title: Swimming pool attendance is related to asthma among atopic school children: a population-based study.
abstract: BACKGROUND
  By-products of water disinfectants have been suggested to cause asthma, especially in atopic children. However, studies on indoor swimming pool attendance and asthma in children have presented conflicting results. The present study examined the relationship between indoor swimming pool attendance and asthma among sensitized and non-sensitized children aged 11-12 years.
  
  
  METHODS
  An extended ISAAC questionnaire was sent to the families of all children attending fifth or sixth grade, aged 11-12 years, in two municipalities in Northern Sweden in 2010. A total of 1866 participated (96% of those invited) in the questionnaire study and 1652 (89%) also participated in skin prick testing for 10 standard airborne allergens. Asthma was defined as physician-diagnosed asthma in combination with wheeze or use of asthma medication in the last 12 months. Current swimming pool attendance was reported as ≥ 1/week or <1/week. Logistic regression models were used for data analysis.
  
  
  RESULTS
  The prevalence of current asthma was 8.9% (10.0% of boys; 7.9% of girls) and 14% had attended indoor pools ≥ 1/week. Children currently attending swimming pools ≥ 1/week had an increased risk of current asthma. Stratified analyses for allergic sensitization adjusted for sex, parental smoking, parental asthma, and damp housing, showed a statistically significant association for current asthma only among sensitized subjects (OR 95% CI 1.90 1.09-3.32). No association was found between current pool attendance and wheeze, sensitization, rhinitis or eczema.
  
  
  CONCLUSIONS
  The present study supports the proposed link between indoor swimming pool attendance and asthma in sensitized children.
authors.affiliation: Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90187, Umeå, Sweden. martin.andersson@envmed.umu.se.|The OLIN Studies, Norrbotten County Council, Luleå, Sweden. martin.andersson@envmed.umu.se.
authors.forename: Martin
authors.initials: M
authors.lastname: Andersson
authors.affiliation: Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90187, Umeå, Sweden. linnea.hedman@nll.se.|The OLIN Studies, Norrbotten County Council, Luleå, Sweden. linnea.hedman@nll.se.
authors.forename: Linnea
authors.initials: L
authors.lastname: Hedman
authors.affiliation: Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90187, Umeå, Sweden. gunnar.nordberg@envmed.umu.se.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Nordberg
authors.affiliation: Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90187, Umeå, Sweden. bertil.forsberg@envmed.umu.se.
authors.forename: Bertil
authors.initials: B
authors.lastname: Forsberg
authors.affiliation: Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90187, Umeå, Sweden. kare.eriksson@envmed.umu.se.
authors.forename: Kåre
authors.initials: K
authors.lastname: Eriksson
authors.affiliation: Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90187, Umeå, Sweden. eva.ronmark@nll.se.|The OLIN Studies, Norrbotten County Council, Luleå, Sweden. eva.ronmark@nll.se.
authors.forename: Eva
authors.initials: E
authors.lastname: Rönmark
mesh_terms: D001249:Asthma / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D015995:Prevalence; D013548:Sweden / Q000453:epidemiology; D013551:Swimming Pools / Q000706:statistics & numerical data