Health effects of exposure to chlorination by-products in swimming
pools: Position Paper
Abstract
Concerns have been raised regarding the potential negative effects on
human health of water disinfectants used in swimming-pools. Among the
disinfection options, the approaches using chlorine-based products have
been typically preferred. Chlorine readily reacts with natural organic
matter that are introduced in the water mainly through the bathers,
leading to the formation of potentially harmful chlorination by-products
(CBPs). The formation of CBPs is of particular concern since they have
been epidemiologically associated with the development of various
clinical manifestations. The higher the concentration of these volatile
CBPs in the water, the higher their concentration in the air above the
pool, and different routes of exposure to chemicals in swimming-pools
(water ingestion, skin absorption and inhalation) contribute to the
individual exposome. CBPs may affect the respiratory and skin health of
those who stay indoor for long periods, such as swimming instructors,
pool staff, and competitive swimmers. Whether those who use
chlorinated-pools as customers, particularly children, may also be
affected has been a matter of debate. In this article, the EAACI Joint
Task Force of the Working Group of Allergy, Asthma & Sports and the
Interest Groupf of Environmental & Occupational Allergy discusses the
current evidence regarding the health effects of both acute and chronic
exposures in different populations (work-related exposures, intensive
sports and recreational attendance) and identify the main
recommendations and unmet needs for research in this area.