title: Respiratory and Ocular Symptoms Among Employees at Swedish Indoor Swimming Pools.
abstract: This study investigated trichloramine exposure and prevalence of respiratory and ocular symptoms among Swedish indoor swimming pool workers.
  
  
  
  Questionnaires were distributed to pool workers and referents. Lung function and fraction of exhaled nitric oxide (FeNO) were measured before and after work. Exposure to trichloramine and trihalomethanes was measured over work shifts.
  
  
  
  The mean personal trichloramine exposure was 36 μg/m. Significantly more exposed workers reported ocular and nasal symptoms. There were significant differences between groups in FeNO change following work, with exposed showing increased FeNO, which grew when analyses included only nonsmokers.
  
  
  
  The findings indicate that indoor swimming pool environments may have irritating effects on mucous membranes. FeNO data also indicate an inflammatory effect on central airways, but the clinical relevance is unclear. Low trichloramine levels found in this study were not associated with health effects.
authors.affiliation: Department of Occupational and Environmental Medicine, Faculty of Medicine and Health (Dr Löfstedt, Ms Westerlund, Dr Graff, Ms Bryngelsson, Mr Mölleby, Dr Westberg); Department of Clinical Medicine, School of Health Sciences, Örebro (Ms Westerlund); Section of Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg (Dr Olin); Department of Occupational and Environmental Medicine, Umeå University, Umeå (Dr Eriksson); and Man-Technology-Environment Research Centre (MTM), Department of Science, Örebro University, Örebro, Sweden (Dr Westberg).
authors.forename: Håkan
authors.initials: H
authors.lastname: Löfstedt
authors.forename: Jessica
authors.initials: J
authors.lastname: Westerlund
authors.forename: Pål
authors.initials: P
authors.lastname: Graff
authors.forename: Ing-Liss
authors.initials: IL
authors.lastname: Bryngelsson
authors.forename: Göte
authors.initials: G
authors.lastname: Mölleby
authors.forename: Anna-Carin
authors.initials: AC
authors.lastname: Olin
authors.forename: Kåre
authors.initials: K
authors.lastname: Eriksson
authors.forename: Håkan
authors.initials: H
authors.lastname: Westberg
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects / Q000032:analysis; D016902:Air Pollution, Indoor / Q000009:adverse effects* / Q000032:analysis; D002712:Chlorides / Q000009:adverse effects* / Q000032:analysis; D005128:Eye Diseases / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017672:Nitrogen Compounds / Q000009:adverse effects* / Q000032:analysis; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects*; D015995:Prevalence; D012129:Respiratory Function Tests; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000453:epidemiology*; D013548:Sweden; D013551:Swimming Pools; D022882:Trihalomethanes / Q000009:adverse effects* / Q000032:analysis; D055815:Young Adult
chemical_list: D000395:Air Pollutants, Occupational; D002712:Chlorides; D017672:Nitrogen Compounds; D022882:Trihalomethanes; C037454:nitrogen chloride