AIRBORNE TRICHLORAMINE (NCl3) EXPOSURE IN INDOOR SWIMMING POOLS

AIRBORNE TRICHLORAMINE (NCl3)
EXPOSURE IN INDOOR SWIMMING POOLS
AND PREVALENCE OF SELF-REPORTED
RESPIRATORY AND OCULAR SYMPTOMS
IN OCCUPATIONALLY EXPOSED
SUBJECTS
Gabriella Aggazzotti, Department of Sciences of Public Health, University of Modena and Reggio Emilia, Italy
Guglielmina Fantuzzi, Department of Sciences of Public Health, University of Modena and Reggio Emilia, Italy
Elena Righi, Department of Sciences of Public Health, University of Modena and Reggio Emilia, Italy
Guerrino Predieri, Department of Sciences of Public Health, University of Modena and Reggio Emilia, Italy
Pierluigi Giacobazzi, Department of Sciences of Public Health, University of Modena and Reggio Emilia, Italy
Petra Bechtold, Department of Sciences of Public Health, University of Modena and Reggio Emilia, Italy
Katia Mastroianni, Department of Sciences of Public Health, University of Modena and Reggio Emilia, Italy
Background and Aims: The aim of this cross-sectional study was to investigate the association between airborne NCl3
exposure in indoor swimming pools and the prevalence of self-reported respiratory and ocular symptoms in occupationally
exposed subjects.
Methods: Twenty indoor swimming pools in the Emilia-Romagna region of Italy were included in the study. Information about
the health status of 128 employees was collected using a self-administered questionnaire. Exposure to airborne NCl3 was
evaluated in indoor swimming pools by a modified DPD/KI method.
Results: The airborne NCl3 levels ranged from 204 to 1020 µg/m3
with a mean value of 648.7 ± 201.4 µg/m3
. More than 50% of
the swimming pools showed airborne NCl3 levels higher than 500 µg/m3
(recommended WHO guidelines). Both ocular and
upper respiratory symptoms were very frequent in the 128 employees: red eyes, runny nose, voice loss and cold symptoms
were declared more frequently by pool attendants (lifeguards and trainers) when compared with employees working in other
areas of the facility (office, cafe, etc.). Pool attendants exposed to airborne NCl3 levels higher than 500 µg/m3
experienced
higher risks for runny nose (OR: 2.9; 95% CI: 1.22-6.94), red eyes (OR: 3.2; 95% CI: 1.5-6.8), voice loss (OR: 3.6; 95% CI: 1.6-
8.0), itchy eyes (OR: 2.2; 95% CI: 1.0-4.8) than other employees. When high levels of airborne NCl3 were taken into account
(airborne NCl3 levels ≥ 800 µg/m3
vs. < 800 µg/m3
) ocular and respiratory symptoms became much more evident, with higher
risks (as ORs) in exposed subjects (lifeguards and trainers) compared with other employees.
Conclusions: This study confirms that lifeguards and trainers are at risk for respiratory and ocular irritative symptoms more
than other employees in indoor swimming pools, in particular in presence of high airborne NCl3 levels.

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