The determinants of prevalence of health complaints among young competitive swimmers.
OBJECTIVE
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.
Institut national de santé publique du Québec, 945 Ave Wolfe, G1V 5B3, Sainte-Foy, Québec, Canada.
Benoit
B
Lévesque
Jean-François
JF
Duchesne
Suzanne
S
Gingras
Robert
R
Lavoie
Denis
D
Prud'Homme
Emmanuelle
E
Bernard
Louis-Philippe
LP
Boulet
Pierre
P
Ernst
D000293:Adolescent; D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity; D016009:Chi-Square Distribution; D002648:Child; D002700:Chloramines / Q000032:analysis* / Q000633:toxicity; D002713:Chlorine / Q000633:toxicity; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D015995:Prevalence; D011792:Quebec / Q000453:epidemiology; D012140:Respiratory Tract Diseases / Q000139:chemically induced* / Q000453:epidemiology; D012916:Soccer / Q000502:physiology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013550:Swimming / Q000502:physiology* / Q000706:statistics & numerical data; D013551:Swimming Pools; D014871:Water Microbiology; D014874:Water Pollutants, Chemical / Q000032:analysis / Q000633:toxicity
D000393:Air Pollutants; D002700:Chloramines; D014874:Water Pollutants, Chemical; D002713:Chlorine