title: Infant swimming practice, pulmonary epithelium integrity, and the risk of allergic and respiratory diseases later in childhood.
abstract: OBJECTIVE
  Irritant gases and aerosols contaminating the air of indoor swimming pools can affect the lung epithelium and increase asthma risk in children. We evaluated the impact of infant swimming practice on allergic status and respiratory health later in childhood.
  
  
  METHODS
  Clara cell protein, surfactant-associated protein D, and total and aeroallergen-specific immunoglobulin E were measured in the serum of 341 schoolchildren aged 10 to 13 years, among whom 43 had followed an infant swimming program. Asthma was defined as doctor-diagnosed asthma and/or positive exercise-induced bronchoconstriction (15% decrease in postexercise forced expiratory volume).
  
  
  RESULTS
  There were no significant differences between the infant swimming group and the other children regarding the levels of exhaled nitric oxide and total or aeroallergen-specific serum immunoglobulin E. Children who swam as infants showed, by contrast, a significant decrease of serum Clara cell protein and of the serum Clara cell protein/surfactant-associated protein D ratio integrating Clara cell damage and permeability changes of the lung epithelial barrier. These effects were associated with higher risks of asthma and of recurrent bronchitis. Passive exposure to tobacco alone had no effect on these outcomes but seemed to interact with infant swimming practice to increase the risk of asthma or of recurrent bronchitis.
  
  
  CONCLUSIONS
  Our data suggest that infant swimming practice in chlorinated indoor swimming pools is associated with airways changes that, along with other factors, seem to predispose children to the development of asthma and recurrent bronchitis.
authors.affiliation: Unit of Toxicology, Faculty of Medicine, Catholic University of Louvain, Avenue E Mounier 53, Box 53.02, B-1200 Brussels, Belgium. alfred.bernard@uclouvain.be
authors.forename: Alfred
authors.initials: A
authors.lastname: Bernard
authors.forename: Sylviane
authors.initials: S
authors.lastname: Carbonnelle
authors.forename: Xavier
authors.initials: X
authors.lastname: Dumont
authors.forename: Marc
authors.initials: M
authors.lastname: Nickmilder
mesh_terms: D001249:Asthma / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D002648:Child; D002713:Chlorine / Q000009:adverse effects; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D007223:Infant; D008297:Male; D012120:Respiration Disorders / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D020545:Respiratory Mucosa / Q000473:pathology / Q000502:physiology; D012307:Risk Factors; D013550:Swimming; D013551:Swimming Pools; D013997:Time Factors
chemical_list: D002713:Chlorine