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The determinants of prevalence of health complaints among young competitive swimmers

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Abstract

Objectives: Chloramines, which are produced by the reaction of chlorine with the organic matter present in indoor pools, are potential airway irritants in swimmers. The objective of this study was to compare the prevalence of health complaints of young swimmers and young indoor soccer players and to evaluate the relationship between chloramine concentrations and the athletes’ health complaints. Methods: Health complaints were first (Part 1) documented by questionnaire in 305 competitive swimmers and 499 indoor soccer players of the Québec City region (Canada). Then, (Part 2) health complaints were documented during five training sessions in 72 competitive swimmers in comparison to 73 soccer players. The chloramines in the swimming pool air and water were measured as well as the peak expiratory flow (PEF) before and after the training session. Results: In Part 1, the swimmers reported more lower (adjusted OR: 1.5; IC95%= 1.0–2.2) and upper respiratory symptoms (adjusted OR: 3.7; IC95%= 2.4–5.8). In Part 2, the swimmers experienced more frequent lower (adjusted OR: 3.5; IC95%= 2.0–6.0) and upper respiratory symptoms (adjusted OR: 3.1; IC95%= 1.8–5.4). Overall, swimmers exposed to the highest levels of chloramines in the air and water had more respiratory complaints. Conclusions: Swimmers exposed to chlorination by-products in both the water and air of indoor swimming pools experience frequent respiratory symptoms that could potentially be reduced by limiting exposure to these products.

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References

  • Aggarwal AN, Gupta D, Chaganti S, Jindal SK (2000) Diurnal variation in peak expiratory flow in healthy young adults. Indian J Chest Dis Allied Sci 42:15–19

    PubMed  CAS  Google Scholar 

  • Anonymous (1979) Wheezing at the swimming pool Lancet 2:1342–1343

    PubMed  Google Scholar 

  • APHA (1998) Standard method for the examination of water and wastewater. American Public Health Association, Washington, DC

  • Bernard A, Carbonnelle S, Michel O, Higuet S, De Burbure C, Buchet JP, Hermans C, Dumont X, Doyle I (2003) Lung hyperpermeability and asthma prevalence in schoolchildren: unexpected associations with the attendance at indoor chlorinated swimming pools. Occup Environ Med 60:385–394

    Article  PubMed  CAS  Google Scholar 

  • Borg G (1970) Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med 2:92–98

    PubMed  CAS  Google Scholar 

  • Fitch KD, Morton AR (1971) Specificity of exercise in exercise-induced asthma. Br Med J 4:577–581

    PubMed  CAS  Google Scholar 

  • Gagnaire F, Azim S, Bonnet P, Hecht G, Hery M (1994) Comparison of the sensory irritation response in mice to chlorine and nitrogen trichloride. J Appl Toxicol 14:405–409

    PubMed  CAS  Google Scholar 

  • Gold DR, Weiss ST, Tager IB, Segal MR, Speizer FE (1989) Comparison of questionnaire and diary methods in acute childhood respiratory illness surveillance. Am Rev Respir Dis 139:847–849

    PubMed  CAS  Google Scholar 

  • Helenius IJ, Rytila P, Metso T, Haahtela T, Venge P, Tikkanen HO (1998a) Respiratory symptoms, bronchial responsiveness, and cellular characteristics of induced sputum in elite swimmers. Allergy 53:346–352

    CAS  Google Scholar 

  • Helenius IJ, Tikkanen HO, Sarna S, Haahtela T (1998b) Asthma and increased bronchial responsiveness in elite athletes: atopy and sport event as risk factors. J Allergy Clin Immunol 101:646–652

    Article  CAS  Google Scholar 

  • Helenius I, Rytila P, Sarna S, Lumme A, Helenius M, Remes V, Haahtela T (2002) Effect of continuing or finishing high-level sports on airway inflammation, bronchial hyperresponsiveness, and asthma: a 5-year prospective follow-up study of 42 highly trained swimmers. J Allergy Clin Immunol 109:962–968

    Article  PubMed  Google Scholar 

  • Hery M, Hecht G, Gerber JM, Gendre JC, Hubert G, Rebuffaud J (1995) Exposure to chloramines in the atmosphere of indoor swimming pools. Ann Occup Hyg 39:427–439

    Article  CAS  Google Scholar 

  • ISAAC (1998) Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet 351:1225–1232

    Google Scholar 

  • ISQ (2002) Enquête sociale et de santé auprès des enfants et adolescents québécois, 1999. Direction Santé Québec, Institut de la statistique du Québec

  • Langdeau JB, Turcotte H, Bowie DM, Jobin J, Desgagne P, Boulet LP (2000) Airway hyperresponsiveness in elite athletes. Am J Respir Crit Care Med 161:1479–1484

    PubMed  CAS  Google Scholar 

  • Massin N, Bohadana AB, Wild P, Hery M, Toamain JP, Hubert G (1998) Respiratory symptoms and bronchial responsiveness in lifeguards exposed to nitrogen trichloride in indoor swimming pools. Occup Environ Med 55:258–263

    PubMed  CAS  Google Scholar 

  • Monto AS, Napier JA, Metzner HL (1971) The Tecumseh study of respiratory illness. I. Plan of study and observations on syndromes of acute respiratory disease. Am J Epidemiol 94:269–279

    PubMed  CAS  Google Scholar 

  • Mustchin CP, Pickering CA (1979) “Coughing water”: bronchial hyperreactivity induced by swimming in a chlorinated pool. Thorax 34:682–683

    Article  PubMed  CAS  Google Scholar 

  • Penny PT (1983) Swimming pool wheezing. Br Med J 287:461–462

    Article  CAS  Google Scholar 

  • Potts J (1994) Adverse respiratory health effects of competitive swimming: The prevalence of symptoms, illness, and bronchial responsiveness to metacholine and exercise. Faculty of Graduate Studies University of British Columbia, Vancouver

    Google Scholar 

  • Potts J (1996) Factors associated with respiratory problems in swimmers. Sports Med 21:256–261

    PubMed  CAS  Google Scholar 

  • Quackenboss JJ, Lebowitz MD, Krzyzanowski M (1991) The normal range of diurnal changes in peak expiratory flow rates. Relationship to symptoms and respiratory disease. Am Rev Respir Dis 143:323–330

    PubMed  CAS  Google Scholar 

  • Thickett KM, McCoach JS, Gerber JM, Sadhra S, Burge PS (2002) Occupational asthma caused by chloramines in indoor swimming-pool air. Eur Respir J 19:827–832

    Article  PubMed  CAS  Google Scholar 

  • Weiler JM, Layton T, Hunt M (1998) Asthma in United States Olympic athletes who participated in the 1996 Summer Games. J Allergy Clin Immunol 102:722–726

    Article  PubMed  CAS  Google Scholar 

  • Weiler JM, Ryan EJ (2000) Asthma in United States olympic athletes who participated in the 1998 olympic winter games. J Allergy Clin Immunol 106:267–271

    Article  PubMed  CAS  Google Scholar 

  • World Health Organization (2000) Draft guidelines for safe recreational-water environment: swimming pools, spas and similar recreational-water environments. Geneva

  • Zeger SL, Liang KY (1986) Longitudinal data analysis for discrete and continuous outcomes. Biometrics 42:121–130

    Article  PubMed  CAS  Google Scholar 

  • Zureik M, Liard R, Segala C, Henry C, Korobaeff M, Neukirch F (1995) Peak expiratory flow rate variability in population surveys. Does the number of assessments matter? Chest 107:418–423

    PubMed  CAS  Google Scholar 

  • Zwick H, Popp W, Budik G, Wanke T, Rauscher H (1990) Increased sensitization to aeroallergens in competitive swimmers. Lung 168:111–115

    PubMed  CAS  Google Scholar 

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Acknowledgements

This study was conducted thanks to the financial support of the Fonds de Recherche en Santé du Québec (FRSQ) through a grant from Hydro-Québec. We thank these organizations for their support. We also want to thank all the swimmers, soccer players, trainers and swimming pool managers who took part in the project, as well as Marc Amyot, Jean-Pierre Haubert, Karl Dupuis, Sylvain Allaire, Jean Tardif, Philippe Cantin, Lise Côté, and finally, Luc Pelletier from Medigas for supplying the peak flow meters.

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Correspondence to Benoit Lévesque.

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Lévesque, B., Duchesne, JF., Gingras, S. et al. The determinants of prevalence of health complaints among young competitive swimmers. Int Arch Occup Environ Health 80, 32–39 (2006). https://doi.org/10.1007/s00420-006-0100-0

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  • DOI: https://doi.org/10.1007/s00420-006-0100-0

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