title: Short term respiratory effects of acute exposure to chlorine due to a swimming pool accident.
abstract: OBJECTIVE
  Acute exposure to chlorine causes lung damage, and recovery may proceed slowly for several weeks. The short term respiratory effects of acute chlorine inhalation during a swimming pool accident were examined.
  
  
  METHODS
  A total of 282 subjects (134 children, aged <14 years) inhaled hydrogen chloride and sodium hypochlorite during an accident caused by a malfunction of the water chlorinating system in a community pool in Rome in 1998. Most people received bronchodilators and cortisone at the emergency room; five children were admitted to hospital. A total of 260 subjects (92.2%) were interviewed about duration of exposure (<3, 3--5, >5 minutes), intensity of exposure (not at all or a little, a moderate amount, a lot), and respiratory symptoms. Lung function was measured in 184 people (82 children) after 15--30 days. The effects of exposure to chlorine were analysed through multiple linear regression, separately in adults and in children.
  
  
  RESULTS
  Acute respiratory symptoms occurred among 66.7% of adults and 71.6% of children. The incidences were highest among those who had chronic respiratory disease and had a longer duration of exposure. In about 30% of the subjects, respiratory symptoms persisted for 15--30 days after the accident. Lung function levels were lower in those who reported a high intensity of exposure than in those who reported low exposure, both in children and in adults (mean (95% confidence interval (95% CI)) differences in forced expiratory volume in 1 second (FEV(1,)) were -109 (-310 to 93) ml, and -275 (-510 to -40) ml, respectively).
  
  
  CONCLUSIONS
  Persistent symptoms and lung function impairment were found up to 1 month after the incident. Although community pool accidents happen rarely, the medical community needs to be alerted to the possible clinical and physiological sequelae, especially among susceptible people.
authors.affiliation: Agency for Public Health, Lazio, Via S Costanza 53, 00198 Rome, Italy. outcome@asplazio.it
authors.forename: N
authors.initials: N
authors.lastname: Agabiti
authors.forename: C
authors.initials: C
authors.lastname: Ancona
authors.forename: F
authors.initials: F
authors.lastname: Forastiere
authors.forename: A
authors.initials: A
authors.lastname: Di Napoli
authors.forename: E
authors.initials: E
authors.lastname: Lo Presti
authors.forename: G M
authors.initials: GM
authors.lastname: Corbo
authors.forename: F
authors.initials: F
authors.lastname: D'Orsi
authors.forename: C A
authors.initials: CA
authors.lastname: Perucci
mesh_terms: D000059:Accidents; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002713:Chlorine / Q000506:poisoning*; D002908:Chronic Disease; D004781:Environmental Exposure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012120:Respiration Disorders / Q000139:chemically induced*; D015656:Respiratory Mechanics / Q000187:drug effects; D013551:Swimming Pools
chemical_list: D002713:Chlorine