Swimming pool chlorination: a health hazard?

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Abstract

A pilot study addressed potential effects of long-term exposure to chlorination products in swimming pools. The indicator compound chloroform was detectable in blood from competitive swimmers in an indoor pool (mean = 0.89 ± 0.34 mg/l; n = 10), but not in outdoor pool swimmers. No hepatotoxic effect was indicated by serum glutamate oxaloacetate transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT) or -γ-glutamyl transpeptidase (γ-GT) enzyme levels. β-2-microglobulin, an indicator of renal damage, was significantly elevated in urine samples of the slightly, but significantly, younger indoor swimmers. The precise ratio between these 2 possible causes, age and chloroform exposure, as well as the mechanism of the former, remain to be elucidated.

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    Chloroform was also the subject of studies by Jackson and Rule (2002), who observed average values for this compound between 11.4 μg/L and 236 μg/L in indoor pool water in several regions in Europe. Other studies have focused on chloroform to study its effects on the health of swimmers and target the main routes of exposure by using plasma, blood, urine or alveolar air as exposure biomarkers (Aggazzotti et al., 1990, 1993; Lévesque et al., 1994; Aiking et al., 1994; Aggazzotti et al., 1995; Cammann and Hübner, 1995; Lindstrom et al., 1997; Aggazzotti et al., 1998; Erdinger et al., 2004; Caro and Gallego, 2007, 2008). Some of these studies have limitations, such as the investigation of a single group of DBPs including THMs (chloroform) or chloramines (Aggazzotti et al., 1990; Aiking et al., 1994; Cammann and Hübner, 1995; Carbonnelle, 2003; Lévesque et al., 2006; Aprea et al., 2010; Schmalz et al., 2011), measurements carried out on pool water on a reduced scale or with samples generated in laboratory-scale simulations (Judd and Jeffrey, 1995; Judd and Black, 2000; Kim et al., 2002; Hansen et al., 2012), the study of a single type of pool, usually indoor (Jackson and Rule, 2002; Lévesque et al., 1994, 2000, 2006; Kanan and Karenfil, 2011), and small numbers of pools studied (Lahl et al., 1981; Fantuzzi et al., 2001; Thacker and Nitnaware, 2003; Cardador and Gallego, 2011).

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Present address: Public Health Service, Amstelveen, The Netherlands

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