The publication of a recent article in the February, 2012 issue of the Journal of Allergy and Clinical Immunology adds to the evidence, and increasing concern, of the unhealthy effects of exposure to disinfection by-products (DBP) in swimming pools. The article, entitled “Airway remodeling and inflammation in competitive swimmers training in indoor chlorinated swimming pools” by Bougault et al provides evidence that intense, long term training in indoor chlorinated swimming pools leads to airway changes similar to those seen in asthma.
The study examined 23 competitive swimmers, age 17 and up. The swimmers were evaluated during a period of rest, at least 3 days after their last competition or strenuous training workout. The evaluation tests included standard lung capacity testing, allergy testing, and bronchoscopy with biopsy collection for pathological evaluation.
The findings of the study demonstrated inflammatory and airway remodeling changes in bronchial biopsies of competing swimmers similar to non-athletes with mild asthma. In fact, some of the measured inflammatory parameters were greater than that seen in asthmatic subjects. A majority of the swimmers had atopy (allergic hyperresponsiveness), an important point according to the authors, “as a recent hypothesis stated that atopy may develop in swimmers because of an increasing exposure to chlorination products.”
Whether recreational swimmers and children will develop these changes remains to be determined. However, according to the authors, “reduction of chloramine exposure in pool environments should be considered.”
Reference:
Airway remodeling and inflammation in competitive swimmers training in indoor chlorinated swimming pools. Bougault, V, Loubaki L, Joubert, P et al. J Allergy Clin Immunol 2012; Vol. 129(2):351-358
Introduction
Walk into a building with a pool and you can instantly tell it’s there by the smell. No matter how big the building, small the pool, or robust the heating and ventilation system, that characteristic “chlorine” smell is there. If you are like me, a few minutes of exposure to the smell will bring tightness to my chest, itching to my eyes, and after about 20 minutes a light headed feeling. Go outside and it all goes away in about an hour. Swim and it can take days to return to normal. Competitively swim or swim daily and you probably get so used to the air you become acclimated to the irritation of disinfection byproducts (DBP). In the past few years, a lot of research has defined what causes this smell, what effect it has on swimmers, and what can change the creation of DBP’s so the pool becomes a “you don’t know there is a pool until you see it” experience. [Read more…]
During our test this last summer at the St. Paul, MN outdoor aquatic park we surveyed the swimmers twice a week. One of the most striking findings was that swimmers with asthma did not need to use their inhalers when swimming in the pools that were conditioned with PoolNaturally® Plus. We then treated the indoor aquatic park in St. Paul and had similar results.
Able to Swim AgainWatch movie online The Transporter Refueled (2015)
In fact one lady wrote to me about her inability to swim indoors due to her asthma. She was a competitive swimmer in her younger years and had to stop swimming because of severe breathing problems from asthma caused by the air in the pool. She heard about the sphagnum moss treated pools and how people could swim without using their inhalers so she tried swimming again. She reported that she could do a full workout without breathing problems and thanked me for “giving her back her favorite sport”.
With a little research the relationship between recreational and home water, chlorine and asthma became clear.
The Chemical Reactions
Here is what happens when we use chlorine to sanitize water in a pool or in our municipal water supply. As it turns out chlorine is not the problem. A byproduct of chlorine and biological molecules that contain nitrogen is the formation chloramines. These chloramines come in many different forms such as mono, di, and trichloramines. One of these compounds, a molecule called trinitrochlorine, has been implicated in causing airway irritation.
Trinitrochlorine is a volatile molecule that is extremely irritating to tissues such as your eyes, skin and airways. Because the molecule is volatile, it rises to the surface of water and is easily inhaled. In fact, in a pool, the levels of trichloronitrate are highest in the air right on top of the water. So every time a swimmer takes a breath, they inhale an irritant that causes airway constriction called reactive airway disease. The smell we all associate with a chlorine pool is actually the smell of the multiple species of chloamines, not chlorine. The problem is that chlorine is so reactive, it immediately finds and combines with nitrogen containing compounds to create chloramines.
Correlation between Pools and Asthma
A recent study reported in the pediatric literature, showed that children who are repeatedly exposed to swimming pools have a significantly higher incidence of reactive airway disease or asthma, than those who aren’t exposed to pools.
In our research laboratory, we are currently studying why the pools treated with PoolNaturally® Plus don’t cause this reactive airway response, skin irritation, or burning eyes and don’t smell. We know that for chlorine to become trichloronitrate you need chlorine, nitrogen containing biological molecules and a low pH. It could be that the amount of organic contamination in the pool correlates with the amount of trichloronitrate because organic contamination contains and produces huge amounts of nitrogen containing molecules and it creates a local microenvironment that has a very low pH. It could therefore be the “engine” that drives the formation of these toxic molecules. In the laboratory we know that the moss in PoolNaturally® Plus inhibits the formation of organic contamination and if our hypothesis is correct it could greatly reduce the formation of chlorine to trichloronitrate by removing the primary nitrogen source, the organic contamination.