Air quality in swimming pools

Air quality in swimming pools (chlorine)

Date: Wed, 27 Mar 1996 22:32:41 +0100
From: (Banken Reiner)
To: Multiple recipients of list <>
Subject: Air quality in swimming pools

Dear listmembers,

As a public health physician working in a regional public health
department I do need some assistance with the following problem: 

A physician referred us a case of a 14 year old girl who is known to be
suffering from asthma.  She is member of a competitive swimming
association.  She has noticed that she gets problems with her asthma
very often after having trained in one particular swimming pool.  The
coach of her swimming group confirms that quite a few members seem
to suffer from respiratory problems when training in that particular pool. 
He has complained of what seemed to be unstable chlorination practices
of the pool in the past to the municipal authorities and he thinks that this
pool has a very poor ventilation system as compared to other pools he
knows of.

Elements of a literature review:

1. Although swimming has traditionally been recommended as a physical
activity for patients suffering from asthma, there is some anecdotal
evidence of an aggravation of asthmatic symptoms in poorly ventilated
indoor swimming pools (see  Fjellbirkeland L, Gulsvik A and  Walloe A,
- Lungeavdelingen Haukeland Sykehus, Bergen.  Title 
-Svommeindusert astma [Swimming-induced asthma]. [Norwegian]
Journal - Tidsskrift for Den Norske Laegeforening 1995 Jun
30;115(17):2051-3 and  Penny PT, Swimming pool wheezing.
Journal  - British Medical Journal Clinical Research Ed. 1983 Aug

Recently James E. Potts (phone 604 822-0872) of the University of
British Columbia, Canada has completed a Ph. D. Thesis with the title :
 Adverse Respiratory Health Effects of Competitive Swimming: The
Prevalance of Symptoms, Illnesses, and Bronchial Responsiveness to
Metacholine and Exercise'.  His work shows that low level exposure to
the chemical substances produced by chlorine disinfection of the pool
water may be responsible for the development of asthmatic symptoms in
competitive swimmers.

2. At the same time there is some evidence to the effect that chloroform
air levels in swimming pools may represent an unacceptable carcinogenic
risk to highly exposed populations like competetive swimmers (see for
example Levesque B et al 1994. Evaluation of Dermal and Respiratory
Chloroform Exposure in Humans. Environmental Health Perspectives

3. The data about the possible role of chlorine disinfection byproducts in
the development of repiratory problems and the carcinogenic risk of
chloroform levels in the air of indoor swimming pools point towards the
question of swimming pool disinfection and of the type and rate of 
ventilation needed when chlorination is used.

A study by Shaw showed that in a indoor wave pool a restriction in
ventilation from 1.8 air exchanges/hour to 0.6 air exhanges/hour for
energy reasons induced different types of health complaints which
disappeared when the ventilation rate was again increased to 1.5 air
exchanges/hour (Shaw JW 1987. Indoor Air Quality of Swimming Pool
Enclosures. N. Zealand J. Sports Med. 15(3):55-58).  The total air space
for this pool was 83 870 cubic meter.  Shaw mentions that the 1.5 air
exchanges/hour which corresponds to 375 cubic feet per minute per
person (625 cubic metres per hour per person) is an order of magnitude
higher than that normally considered adequate.  

A reference from Germany on the chloramine air level of swimming
pools mentions a minimum rate of 4 to 5 air exhanges/hour in one of the
poole examined (Jessen HJ 1986. Chloraminkonzentration in der
Raumluft von Hallenbaedern. Z. Gesamte Hyg 32 (3):180-181).  4 to 5
air exhanges/hour correspond to 8000 cubic meter of fresh air per hour.

A recent french publication proposes a comfort threshold value for
chloramine air concentration in swimming pools of 0.5 mg per cubic 
meter of trichloride nitrogen equivalents.  This level has been 
proposed by comparing the chloramine air concentrations with the answers to a
simple questionnaire for respiratory and ocular comfort (Hery M et al.
1994. Exposition aux chloramines dans les atmosph
res des halls de
pisine. Cahier de notes documentaires- Institut national de recherches
scientifiques 156, ND 1963).

The municipality is aware that there is a problem with their ventilation
system for the pool.  They do have some condensation problems and
they are ready to undertake some remedial action.  The only widely
known standard for indoor swimming pools I have heard of comes from
ASHRAE and was conceived on the basis of condensation problems.

We are looking for some health based standards in order to recommand
such ventilation levels for future remedial action.

Is anybody aware of health based standards or objectives for ventilation
of indoor swimming pools or of any other research in this area?

Please do forward this message to any individual or any mailing list who
may have some information on this problem.

Reiner Banken M.D.
Medecin-conseil en sante publique
Direction regionale de la sante publique des Laurentides
185, rue Durand
Saint-Jerome (Quebec)
Canada J7Z 2V4

Tel: (514) 436-5669, # 273
Fax: (514) 436-1761

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