A Review of Chlorine in Indoor Swimming Pools and its Increased Risk of Adverse Health Effects
DOI :
https://doi.org/10.18192/riss-ijhs.v2i1.1526Mots-clés :
Chlore, effets nuisibles pour la sante, piscines intérieuresRésumé
Contexte : Le chlore est un agent communément utilisé pour désinfecter l’eau des piscines. La ventilation inadéquate des piscines intérieures et les produits dérivés de la désinfection au chlore (DDC) provenant de la matière organique favorisent l’augmentation des risques de conséquences nuisibles pour la santé. On doit surveiller la qualité de l’eau et une ventilation adéquate pour éviter que les jeunes et les adolescents courent des risques.
Méthodes : Les auteurs ont étudié des recherches menées sur des enfants et adolescents âgés de 2 à 18 ans qui nagent dans les piscines intérieures. Toutefois, ils ont seulement étudié celles parues dans les journaux des années 2000 à 2010, et contenant des statistiques globales. Ils ont aussi passé en revue des articles scientifiques de collègues, et fait la méta-analyse de trois bases de données scientifiques différentes : PubMed, Web of Science et Google Scholar.
Résultats et Conclusions : Les enfants de moins de cinq ans, les maîtres-nageurs et les nageurs d’élite courent un risque accru de symptômes des voies respiratoires supérieures et inférieures, tels que l’asthme, parce qu’ils sont exposés fréquemment à de l’eau chlorée. Mais les nageurs récréatifs qui ne nagent que modérément ont moins de risques de contracter de l’asthme professionnel.
Conséquences : Si on réduit l’exposition au chlore des piscines intérieures, cela peut diminuer les risques de contracter des infections des voies respiratoires supérieures et inférieures.
Références
Bernard, A. (2007). Chlorination products: Emerging links with allergic diseases. Current Medicinal Chemistry, 14(16), 1771-1782. doi: 10.2174/092986707781058940
Bernard, A., Carbonnelle, S., de Burbure, C., Michel, O., & Nickmilder, M. (2006). Chlorinated pool attendance, atopy, and the risk of asthma during childhood. Environmental Health Perspectives, 114(10),1567- 1573. Retrieved from http://ehp.niehs.nih.gov/
Bernard, A., Carbonnelle, S., Dumont, X., & Nickmilder, M. (2007). Infant swimming practice, pulmonary epithelium integrity, and the risk of allergic and respiratory diseases later in childhood. Pediatrics, 119(6). 1095-1103. doi: 10.1542/peds.2006-3333
Bernard, A., Nickmilder, M., & Voisin, C. (2008). Outdoor swimming pools and the risks of asthma and allergies during adolescence. The European Respiratory Journal, 32(4), 979-988. doi: 10.1183/09031936.00114807
Bernard, A., Nickmilder, M., Voisin, C., & Sardella, A. (2009). Impact of chlorinated swimming pool attendance on the respiratory health of adolescents. Pediatrics, 124 (4), 1110-1118. doi: 10.1542/peds.2009-0032
Bougault, V., Turmel, J., Levesque, B., & Boulet, L. P. (2009). The respiratory health of swimmers. Sports Medicine, 39(4), 295-312. doi: 10.2165/00007256-200939040- 00003
Canadian Center for Occupational Health and Safety. (2003). Working safely with chlorine. Retrieved from http://www.ccohs.ca/oshanswers/chemicals/chem_profiles/chlorine.html
Carbonnelle, S., Francaux, M., Doyle, I., Dumont, X., de Burbure, C., Morel, G., ... & Bernard, A. (2002). Changes in serum pneumoproteins caused by short-term exposures to nitrogen trichloride in indoor chlorinated swimming pools. Biomarkers, 7(6),464-478. doi: 10.1080/13547500210166612
Carraro, S., Pasquale, M. F., Da Fre, M., Rusconi, F., Bonetto, G., Zanconato, S., & Baraldi, E. (2006). Swimming pool attendance and exhaled nitric oxide in children. The Journal of Allergy and Clinical Immunology, 118(4), 958- 960. doi: 10.1016/j.jaci.2006.07.016
Centers for Disease Control and Prevention. (2010a). Violations identified from routine swimming pool inspections—selected states and counties, United States, 2008. Morbidity and Mortality Weekly Report, 59(19), 582-587. Retrieved from http://www.cdc.gov/mmwr/
Centers for Disease Control and Prevention. (2010b). Your disinfection team: Chlorine & pH. Retrieved from http://www.cdc.gov/healthywater/pdf/swimming/resources/ disinfection-team-chlorine-phfactsheet.pdf
Eggleston, P. A. (2007). Chlorinated pools and the risk of asthma. Environmental Health Perspectives, 115(5), A240- A241; author reply.
Font-Ribera, L., Kogevinas, M., Zock, J. P., Nieu- wenhuijsen, M. J., Heederik, D., & Villanueva, C. M. (2009). Swimming pool attendance and risk of asthma and allergic symptoms in children. The European Respiratory Journal, 34(6), 1304-1310. doi: 10.1183/09031936.00180608
Health Canada. (2009). Swimming pool and spa sanitation. Retrieved from http://publications.gc.ca/collections/Collection/H113-1-24-1999E.pdf
Ishioka, M., Kato, N., Kobayashi, A., Dogru, M., & Tsubota, K. (2008). Deleterious effects of swimming pool chlorine on the corneal epithelium. Cornea, 27(1), 40-43. doi: 10.1097/ICO.0b013e318156d20
Life Saving Society. (2004). Public wading pool safety standards. Retrieved from http://www.lifesaving.org/download/PublicWadingPoolSafetyStandards.pdf
Lourencetti, C., Fernández, P., Marco, E., Ballesté, C., Grimalt, J. O., Font, L., ... & Kogevinas, M. (2008). Trihalomethane levels in exhaled breath as indicators of exposure to disinfection by-products in indoor swimming pools using chlorine and bromine as disinfectants. Epidemiology, 19(6), 191-192. doi: 10.1097/01.ede.0000340079.17087.fc
McGrath, P. (Ed.). (2004). Guidelines for swimming pools: Province of Nova Scotia. Department of Labour and Environment. **Editor’s note: this reference (1987 Department of Health Public Swimming Pool Guidelines) was retired by the Department in late 2011 because there were sections that were scientifically out of date.
Nemery, B., Hoet, P. H., & Nowak, D. (2002). Indoor swimming pools, water chlorination and respiratory health. European Respiratory Journal, 19(5), 790-793. doi: 10.1183/09031936.02.00308602
Nickmilder, M., & Bernard, A. (2007). Ecological association between childhood asthma and availability of indoor chlorinated swimming pools in Europe. Occupational and Environmental Medicine, 64(1), 37-46. doi: 10.1136/oem.2005.025452
Nieuwenhuijsen, M. J. (2007). The chorine hypothesis: Fact or fiction? Occupational and Environmental Medicine, 64(1), 6-7. doi: 10.1136/oem.2006.029850
Spivey, A. (2006). Swimming in allergens: Pool use and asthma. Environmental Health Perspectives, 114(10), A600. Retrieved from http://ehp.niehs.nih.gov/
Thomas, L., & Murray, V. (2008). Review of acute chemical incidents involving exposure to chlorine associated with swimming pools in England and Wales, June-October 2007. Journal of Public Health, 30(4), 391-397. doi: 10.1093/pubmed/fdn073
Uyan, Z. S., Carraro, S., Piacentini, G., & Baraldi, E. (2009). Swimming pool, respiratory health, and childhood asthma: Should we change our beliefs? Pediatric Pulmonology, 44(1), 31-37. doi: 10.1002/ppul.20947
Villanueva, C. M., Font-Ribera, L., Gómez, F. P., Barreiro, E., Zock, J., Nieuwenhuijsen, M. J.,...Kogevinas, M. (2008). Acute exposure to disinfection by-products in swimming pools and short term changes in respiratory biomarkers [Abstract]. Epidemiology, 19(6), S107 doi: 10.1097/01.ede.0000339853.71572.70
Voisin, C., & Bernard, A. (2008). Risks of allergic reactions to chlorination byproducts in swimming pools. Environnement Risques & Santé, 7(6), 417-423. doi: 10.1684/ers.2008.0181
Wattigney, W. A., Kaye, W. E., & Orr, M. F. (2007). Acute hazardous substance releases resulting in adverse health consequences in children: Hazardous substances emergency events surveillance system, 1996-2003. Journal of Environmental Health, 70(4), 17-24. Retrieved from http:// www.neha.org/JEH/
Weaver, W. A., Li, J., Wen, Y., Johnston, J., Blatchley, M. R., & Blatchley, E. R., III. (2009). Volatile disinfection by-product analysis from chlorinated indoor swimming pools. Water Research, 43(13),3308-3318. doi: 10.1016/ j.watres.2009.04.035
Weisel, C. P., Richardson, S. D., Nemery, B., Aggazzotti, G., Baraldi, E., Blatchley, E. R., III, ... & Sattar, S. (2009). Childhood asthma and environmental exposures at swimming pools: State of the science and research recommendations. Environmental Health Perspectives, 117(4), 500- 507. doi: 10.1289/ehp.11513
World Health Organization. (2006). Guidelines for safe recreational water environments. Volume 2: Swimming pools and similar environments. Retrieved from http://apps.who.int/iris/bitstream/10665/43336/1/9241546808_eng.pdf?ua=1
Zwiener, C., Richardson, S. D., DeMarini, D. M., Grummt, T., Glauner, T., & Frimmel, F. H. (2007). Drowning in disinfection by products? Assessing swimming pool water. Environmental Science & Technology, 41(2), 363-372. doi: 10.1021/es062367v
Bernard, A., Carbonnelle, S., de Burbure, C., Michel, O., & Nickmilder, M. (2006). Chlorinated pool attendance, atopy, and the risk of asthma during childhood. Environmental Health Perspectives, 114(10),1567- 1573. Retrieved from http://ehp.niehs.nih.gov/
Bernard, A., Carbonnelle, S., Dumont, X., & Nickmilder, M. (2007). Infant swimming practice, pulmonary epithelium integrity, and the risk of allergic and respiratory diseases later in childhood. Pediatrics, 119(6). 1095-1103. doi: 10.1542/peds.2006-3333
Bernard, A., Nickmilder, M., & Voisin, C. (2008). Outdoor swimming pools and the risks of asthma and allergies during adolescence. The European Respiratory Journal, 32(4), 979-988. doi: 10.1183/09031936.00114807
Bernard, A., Nickmilder, M., Voisin, C., & Sardella, A. (2009). Impact of chlorinated swimming pool attendance on the respiratory health of adolescents. Pediatrics, 124 (4), 1110-1118. doi: 10.1542/peds.2009-0032
Bougault, V., Turmel, J., Levesque, B., & Boulet, L. P. (2009). The respiratory health of swimmers. Sports Medicine, 39(4), 295-312. doi: 10.2165/00007256-200939040- 00003
Canadian Center for Occupational Health and Safety. (2003). Working safely with chlorine. Retrieved from http://www.ccohs.ca/oshanswers/chemicals/chem_profiles/chlorine.html
Carbonnelle, S., Francaux, M., Doyle, I., Dumont, X., de Burbure, C., Morel, G., ... & Bernard, A. (2002). Changes in serum pneumoproteins caused by short-term exposures to nitrogen trichloride in indoor chlorinated swimming pools. Biomarkers, 7(6),464-478. doi: 10.1080/13547500210166612
Carraro, S., Pasquale, M. F., Da Fre, M., Rusconi, F., Bonetto, G., Zanconato, S., & Baraldi, E. (2006). Swimming pool attendance and exhaled nitric oxide in children. The Journal of Allergy and Clinical Immunology, 118(4), 958- 960. doi: 10.1016/j.jaci.2006.07.016
Centers for Disease Control and Prevention. (2010a). Violations identified from routine swimming pool inspections—selected states and counties, United States, 2008. Morbidity and Mortality Weekly Report, 59(19), 582-587. Retrieved from http://www.cdc.gov/mmwr/
Centers for Disease Control and Prevention. (2010b). Your disinfection team: Chlorine & pH. Retrieved from http://www.cdc.gov/healthywater/pdf/swimming/resources/ disinfection-team-chlorine-phfactsheet.pdf
Eggleston, P. A. (2007). Chlorinated pools and the risk of asthma. Environmental Health Perspectives, 115(5), A240- A241; author reply.
Font-Ribera, L., Kogevinas, M., Zock, J. P., Nieu- wenhuijsen, M. J., Heederik, D., & Villanueva, C. M. (2009). Swimming pool attendance and risk of asthma and allergic symptoms in children. The European Respiratory Journal, 34(6), 1304-1310. doi: 10.1183/09031936.00180608
Health Canada. (2009). Swimming pool and spa sanitation. Retrieved from http://publications.gc.ca/collections/Collection/H113-1-24-1999E.pdf
Ishioka, M., Kato, N., Kobayashi, A., Dogru, M., & Tsubota, K. (2008). Deleterious effects of swimming pool chlorine on the corneal epithelium. Cornea, 27(1), 40-43. doi: 10.1097/ICO.0b013e318156d20
Life Saving Society. (2004). Public wading pool safety standards. Retrieved from http://www.lifesaving.org/download/PublicWadingPoolSafetyStandards.pdf
Lourencetti, C., Fernández, P., Marco, E., Ballesté, C., Grimalt, J. O., Font, L., ... & Kogevinas, M. (2008). Trihalomethane levels in exhaled breath as indicators of exposure to disinfection by-products in indoor swimming pools using chlorine and bromine as disinfectants. Epidemiology, 19(6), 191-192. doi: 10.1097/01.ede.0000340079.17087.fc
McGrath, P. (Ed.). (2004). Guidelines for swimming pools: Province of Nova Scotia. Department of Labour and Environment. **Editor’s note: this reference (1987 Department of Health Public Swimming Pool Guidelines) was retired by the Department in late 2011 because there were sections that were scientifically out of date.
Nemery, B., Hoet, P. H., & Nowak, D. (2002). Indoor swimming pools, water chlorination and respiratory health. European Respiratory Journal, 19(5), 790-793. doi: 10.1183/09031936.02.00308602
Nickmilder, M., & Bernard, A. (2007). Ecological association between childhood asthma and availability of indoor chlorinated swimming pools in Europe. Occupational and Environmental Medicine, 64(1), 37-46. doi: 10.1136/oem.2005.025452
Nieuwenhuijsen, M. J. (2007). The chorine hypothesis: Fact or fiction? Occupational and Environmental Medicine, 64(1), 6-7. doi: 10.1136/oem.2006.029850
Spivey, A. (2006). Swimming in allergens: Pool use and asthma. Environmental Health Perspectives, 114(10), A600. Retrieved from http://ehp.niehs.nih.gov/
Thomas, L., & Murray, V. (2008). Review of acute chemical incidents involving exposure to chlorine associated with swimming pools in England and Wales, June-October 2007. Journal of Public Health, 30(4), 391-397. doi: 10.1093/pubmed/fdn073
Uyan, Z. S., Carraro, S., Piacentini, G., & Baraldi, E. (2009). Swimming pool, respiratory health, and childhood asthma: Should we change our beliefs? Pediatric Pulmonology, 44(1), 31-37. doi: 10.1002/ppul.20947
Villanueva, C. M., Font-Ribera, L., Gómez, F. P., Barreiro, E., Zock, J., Nieuwenhuijsen, M. J.,...Kogevinas, M. (2008). Acute exposure to disinfection by-products in swimming pools and short term changes in respiratory biomarkers [Abstract]. Epidemiology, 19(6), S107 doi: 10.1097/01.ede.0000339853.71572.70
Voisin, C., & Bernard, A. (2008). Risks of allergic reactions to chlorination byproducts in swimming pools. Environnement Risques & Santé, 7(6), 417-423. doi: 10.1684/ers.2008.0181
Wattigney, W. A., Kaye, W. E., & Orr, M. F. (2007). Acute hazardous substance releases resulting in adverse health consequences in children: Hazardous substances emergency events surveillance system, 1996-2003. Journal of Environmental Health, 70(4), 17-24. Retrieved from http:// www.neha.org/JEH/
Weaver, W. A., Li, J., Wen, Y., Johnston, J., Blatchley, M. R., & Blatchley, E. R., III. (2009). Volatile disinfection by-product analysis from chlorinated indoor swimming pools. Water Research, 43(13),3308-3318. doi: 10.1016/ j.watres.2009.04.035
Weisel, C. P., Richardson, S. D., Nemery, B., Aggazzotti, G., Baraldi, E., Blatchley, E. R., III, ... & Sattar, S. (2009). Childhood asthma and environmental exposures at swimming pools: State of the science and research recommendations. Environmental Health Perspectives, 117(4), 500- 507. doi: 10.1289/ehp.11513
World Health Organization. (2006). Guidelines for safe recreational water environments. Volume 2: Swimming pools and similar environments. Retrieved from http://apps.who.int/iris/bitstream/10665/43336/1/9241546808_eng.pdf?ua=1
Zwiener, C., Richardson, S. D., DeMarini, D. M., Grummt, T., Glauner, T., & Frimmel, F. H. (2007). Drowning in disinfection by products? Assessing swimming pool water. Environmental Science & Technology, 41(2), 363-372. doi: 10.1021/es062367v
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