Non-respiratory symptoms
Concerning self-reported ocular symptoms, indoor swimming-pools
employees declared frequently having red (48.9%) and itchy (44.4%)
eyes, mostly lifeguards and trainers13.
Regarding the skin, both water itself and CBPs have negative effects due
to a dilution or flushing out of the natural moisturizing. An increasing
risk of irritative skin symptoms was demonstrated dependent on the
NCl3 concentrations21. Recreational
swimming leads to transient but significant changes in skin surface
properties of women with healthy skin22; skin dryness,
itch and erythema are non-specific complains in swimming-pool
attendants23,24. Additionally, both allergic contact
dermatitis and contact urticaria due to chlorinated-pool water have been
identified20,23,25,26. Swimming in public pools/spas
in the current or previous week has been associated with dermal symptoms
(rash, generalized itching, dermal infection)27.
Besides, more verrucas, mycosis, eczema and rash have been identified in
lifeguards and trainers compared to other workers at swimming
pools13.
Three different disinfection systems (chlorine, chlorine/ozone and
bromine/ozone) were investigated to assess adverse skin and eye
effects28: compared with the bromine/ozone pool, the
odds ratio (OR) of having a rash <24 h after pool use was 1.91
(CI 0.71-5.10) for the chlorine-pool and 1.88 (CI 0.61-5.81) for the
chlorine/ozone pool. Gomà et al.29 reported the
efficacy of a new disinfection method (based upon on replacement of the
strong HCl by CO2, inclusion of a low concentration salt
electrolysis system, and ultraviolet radiation phase) to markedly reduce
the irritant substances levels in the pool atmosphere and significantly
reduce eye, nose, skin and cough complaints, both in recreational and
competitive swimmers.