Occupational exposures of airborne trichloramine at indoor swimming pools in Taipei
Abstract
Ten indoor swimming pools in Taipei, Taiwan were included in the study to assess the exposure of people to airborne trichloramine (NCl3) and also to discover the factors that might affect the associated concentrations. An active air sampling method was performed to determine the levels of NCl3, while questionnaires were administered to swimming pool workers, including lifeguards, swimming instructors, and management employees. The results show that the concentrations of trichloramine ranged from 0.017 to 0.15 mg m(-3), which were generally lower than what have been reported from other studies. Symptoms of sore throat and phlegm were more frequent among lifeguards and swimming instructors (exposure group) than management employees (reference group) (odds ratios were 11.28 and 4.22 for sore throat and phlegm, respectively). It seems that the current exposure limit for airborne NCl3, which was recommended by WHO, was not lower enough to protect the health of pool attendants. Regulated level of free available chlorine in Taipei (i.e., 0.3-0.7 ppm) is lower than what is required in other countries (e.g., 1-3 ppm in the UK). This might be the main reason why the concentrations of NCl3 reported elsewhere were higher than what were found in this research. Further international comparisons will help to elucidate if low free chlorine concentration should be adopted as an operating standard. For the indoor swimming pools in Taipei, the air quality is suggested to be improved, since even with the low concentrations of NCl3, higher respiratory ailments among pool workers were observed.
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Irritative ocular and upper airway symptoms among swimming pool employees have been associated with trichloramine levels of 17-150 μg/m3.
“Irritative ocular and upper airway symptoms among swimming pool employees have been associated with varying levels of trichloramine, namely, 17 -150 m g/m 3[20] and 200 -300 m g/m 3 . [21]”
From Occupational exposure to trichloramine and trihalomethanes: adverse health effects among personnel in habilitation and rehabilitation swimming pools (2019) · cites this paper as [20]
Previous studies reported that trichloramine levels of 17-150 μg/m3 and 200-300 μg/m3 were associated with ocular and upper airway symptoms, respectively, among swimming pool employees.
“Previous studies reported that trichloramine levels of 17 -150 m g/m 3 and 200 -300 m g/m 3 were associated with ocular and upper airway symptoms, respectively, among swimming pool employees. [20,21]”
From Occupational exposure to trichloramine and trihalomethanes: adverse health effects among personnel in habilitation and rehabilitation swimming pools (2019) · cites this paper as [20]
Several studies have demonstrated significantly more ocular and upper airway irritation in pool workers than in referents.
“Several studies have demonstrated significantly more ocular and upper airway irritation in pool workers than in referents (Jacobs et al. 2007;Dang et al. 2010, Chu et al. 2013;Fantuzzi et al. 2013;L€ ofstedt et al. 2016)”
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 Chu et al. 2013
In pool workers, exposed workers had significantly more throat irritation (OR 11.3, 95% CI 1.4-88) and phlegm (OR 4.2, 95% CI 1.2-15) than non-exposed subjects, but there were no significant differences for ocular and nose irritation.
“Exposed workers had significantly more [odds ratio (OR), 95% CI] throat irritation ( 11.3, 1.4-88] and phlegm (4.2, 1.2-15) than non-exposed subjects, but there were no significant differences for ocular and nose irritation.”
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 Chu et al. 2013
Chu et al. (2013) reported significantly more irritation in the throat in pool workers exposed to trichloramine concentrations of 0.017-0.15 mg/m3 compared to unexposed referents, but no concentration-response data were presented.
“Chu et al. (2013) reported significantly more irritation in the throat in pool workers exposed to trichloramine concentrations of 0.017-0.15mg/m 3 compared to unexposed referents, however, no concentration-response data were presented.”
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 Chu et al. 2013
Irritation below 0.5 mg/m3 has been reported in some additional studies, but due to lack of exposure-response relationships, these studies were considered less suited to form the basis for a health-based OEL.
“Irritation below 0.5 mg/m 3 has been reported in some additional studies (Chu et al. 2013;L€ ofstedt et al. 2016).However, due to lack of exposure-response relationships, these studies were considered less suited to form the basis for a health-based OEL.”
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 Chu et al. 2013
In that study, there were no significant differences for asthma-related symptoms such as shortness of breath, cough, chest tightness and wheezing.
“but there were no significant differences for asthma- | related symptoms such as shortness of breath, | cough, chest tightness and 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 Chu et al. (2013)
In a cross-sectional study of Taiwanese swimming pool workers, exposed workers had more phlegm (30% versus 6.9%) (OR 4.2, 95% CI 1.2-15) than non-exposed subjects.
“Exposed workers had more phlegm (30% versus 6.9%) | (OR 4.2, 95% CI 1.2-15) than non-exposed subjects”
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 Chu et al. (2013)
In a cross-sectional study of Taiwanese swimming pool workers, throat irritation was reported with OR 11.3 (95% CI 1.4-88); prevalence 26% versus 2.3%.
“Throat irritation: 11.3 (1.4-88); 26% versus 2.3%”
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 Chu et al. (2013)
In that study, cough was reported with OR 1.3 (95% CI 0.5-3.4); prevalence 25% versus 19%.
“Cough: 1.3 (0.5-3.4); 25% versus 19 %”
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 Chu et al. (2013)
In that study, eye irritation was reported with OR 1.7 (95% CI 0.6-4.6); prevalence 28% versus 16%.
“Eye irritation: 1.7 (0.6-4.6); 28% versus 16%”
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 Chu et al. (2013)
In that study, phlegm was reported with OR 4.2 (95% CI 1.2-15); prevalence 30% versus 6.9%.
“Phlegm: 4.2 (1.2-15); 30% versus 6.9%”
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 Chu et al. (2013)
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- Authors
- Chu, T.-S., Cheng, S.-F., Wang, G.-S., & Tsai, S.-W.
- Affiliations
- National Taiwan University (TW)
- Institute of Labor, Occupational Safety And Health, Ministry of Labor (TW)
- Corresponding author
- Tsai, Shih-Wei
- Venue
- Science of The Total Environment
- Publisher
- Elsevier BV
- Published
- 2013-09
- Volume
- 461-462
- Pages
- 317-322
- ISSN
- 0048-9697 (ISSN-L)
- OpenAlex
- W1976351621
- Cited by
- 41
- References
- 29
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 6 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 4 · 2015: 2 · 2014: 2 · 2013: 1
- FWCI
- 2.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Science of The Total Environment (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Institute of Occupational Safety and Health, Council of Labor Affairs (IOSH99-A318)
- National Science Council (NSC99-2314-B-002-134-MY3)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Water Treatment and Disinfection
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Keywords
- trichloramine, indoor swimming pools, occupational exposure, lifeguards, respiratory symptoms, sore throat, sputum, free chlorine, indoor air quality, exposure limits, Taipei
- MeSH terms
- Chlorides, Humans, Surveys and Questionnaires, Respiratory Tract Diseases, Swimming Pools, Taiwan, Occupational Exposure, Air Pollution, Indoor, Nitrogen Compounds
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