Indoor swimming pool attendance and respiratory and dermal health in schoolchildren – HITEA Catalonia
Open accessAbstract
Background Health benefits of swimming in pools may outweigh adverse health outcomes in children, but evidence from epidemiological studies is scarce or inconclusive for different health outcomes. We evaluated the association between indoor swimming pool attendance during childhood and respiratory and dermal conditions and symptoms in Catalan schoolchildren.Methods Cross-sectional study in 2758 children aged 6-12 years from 18 primary schools in Barcelona province. Information on regular indoor swimming pool attendance in seven age periods, history of health conditions (asthma, wheezing, eczema, dermatitis, rhinitis, allergic rhinitis) and symptoms in the last 12 months (wheezing, dermatitis, rhinitis and number of cold, tonsillitis or otitis episodes) were collected through parental self-administered questionnaires. The associations between swimming pool attendance and health outcomes were evaluated using multivariate mixed logistic and Poisson regression models.Results Regular indoor swimming before 2 years of age was not related to having ever had asthma (Odds Ratio (OR) = 1.14; 95%CI = 0.73-1.77), wheezing (OR = 1.02; 95%CI = 0.82-1.28), or eczema (OR = 1.09; 95%CI = 0.87-1.36). Current indoor swimming was not associated with symptoms in the last 12 months (Incidence Rate Ratio for otitis was 0.94; 95%CI = 0.77-1.15). Stratification by eczema or maternal education gave very similar results.Conclusion This new large population-based study indicates that regular indoor swimming during infancy does not increase respiratory, allergic or dermal symptoms in Catalan schoolchildren aged 6-12 years.
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These findings are contradicted by results from other large population-based studies in children.
“but these findings are contradicted by results from other large population-based studies in children (Font-Ribera et al. 2009, 2011;Jacobs et al. 2012;Font-Ribera et al. 2014).”
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. 2014
In that study, regular indoor pool attendance before 2 years of age was not associated with ever had or having asthma or wheezing.
“Regular indoor pool attendance before 2 years of | age was not associated with ever had or having | asthma or wheezing”
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. (2014)
In a cross-sectional study of Spanish children, current regular swimming in indoor pools was not associated with symptoms in the last 12 months.
“Current regular swimming in indoor pools was not | associated with symptoms in the last 12 months.”
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. (2014)
Studies in Germany, Spain, the UK, and the Netherlands found no association between swimming pool attendance and respiratory symptoms among children.
“However, studies in other European countries such as Germany [91], Spain [92,93], the UK [94•], and the Netherlands [95], have found no association between swimming pool attendance and respiratory symptoms among children.”
From Overview of Disinfection By-products and Associated Health Effects (2015) · cites this paper as [93]
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Cites
Sterne, J. A. C., White, I. R., Carlin, J. B., Spratt, M., Royston, P., Kenward, M. G., Wood, A. M., & Carpenter, J. R. (2009) · BMJ · doi:10.1136/bmj.b2393 · Cited by 7,299 · see citing works
Multiple Imputation of Missing Values
Royston, P. (2004) · The Stata Journal: Promoting communications on statistics and Stata · doi:10.1177/1536867x0400400301 · Cited by 2,340 · cited 1× · see citing works
“One hundred complete data sets were generated and results were combined using Rubin’s rules [17].”
MethodOverview of Disinfection By-products and Associated Health Effects
Villanueva, C. M., Cordier, S., Font-Ribera, L., Salas, L. A., & Levallois, P. (2015) · Current Environmental Health Reports · doi:10.1007/s40572-014-0032-x · Cited by 291 · see citing works
Self-citationBernard, A., Carbonnelle, S., Michel, O., Higuet, S., de Burbure, C., Buchet, J.-P., Hermans, C., Dumont, X., & Doyle, I. (2003) · Occupational and Environmental Medicine · doi:10.1136/oem.60.6.385 · Cited by 256 · see citing works
Chlorinated Pool Attendance, Atopy, and the Risk of Asthma during Childhood
Bernard, A., Carbonnelle, S., de Burbure, C., Michel, O., & Nickmilder, M. (2006) · Environmental Health Perspectives · doi:10.1289/ehp.8461 · Cited by 201 · see citing works
Bernard, A., Carbonnelle, S., Dumont, X., & Nickmilder, M. (2007) · Pediatrics · doi:10.1542/peds.2006-3333 · Cited by 141 · see citing works
Font-Ribera, L., Villanueva, C. M., Nieuwenhuijsen, M. J., Zock, J.-P., Kogevinas, M., & Henderson, J. (2011) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201005-0761oc · Cited by 117 · see citing works
Self-citationAsthma and Swimming: A Meta-Analysis
Goodman, M., & Hays, S. (2008) · Journal of Asthma · doi:10.1080/02770900802165980 · Cited by 109 · see citing works
Validation of the Spanish version of the Phase III ISAAC questionnaire on asthma.
Fernández, C. M., Fernández‐Benítez, M., Miranda, M., & Grima, F. G. (2005) · PubMed · Cited by 100 · see citing works
Health risks of early swimming pool attendance
Schoefer, Y., Zutavern, A., Brockow, I., Schäfer, T., Krämer, U., Schaaf, B., Herbarth, O., von Berg, A., Wichmann, H.-E., & Heinrich, J. (2008) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2007.08.001 · Cited by 80 · see citing works
Swimming pool attendance and risk of asthma and allergic symptoms in children
Font-Ribera, L., Kogevinas, M., Zock, J.-P., Nieuwenhuijsen, M. J., Heederik, D., & Villanueva, C. M. (2009) · European Respiratory Journal · doi:10.1183/09031936.00180608 · Cited by 77 · see citing works
Self-citationInfant swimming in chlorinated pools and the risks of bronchiolitis, asthma and allergy
Voisin, C., Sardella, A., Marcucci, F., & Bernard, A. (2010) · European Respiratory Journal · doi:10.1183/09031936.00118009 · Cited by 76 · see citing works
Baby swimming increases the risk of recurrent respiratory tract infections and otitis media
Nystad, W., Njå, F., Magnus, P., & Nafstad, P. (2003) · Acta paediatrica · doi:10.1111/j.1651-2227.2003.tb00622.x · Cited by 49 · see citing works
Baby swimming and respiratory health
Nystad, W., Håberg, S. E., London, S. J., Nafstad, P., & Magnus, P. (2008) · Acta Paediatrica · doi:10.1111/j.1651-2227.2008.00756.x · Cited by 39 · see citing works
Swimming pool attendance and respiratory symptoms and allergies among Dutch children
Jacobs, J. H., Fuertes, E., Krop, E. J. M., Spithoven, J., Tromp, P., & Heederik, D. J. J. (2012) · Occupational and Environmental Medicine · doi:10.1136/oemed-2011-100621 · Cited by 34 · see citing works
Voisin, C., Sardella, A., & Bernard, A. (2013) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2013.03.004 · Cited by 30 · see citing works
Swimming pool attendance, respiratory symptoms and infections in the first year of life
Font-Ribera, L., Villanueva, C. M., Ballester, F., Santa‐Marina, L., Tardón, A., Espejo‐Herrera, N., Esplugues, A., Dehli, C. R., Basterrechea, M., & Sunyer, J. (2013) · European Journal of Pediatrics · doi:10.1007/s00431-013-1975-x · Cited by 16 · see citing works
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Cited by
Sorted by citations
Overview of Disinfection By-products and Associated Health Effects
Villanueva, C. M., Cordier, S., Font-Ribera, L., Salas, L. A., & Levallois, P. (2015) · Current Environmental Health Reports · doi:10.1007/s40572-014-0032-x · Cited by 291 · see citing works
Self-citationPotential risks and approaches to reduce the toxicity of disinfection by-product – A review
Pandian, A. M. K., Rajamehala, M., Singh, M. V. P., Sarojini, G., & Rajamohan, N. (2022) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2022.153323 · Cited by 105 · see citing works
Danby, S. G., Brown, K., Wigley, A., Chittock, J., Pyae, P. K., Flohr, C., & Cork, M. J. (2017) · Journal of Investigative Dermatology · doi:10.1016/j.jid.2017.08.037 · Cited by 85 · see citing works
S3 guideline Allergy Prevention
Kopp, M., Muche‐Borowski, C., Abou‐Dakn, M., Ahrens, B., Beyer, K., Blümchen, K., Bubel, P., Chaker, A. M., Cremer, M., Ensenauer, R. E., et al. (2022) · Kölner Universitäts PublikationsServer (Universität zu Köln) · Cited by 84 · see citing works
Health effects of exposure to chlorination by‐products in swimming pools
Couto, M., Bernard, A., Delgado, L., Drobnic, F., Kurowski, M. M., Moreira, A. M., Alves, R. R., Rukhadze, M., Seys, S., Wiszniewska, M., et al. (2021) · Allergy · doi:10.1111/all.15014 · Cited by 42 · see citing works
Gabriel, M. F., Paciência, I., Felgueiras, F., Rufo, J. C., Mendes, F. C., Farraia, M., Mourão, Z. S., Moreira, A. M., & Fernandes, E. D. O. (2021) · Energy and Buildings · doi:10.1016/j.enbuild.2021.111305 · Cited by 41 · see citing works
Swimming attendance during childhood and development of asthma: Meta‐analysis
Valeriani, F., Protano, C., Vitali, M., & Spica, V. R. (2016) · Pediatrics International · doi:10.1111/ped.13230 · Cited by 39 · see citing works
Wastensson, G., & Eriksson, K. (2020) · Critical Reviews in Toxicology · doi:10.1080/10408444.2020.1744514 · Cited by 30 · see citing works
Influence of chlorinated water on the development of allergic diseases – An overview
Kanikowska, A., Napiórkowska-Baran, K., Graczyk, M., & Kucharski, M. (2018) · Annals of Agricultural and Environmental Medicine · doi:10.26444/aaem/79810 · Cited by 29 · see citing works
Holm, S. M., Leonard, V. W., Durrani, T. S., & Miller, M. D. (2018) · American Journal of Infection Control · doi:10.1016/j.ajic.2018.06.013 · Cited by 29 · see citing works
Gallé, F., Dallolio, L., Marotta, M., Raggi, A., Onofrio, V. D., Liguori, G., Toni, F., & Leoni, E. (2016) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph13050513 · Cited by 28 · see citing works
Early life swimming pool exposure and asthma onset in children – a case-control study
Andersson, M., Bäckman, H., Nordberg, G. F., Hagenbjörk, A., Hedman, L., Eriksson, K., Forsberg, B., & Rönmark, E. (2018) · Environmental Health · doi:10.1186/s12940-018-0383-0 · Cited by 25 · see citing works
The role of sports and exercise in allergic disease: drawbacks and benefits
Silva, D., & Moreira, A. M. (2015) · Expert Review of Clinical Immunology · doi:10.1586/1744666x.2015.1058158 · Cited by 24 · see citing works
Irahara, M., Yamamoto‐Hanada, K., Yang, L., Saito‐Abe, M., Sato, M., Inuzuka, Y., Toyokuni, K., Nishimura, K., Ishikawa, F., Miyaji, Y., et al. (2020) · PLoS ONE · doi:10.1371/journal.pone.0234161 · Cited by 19 · see citing works
Rufo, J. C., Paciência, I., Silva, D., Martins, C., Madureira, J., Fernandes, E. D. O., Padrão, P., Moreira, P. A. M., Delgado, L., & Moreira, A. M. (2018) · PLoS ONE · doi:10.1371/journal.pone.0193848 · Cited by 17 · see citing works
Paciência, I., Rodolfo, A., Carneiro‐Leão, L., Silva, D., Rufo, J. C., Mendes, F. C., Padrão, P., Moreira, P. A. M., Boechat, J. L., Delgado, L., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18020653 · Cited by 15 · see citing works
Water hardness and eczema at 1 and 4y of age in the INMA birth cohort
Font-Ribera, L., Gràcia‐Lavedan, E., Esplugues, A., Ballester, F., Jiménez-Zabala, A., Santa‐Marina, L., Fernández‐Somoano, A., Sunyer, J., & Villanueva, C. M. (2015) · Environmental Research · doi:10.1016/j.envres.2015.07.013 · Cited by 13 · see citing works
Self-citationDuyx, B., Urlings, M. J. E., Swaen, G. M. H., Bouter, L. M., & Zeegers, M. P. (2017) · Research Integrity and Peer Review · doi:10.1186/s41073-017-0041-z · Cited by 8 · see citing works
Heaney, L. M., Kang, S., Turner, M. A., Lindley, M. R., & Thomas, C. L. P. (2019) · Indoor Air · doi:10.1111/ina.12630 · Cited by 6 · see citing works
Pulmonary function in swimmers exposed to disinfection by-products: a narrative review
Boraczyński, M., Balcerek, T., Rożkiewicz, N., Pabiszczak, M., Harasymczuk, M., Sławska, A., & Lutomski, P. (2025) · Frontiers in Physiology · doi:10.3389/fphys.2024.1473302 · Cited by 9 · see citing works
Asthma risk in young people who attended chlorinated swimming pools in early childhood
Silvestre, C. D. L., Dias, R. D. F., Costa, E. C., dos Santos, M. A. M., Júnior, J. L. C., Medeiros, D., Filho, E. D. A. R., & Correia, M. A. D. V. (2025) · Revista Paulista de Pediatria · doi:10.1590/1984-0462/2025/43/2024251 · Cited by 4 · see citing works
Lee, B.-A. (2023) · Journal of Water and Health · doi:10.2166/wh.2023.335 · Cited by 4 · see citing works
Health effects of exposure to chlorination by-products in swimming pools: Position PaperPreprint
Couto, M., Bernard, A., Delgado, L., Drobnic, F., Kurowski, M. M., Moreira, A. M., Alves, R. R., Rukhadze, M., Seys, S., Wiszniewska, M., et al. (2021) · doi:10.22541/au.161411355.53060401/v1
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da Silva, G. A., Barbosa, R. P., Fernandes, S. C. O., & Barbosa, I. T. F. (2022) · doi:10.22533/at.ed.6542229062
EXPOSIÇÃO SOLAR E ENVELHECIMENTO CUTÂNEO - IMPACTOS CAUSADOS PELAS RADIAÇÕES ULTRAVIOLETAS
de Souza, B. C., de Queiroz, F. A. S., & Fazenda, J. (2022) · doi:10.22533/at.ed.65422290615
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Mendes, R. C. M. G., Gonçalves, J. E., Silva, L. M., Ferreira, J. G., Machado, R. M., & Silva, A. P. D. S. C. (2022) · doi:10.22533/at.ed.65422290621
Lee, B.-A. (2024) · Journal of Water and Health · doi:10.2166/wh.2024.390
Wu, Q., Chen, X., Ye, X., Yan, Y., Ma, X., Wang, Y., Liu, M., Zhang, C., Zhao, X., Liu, Y., et al. (2026) · Regulatory Toxicology and Pharmacology · doi:10.1016/j.yrtph.2026.106061
- Authors
- Font-Ribera, L., Villanueva, C. M., Gràcia-Lavedan, E., Borràs-Santos, A., Kogevinas, M., & Zock, J.-P.
- Affiliations
- Universitat Pompeu Fabra (ES)
- Corresponding author
- Font-Ribera, Laia
- Venue
- Respiratory Medicine
- Publisher
- Elsevier BV
- Published
- 2014-07
- Volume
- 108
- Issue
- 7
- Pages
- 1056-1059
- ISSN
- 0954-6111 (ISSN-L)
- OpenAlex
- W2013464562
- Semantic Scholar
- 39b46f8f7e4142b39c314f7886760dbacf591c8b
- Cited by
- 28
- References
- 17
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 5 · 2021: 4 · 2020: 2 · 2019: 1 · 2018: 4 · 2017: 2 · 2016: 2 · 2015: 3
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Respiratory Medicine (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- European Commission (211488)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- asthma, wheezing, atopic dermatitis, allergic rhinitis, rhinitis, skin inflammation, otitis media, respiratory symptoms, dermal symptoms, elementary school students, maternal education
- MeSH terms
- Asthma, Child, Child, Preschool, Cross-Sectional Studies, Eczema, Environmental Exposure, Female, Humans, Male, Respiratory Sounds, Respiratory Tract Diseases, Rhinitis, Spain, Swimming Pools, Prevalence, Rhinitis, Allergic
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