Prevalence of ocular, respiratory and cutaneous symptoms in indoor swimming pool workers and exposure to disinfection by-products (DBPs)
Open accessAbstract
The objective of this cross-sectional study was to investigate the prevalence of self-reported respiratory, ocular and cutaneous symptoms in subjects working at indoor swimming pools and to assess the relationship between frequency of declared symptoms and occupational exposure to disinfection by-products (DBPs). Twenty indoor swimming pools in the Emilia Romagna region of Italy were included in the study. Information about the health status of 133 employees was collected using a self-administered questionnaire. Subjects working at swimming pools claimed to frequently experience the following symptoms: cold (65.4%), sneezing (52.6%), red eyes (48.9%) and itchy eyes (44.4%). Only 7.5% claimed to suffer from asthma. Red eyes, runny nose, voice loss and cold symptoms were declared more frequently by pool attendants (lifeguards and trainers) when compared with employees working in other areas of the facility (office, cafe, etc.). Pool attendants experienced generally more verrucas, mycosis, eczema and rash than others workers; however, only the difference in the frequency of self-declared mycosis was statistically significant (p = 0.010). Exposure to DBPs was evaluated using both environmental and biological monitoring. Trihalomethanes (THMs), the main DBPs, were evaluated in alveolar air samples collected from subjects. Swimming pool workers experienced different THM exposure levels: lifeguards and trainers showed the highest mean values of THMs in alveolar air samples (28.5 ± 20.2 µg/m3), while subjects working in cafe areas (17.6 ± 12.1 µg/m3), offices (14.4 ± 12.0 µg/m3) and engine rooms (13.6 ± 4.4 µg/m3) showed lower exposure levels. Employees with THM alveolar air values higher than 21 µg/m3 (median value) experienced higher risks for red eyes (OR 6.2; 95% CI 2.6–14.9), itchy eyes (OR 3.5; 95% CI 1.5–8.0), dyspnea/asthma (OR 5.1; 95% CI 1.0–27.2) and blocked nose (OR 2.2; 95% CI 1.0–4.7) than subjects with less exposure. This study confirms that lifeguards and trainers are more at risk for respiratory and ocular irritative symptoms and cutaneous diseases than subjects with other occupations at swimming pool facilities.
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Workers in swimming pools suffered frequently from cold (65.4%), sneezing (52.6%), red eyes (48.9%) and itchy eyes (44.4%).
“It showed that workers in swimming pools suffered frequently from cold (65.4%), sneezing (52.6%), red eyes (48.9%) and itchy eyes (44.4%).”
From Regulation, formation, exposure, and treatment of disinfection by-products (DBPs) in swimming pool waters: A critical review (2018) · cites this paper as Fantuzzi et al. (2010)
The prevalence of health symptoms including red eyes, itchy eyes, dyspnea/asthma, and blocked nose was positively linked to THM concentration in alveolar air (>21 μg/m3) based on a survey in twenty indoor pools.
“The prevalence of health symptoms including red eyes, itchy eyes, dyspnea/ asthma, and blocked nose was positively linked to THM concentration in alveolar air (> 21 μg/m 3 ) based on a survey in twenty indoor pools (Fantuzzi et al., 2010).”
From Regulation, formation, exposure, and treatment of disinfection by-products (DBPs) in swimming pool waters: A critical review (2018) · cites this paper as Fantuzzi et al., 2010
Personnel in swimming pool facilities typically experience ocular and respiratory symptoms.
“Personnel in swimming pool facilities typically experience ocular and respiratory symptoms. [11,16 -19]”
From Occupational exposure to trichloramine and trihalomethanes: adverse health effects among personnel in habilitation and rehabilitation swimming pools (2019) · cites this paper as [18]
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EXPOSURES AND RISKS ASSOCIATED WITH ACTIVITIES AND BEHAVIORS IN SWIMMING POOL ENVIRONMENTS
Suppes, L. M. (2013) · UA Campus Repository (The University of Arizona)
- Authors
- Fantuzzi, G., Righi, E., Predieri, G., Giacobazzi, P., Mastroianni, K., & Aggazzotti, G.
- Affiliations
- University of Modena and Reggio Emilia (IT)
- Corresponding author
- Fantuzzi, Guglielmina
- Venue
- International Journal of Environmental Research and Public Health
- Publisher
- MDPI AG
- Published
- 2010-03-29
- Volume
- 7
- Issue
- 4
- Pages
- 1379-1391
- ISSN
- 1660-4601 (ISSN-L)
- PMC
- PMC2872330
- OpenAlex
- W2081877777
- Cited by
- 95
- References
- 31
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 6 · 2023: 4 · 2022: 5 · 2021: 6 · 2020: 3 · 2019: 6 · 2018: 6 · 2017: 9 · 2016: 6 · 2015: 8 · 2014: 4 · 2013: 4 · 2012: 8
- FWCI
- 6.36
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- 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
- Keywords
- disinfection by-products, trihalomethanes, occupational exposure, respiratory symptoms, ocular symptoms, cutaneous manifestations, asthma, fungal infection, biomonitoring, environmental monitoring, lifeguards, occupational health, Emilia-Romagna, chlorination, water disinfection, atopic dermatitis
- MeSH terms
- Adult, Chromatography, Gas, Cross-Sectional Studies, Disinfectants, Eye Diseases, Female, Humans, Male, Respiratory Tract Infections, Skin Diseases, Prevalence, Occupational Exposure
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