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