environmental Research
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 152
- Pages
- 315-321
- ISSN
- 0013-9351 (ISSN-L)
- OpenAlex
- W2552245322
- Semantic Scholar
- c575d52251c7a928474bbfe42afd362ddd0cbcc1
- Cited by
- 23
- References
- 7
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 1 · 2022: 4 · 2021: 5 · 2020: 7 · 2019: 2 · 2018: 1 · 2017: 1
- FWCI
- 0.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Environmental Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Xavier Vila (Fluidra)
- Club Natació Atlètic Barceloneta
- Xavier Lorente
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Water Treatment and Disinfection
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Keywords
- chlorination by-products, swimming pool water disinfection, recreational swimmers, competitive swimmers, nitrogen trichloride, exhaled breath condensate, cysteinyl leukotrienes, leukotriene B4, airway inflammation, eye irritation, cough, skin irritation, respiratory health
- MeSH terms
- Adult, Chlorine, Disinfectants, Disinfection, Eye Diseases, Female, Health Status, Humans, Male, Recreation, Respiratory Tract Diseases, Skin Diseases, Spain, Swimming, Swimming Pools, Prevalence, Oxidants, Young Adult
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