Health effects of exposure to chlorination by‐products in swimming pools

Couto, Mariana; Bernard, Alfred; Delgado, Luís; Drobnic, Franchek; Kurowski, Marcin; Moreira, André; Rodrigues-Alves, Rodrigo; Rukhadze, Maia; Seys, Sven; Wiszniewska, Marta; Quirce, Santiago

doi:10.1111/all.15014

Cited by 21 publications

(7 citation statements)

References 139 publications

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“…Chlorine bleach or sodium hypochlorite is the most used disinfecting and cleaning agent, and chlorine disinfection‐by‐products (DBPs), such as chlorine or trichloramine, are irritants to the respiratory tract and are also associated with acute lung injury 46 . A recent position paper on the evidence of the health effects of acute and chronic exposure to swimming pools suggested that early and chronic exposure to DBPs may be associated with a higher risk of childhood asthma 47 . Taken together the evidence supports a growing call for mitigation and prevention actions on the role of cleaning and consumer products on childhood asthma.…”

Section: Environmental Pollutants As Determinants Of Childhood Asthmamentioning

confidence: 99%

Environmental inequality: Air pollution and asthma in children

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2022

Pediatric Allergy Immunology

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Dirty air is now recognized as the single biggest environmental threat to human health. 1 The air we breathe is becoming increasingly polluted and its impact on health is appraised to be as great as other major global health risks such as unhealthy diet, sedentarism, or tobacco. Nonetheless, air pollution is hard to escape. An emerging body of evidence emphasizes the associations between poorquality environments and socioeconomic conditions at both local and regional scales. 2 Whether you benefit from high-quality urban

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Section: Environmental Pollutants As Determinants Of Childhood Asthmamentioning

confidence: 99%

Environmental inequality: Air pollution and asthma in children

Paciência

Rufo

Moreira

2022

Pediatric Allergy Immunology

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“…Chlorine bleach or sodium hypochlorite is the most used disinfecting and cleaning agent, and chlorine disinfection by-products (DBPs), such as chlorine or trichloramine, are irritants to the respiratory tract and are also associated with acute lung injury [46]. A recent position paper on the evidence of the health effects of acute and chronic exposure to swimming pools suggested that early and chronic exposure to DBPs may be associated with a higher risk of childhood asthma [47]. Taken together the evidence supports a growing call to mitigation and prevention actions on the role of cleaning and consumer products on childhood asthma.…”

Section: Cleaning and Consumer Products And Childhood Asthmamentioning

confidence: 99%

Environmental inequality: air pollution and asthma in children

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2022

Preprint

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Whether you benefit from high-quality urban environments, such as those rich in green and blue spaces, that may offer benefits to allergic and respiratory health depends on where you live and work. Environmental inequality, therefore, results from the unequal distribution of the risks and benefits that stem from interactions with our environment. Within this perspective, this article reviews the evidence for an association between air pollution caused by industrial activities, traffic, disinfection-by-products and tobacco/e-cigarettes and asthma in children. We also discuss the proposed mechanisms by which air pollution increases asthma risk, including environmental epigenetic regulations, oxidative stress, and damage, disrupted barrier integrity, inflammatory pathways, and enhancement of respiratory sensitization to aeroallergens. Environmental air pollution is a major determinant of childhood asthma, but magnitude of effect is not shared equally across the population, regions, and settings where people live, work, and spend their time. Improvement of the exposure assessment, a better understanding of critical exposure time windows, underlying mechanisms, and drivers of heterogeneity may improve the risk estimates. Urban conditions and air quality are not only important features for national and local authorities to shape healthy cities and protect their citizens from environmental and health risks, but they also provide opportunities to mitigate inequalities in the most deprived areas where the environmental burden is highest. Actions to avoid exposure to indoor and outdoor air pollutants should be complementary at different levels – individual, local, and national levels – to take effective measures to protect children who have little or no control over the air they breathe.

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“…Further, more than 100 DBPs, including trihalomethanes (THMs), haloacetamides, haloketones, haloacetic acids (HAAs), haloacetaldehydes, halonitromethanes, haloacetonitriles (HANs), halogenated cyanogens, halophenols, halobenzoquinones, and Nnitrosamines have been identified in swimming pool water (Richardson et al, 2010;Xia et al, 2012;Weng et al, 2013;Daiber et al, 2016;Li and Blatchley, 2017;Manasfi et al, 2017a). the majority of them are known to have adverse health effects for indoor swimming pool users (swimmers and workers as lifeguards) (Westerlund et al, 2019;Couto et al, 2021;Han et al, 2021;Manasfi et al, 2017b), as being cytotoxic, genotoxic, and mutagenic in vitro or in vivo (Deng et al, 2014;Wagner and Plewa, 2017;Liberatore et al, 2022;Wu et al, 2022). For instance, trichloramine (NCl3) causes the most irritating symptoms (Fantuzzi et al, 2010;Villanueva et al 2015), whereas THMs may cause adverse effects on the reproductive system, liver, kidneys, and nervous system as well as potential long-term risks for the development of cancers (Bessonneau et al, 2011;Zazouli and Kalankesh.…”

Section: Introductionmentioning

confidence: 99%