Ocular and Respiratory Illness Associated with an Indoor Swimming Pool

The use of chlorine has become very popular for the treatment of swimming pools, both for indoor and outdoor swimming pools. However, the lack of control over the quantities and frequency of application means that most pools are treated with chlorine levels much higher than those recommended.

Whether by looking for a more efficient or a faster treatment, people forget that chlorine is a highly toxic chemical and often abuse the quantity and frequency of chlorine applied, thus causing damage to health, often not detected immediately. The use of chlorine also requires a period of rest and stabilization that is often not respected.

Most sensitive people show immediate symptoms, such as red and irritated eyes, tearing, burning, or even, red and irritated skin. A CDC (Centers for Disease Control and Prevention) publication reports on ocular and respiratory diseases associated with the use of indoor swimming pools in Nebraska in 2006.

“On December 26, 2006, the Nebraska Department of Health and Human Services (NDHHS) received a report of a child hospitalized in an intensive care unit for severe chemical epiglottitis and laryngotracheobronchitis after swimming in an indoor motel swimming pool. The pool was inspected the same day and immediately closed by NDHHS because of multiple state health code violations. NDHHS initiated an outbreak investigation to identify additional cases and the cause of the illness. This report describes the results of that investigation, which indicated that 24 persons became ill, and the outbreak likely was the result of exposure to toxic levels of chloramines* (1,2) that had accumulated in the air in the enclosed space above the swimming pool. This outbreak highlights the potential health risks from chemical exposure at improperly maintained pools and the need for properly trained pool operators to maintain water quality. (…)
*Disinfection by-products formed when free chlorine, a common disinfectant used in swimming pools, combines with nitrogenous human wastes (e.g., sweat, urine, or feces) in pool water. “

TABLE 1 – NUMBER AND PERCENTAGE OF PERSONS WITH VARIOUS SYMPTOMS OF ILLNESS AFTER EXPOSURE TO AN INDOOR MOTEL SWIMMING POOL* – NEBRASKA, 2006

Symptoms

No.

(%)

Included in case definition

Burning eyes

Sore throat

Watery eyes

Coughing

Sneezing

Burning inside nose

Wheezing

Chest tightness

Shortness of breath


22

20

19

19

18

13

11

7

5


(92)

(83)

(79)

(79)

(75)

(54)

(46)

(29)

(21)

Not Included in case definition
Headache

Blurry vision

Dry mouth

Nausea

Diarrhea

Vomiting

Skin rash

Fever

Abdominal cramping

Photophobia


18

8

8

7

7

4

4

3

2

1


(75)

(33)

(33)

(29)

(29)

(17)

(17)

(13)

(8)

(4)

* N=24. A total of 20 persons entered the immediate pool area and became ill. In addition, four persons who became ill did not enter the immediate pool area but entered the larger, enclosed courtyard area in which the pool was located.

TABLE 2 – TIME FROM ENTERING THE IMMEDIATE AREA OF AN INDOOR MOTEL SWIMMING POOL UNTIL ONSET OF ILLNESS** – NEBRASKA, 2006

Time (min)

No.

(%)

< 120

≤ 29

30 – 59

60 – 89

90 – 119

≥ 120

14

3

4

1

6

6

(70)

(15)

(20)

(5)

(30)

(30)

** A total of 20 persons entered the immediate pool area and became ill. In addition, four persons (not included in this table) who became ill did not enter the immediate pool area but entered the larger, enclosed courtyard area in which the pool was located.

READ HERE THE FULL ARTICLE.

 

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