The aim of our study was to investigate the risk and characteristics of self-reported skin diseases among hydrotherapists. We attempted to contact 400 adults who participated in 1 of 2 training courses. 248 were reached and 190 of them (76.6%) completed the questionnaires. The data were collected by means of a telephone interview and a detailed questionnaire sent by mail. Statistical analysis included descriptive statistics, univariate and multifactorial analysis. Of those completing the questionnaire (75.8% females and 24.2% males), 44.4% of the hydrotherapists reported on the development of skin disease for the first time after the beginning of work at the swimming pool. The most common symptoms included pruritus and erythematous patches affecting mainly the extremities and trunk. Both smoking and increased exposure hours to pool water were independently associated with skin disease, suggesting a dose-response relationship. We conclude that contact dermatitis should be recognized as an occupational disease in hydrotherapists.

Dosing the water with larger amounts of gaseous chlorine compared to other disinfectants and a subsequent temporary decrease in the pH of the water may produce a more aggressive environment. It is suggested that combined effect of the various factors concomitantly with the irritating effect of prolonged exposure to water may trigger CD in pools treated with other chlorine-based compounds.