title: Health impact of disinfection by-products in swimming pools.
abstract: This article is focused on the epidemiological evidence on the health impacts  related to disinfection by-products (DBPs) in swimming pools, which is a chemical hazard  generated as an undesired consequence to reduce the microbial pathogens. Specific DBPs  are carcinogenic, fetotoxic and/or irritant to the airways according to experimental  studies. Epidemiological evidence shows that swimming in pools during pregnancy  is not associated with an increased risk of reproductive outcomes. An epidemiological  study suggested an increased risk of bladder cancer with swimming pool attendance,  although evidence is inconclusive. A higher prevalence of respiratory symptoms including asthma is found among swimming pool workers and elite swimmers,  although the causality of this association is unclear. The body of evidence in  children indicates that asthma is not increased by swimming pool attendance.  Overall, the available knowledge suggests that the health benefits of swimming  outweigh the potential health risks of chemical contamination. However, the positive  effects of swimming should be enhanced by minimising potential risks.
authors.affiliation: Centre for Research in Environmental Epidemiology, Barcelona, Spain. cvillanueva@creal.cat
authors.forename: Cristina M
authors.initials: CM
authors.lastname: Villanueva
authors.forename: Laia
authors.initials: L
authors.lastname: Font-Ribera
mesh_terms: D000328:Adult; D000818:Animals; D002648:Child; D004202:Disinfectants / Q000633:toxicity*; D004203:Disinfection; D004781:Environmental Exposure; D062489:Health Impact Assessment; D006801:Humans; D007246:Infertility / Q000139:chemically induced; D009153:Mutagens / Q000633:toxicity; D009369:Neoplasms / Q000139:chemically induced; D012140:Respiratory Tract Diseases / Q000139:chemically induced / Q000453:epidemiology; D013551:Swimming Pools / Q000592:standards*
chemical_list: D004202:Disinfectants; D009153:Mutagens