Chlorine in Pools Raises Kids' Asthma, Allergy Risk

Too many homes over-treat their pools, boosting the odds, experts say

Posted: September 14, 2009

By Serena Gordon
HealthDay Reporter

MONDAY, Sept. 14 (HealthDay News) -- Swimming in pools disinfected with chlorine may increase the odds that a child will develop asthma or allergies, new research suggests.

The study found that teenagers who spent more than 1,000 hours swimming in chlorinated pools, either indoors or outdoors, had more than eight times the risk of having asthma than did teens who primarily swam in pools using a copper-silver disinfecting method.

"Chlorinated pool attendance has a very significant impact on the prevalence of allergic diseases in the studied population," said lead author Alfred Bernard, a professor of toxicology and research director at Catholic University of Louvain in Brussels, Belgium.

"When used properly, [chlorine] is an efficient and safe disinfectant for swimming pools. However, when too much chlorine is added to water or builds up in the air of indoor pools, there is unavoidably some irritation of the organs of the bather in contact with the water and air," he explained. "There is now increasing evidence that these irritating effects may be detrimental to the airways of regular swimmers, especially the children who are the most vulnerable and the most frequent attendees of chlorinated pools."

Results of the study will be published in the Sept. 14 online issue of Pediatrics.

More than 17 million people in the United States have asthma, according to the American Academy of Allergy, Asthma and Immunology. Symptoms of the disease include wheezing, shortness of breath and coughing. The airway disease can be triggered by a number of factors, such as cold air, exercise and chemical irritants. While chlorine has long been known to be an airway irritant and potential trigger of asthma, particularly in indoor pools, Bernard's study suggests that chlorinated pools might play a role in the development of asthma and allergy.

The study included 847 Belgian teenagers between the ages of 13 and 18. All had attended indoor or outdoor swimming pools, but at various rates of attendance. One hundred and fourteen children mainly attended pools that were kept clean with a copper-silver disinfect, rather than chlorine. The remainder primarily attended pools disinfected with chlorine.

The number of children who ever had asthma went up in proportion to their chlorinated pool exposure. Teens who swam for 100 to 500 hours in chlorinated pools had an 80 percent increased risk of having asthma, while those who logged 500 to 1,000 hours had just over twice the risk. When teens spend more than 1,000 hours swimming in chlorinated water, the risk of ever having had asthma nearly quadrupled. The risk of currently having asthma was more than eight times higher in the group with more than 1,000 hours in chlorinated pools compared to those who were rarely in chlorinated water, according to the study.

The risk of allergies also increased significantly when adolescents spent more than 100 hours swimming in chlorinated pools. In fact, the risk of hay fever and other allergies more than doubled with significant chlorinated pool exposure.

Dr. Jennifer Appleyard, chief of allergy and immunology at St. John Hospital and Medical Center in Detroit, said this study highlights the fact that "asthma and allergies are caused by a multitude of different factors, and chlorine may have a potential effect. But, this is a very preliminary study, and we don't yet know what the whole picture is."

She said that she wouldn't advise parents to stop taking their kids swimming, even if they have asthma already. "If your kids have asthma and you know chlorine is a trigger, it's a good idea to try to limit their exposure, but you can't exclude your child from everything and every potential trigger. You have to let them be kids."

If you know your child is bothered by chlorine exposure, and they have an event such as a birthday party that they really want to attend, discuss it with your child's doctor to find out the best way to manage the exposure.

Bernard said that if you have a backyard pool, you should use as little chlorine as you can to safely disinfect the pool. He said that many people over chlorinate their pools to get clear blue water. But, he said, "chlorine is a disinfectant, not a cleaning agent."

Article on Chlorine and Asthma Link not the whole story

The new study by Bernard et al. should be taken with a grain of salt and evaluated carefully along with other data on pools and respiratory health. Despite the assertions put forth by Bernard, the evidence to date has shown no conclusive link between pools and childhood asthma:

• A 2008 scientific review of 25 relevant studies (Goodman and Hays, 2008) on swimming and asthma suggests that a correlation between swimming pools and childhood asthma does not exist, and that “it is premature to draw conclusions about the causal link between swimming and asthma.”

• An international group of experts (Weisel et al., 2009) met in 2007 to discuss the science and concluded, “Current evidence of an association between childhood swimming and new-onset asthma is suggestive but not conclusive.”

• Several large, well executed studies published after these reviews have failed to find a correlation between swimming and asthma.

Proper chlorination is essential to healthy pools, helping to control germs that can cause diarrhea, ear infections and skin rashes. It is inappropriate to suggest that pool owners should reduce chlorine levels. While the Bernard et al. paper speculates that potential effects in swimmers might be caused by chlorine oxidizers, the study did not measure concentrations of any chemicals in water or air.

In well managed swimming pools, chlorination byproducts pose little risk to health. Byproduct irritants, known as chloramines, form when chlorine combines with substances introduced into pools on the bodies of swimmers, such as perspiration, urine, saliva, body oils and lotions. Swimmers can do their part to keep a pool healthy by showering before entering the pool and not urinating in the pool. For more information, visit www.healthypools.org.

Scott Jensen

American Chemistry Council

Scott Jensen of VA @ Sep 15, 2009 17:37:31 PM

Add Your Thoughts
About You

advertisement

U.S. News Rankings & Research

Best Hospitals

See the best hospitals, and the best children's hospitals, in specialties from cancer to urology.

Best Health Plans

U.S. News and NCQA review over 700 health insurance plans in the Best Health Plan rankings.

Best Nursing Homes

The Best Nursing Homes rankings feature data on 15,000-plus homes. Search for one near you.

Diseases & Conditions

Get information on preventing, treating, and managing diseases and conditions. Centers:

advertisement

Sponsored Poll

What factor do you think is responsible for the majority of teen-driving crashes?

View Results

advertisement

Subscribe

U.S. News Digital Weekly

A weekly insider's guide to politics and policy — in a multimedia, digital format. 52 issues for $19.95!

U.S. News & World Report

6 months of U.S. News & World Report's print edition for only $15. Save up to 67% off the cover price!