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To swim or not to swim: childhood asthma and indoor swimming pools
Over the last few decades, enthusiasm for indoor swimming has been on the rise, as aquatic swim programs for babies and toddlers grew in popularity and swimming has become mandatory in many school curricula. In particular, swimming had been long recommended as a better sport for children with childhood asthma as a way to improve fitness without unduly straining the respiratory system. However, many health and safety issues remained, since increased eye and respiratory symptoms have been reported in swimmers due to their exposure to swimming pool water disinfectants or disinfection byproducts.
Now a “state of the science” report presented by researchers from premier academic institutions and government regulatory agencies from the U.S., Canada, and Europe summarized findings of 18 different studies that all noted an association between attendance at chlorinated indoor pools and increasing frequencies of allergic disease and asthma. Similar health concerns are noted for Olympic swimmers, pool workers, and lifeguards who spend a lot of time by the poolside. Moreover, the increased use of swimming pools by the very young has increased their exposure to potential respiratory irritants within the indoor swimming pool environment.
What chemicals in indoor pool water and air pose particular risks to children’s health? Chlorine is the most common chemical used to disinfect swimming pools. And while disinfection is absolutely necessary to prevent the spread of water-borne diseases, the type of disinfection, quantities of disinfection chemicals added and pool hygiene practices can have a significant impact on the safety of swimming pool water. Chlorine reacts with residual organic matter in pool water to form volatile disinfection byproducts such as chloroform and other potent respiratory irritants. Long-term exposure to these chemicals is known to pose a variety of health risks, from breathing problems to increased risk of cancer.
The best way to minimize public health risks associated with disinfection byproducts in swimming pool water is to ensure that pool construction, maintenance, and especially ventilation are optimized. For example, free chlorine levels are highest for the U.S. pools compared to swimming pools in the United Kingdom, Germany, and Italy. One cannot but wonder whether these high allowable levels of chlorine in our swimming pools are a necessary safety measure - or just an unreasonably large quantity of chlorine that pool operators use so as to avoid applying other preventive cleanliness measures.
Parents, of course, will be eager to get a straightforward Yes or No answer to a simple question: “Will swimming or spending time at indoor pools pose an asthma risk for my child?” And while few questions in the environmental health field are ever completely settled, the opinions of scientists and findings from many countries’ experience of operating indoor swimming pools are enough to sound a strong alarm. Meanwhile, as winter approaches, many of us will have no choice but to swim indoors. The good news is that there are several common sense steps we can take to protect ourselves and our families from unnecessary exposure to disinfection byproducts in pool water:
1. Ask pool operators whether they conduct routine measurements of chemical pollutants in water. If you have your local municipal water quality report on hand, compare the levels of pool water chemicals to those in the tap water. If you wouldn’t drink it, you might not want to swim in it, especially since most young children ingest pool water while swimming.
2. Ask about ventilation, frequency of water replacement, and other hygiene practices. The steamed, misty air of an indoor pool? You probably don’t want it – more likely than not it will be loaded with volatile disinfection byproducts. Better ventilation is always a safer choice.
3. Finally, all children require adequate exercise. Splashing about the pool is one of the most memorable joys of childhood. Yet, we need to make sure that by providing our children with opportunities to exercise we are not exposing them to dangerous levels of potentially toxic chemicals.
4. Besides chlorine, pool water can be disinfected with a variety of other treatments, such as ozone or ultraviolet light. Although these water treatment methods tend to be costly, they are becoming more common.
Meanwhile, what we really need are strong federal and state programs to ensure that our streams, lakes and ocean coastal waters are clean and healthy, so that all children, everywhere, may have access to safe, natural water to play and swim in.
Photo by celikins
My three boys spend hours in the pool training everyday. We witnessed first hand what bad ventilation in an indoor pool area will do and actually left a team over it. If you are coughing, experiencing illness - show any signs of asthma - it's time to find a new pool!
Wow! I had a rare asthma attack after spending an afternoon at a highly chlorinated pool last spring. I wonder if the pool could have caused it.
My husband and I feel guilty that our four year old doesn't know how to swim. We never take him to pools because we both have sensitive skin and really hate chlorine.
I have heard that a health club in Portland Oregon has a salt water pool (no chlorine) but since we are not members, we haven't checked it out.
We would LOVE it if there were a safe, chemical free place to swim in our area.
Sunset Athletic Club on NW Cornell Road in Portland/Beaverton, has an indoor aquatic center with 3 saline pools, sauna, steam room, and saline jacuzzi. Unfortunately, the outdoor pool and jacuzzi in the locker rooms are chlorine. Family friendly and a variety of classes available... but on the pricey side for the occasional swimmer. Since it is an athletic club, you pay a deposit of around $400 plus annual towel fees and a monthly membership of more than $110 for a family (varies depending on whether you play tennis or racquetball too) for the club, rather than just admission for each time you swim. If you would use all of the facilities or you swim regularly... it is a fantastic deal! URL listed so you can check it out yourself.
Also, Mt Hood Athletic Club and 24 Hour Fitness have lap lanes that are saline, most of the McMennamins have saline soaking pools, and the Hilton Athletic Club downtown has a saline pool. I still think Sunset Athletic Club is the only one where you can get swimming lessons, swim team, water aerobics, etc... for the whole family.
Click on my name for the URL to Sunset. Hope this helps all with asthma and sensitive skin!