Respiratory Function and Changes in Lung Epithelium Biomarkers after a Short-Training Intervention in Chlorinated vs. Ozone Indoor Pools

Abstract

BackgroundSwimming in indoor pools treated with combined chemical treatments (e.g. ozone) may reduce direct exposure to disinfection byproducts and thus have less negative effects on respiratory function compared to chlorinated pools. The aim of this study is to analyze the effects of a short-term training intervention on respiratory function and lung epithelial damage in adults exercising in indoor swimming pool waters treated with different disinfection methods (chlorine vs. ozone with bromine).MethodsLung permeability biomakers [surfactant protein D (SP-D) and Clara cell secretory protein (CC16) in plasma] and forced expiratory volumes and flow (FEV1, FVC and FEF25–75) were measured in 39 healthy adults. Thirteen participants swam during 20 sessions in a chlorinated pool (CP), 13 performed and equivolumic intervention in an ozone pool (OP) and 13 were included in a control group (CG) without exposition.ResultsMedian plasma CC16 levels increased in CP swimmers (4.27±3.29 and 6.62±5.51 µg/L, p = 0.01, pre and post intervention respectively) while no significant changes in OP and CG participants were found. No significant changes in median plasma SP-D levels were found in any of the groups after the training period. FVC increased in OP (4.26±0.86 and 4.43±0.92 L, p<0.01) and CP swimmers (4.25±0.86 and 4.35±0.85 L, p<0.01). FEV1 only increased in OP swimmers (3.50±0.65 and 3.59±0.67, p = 0.02) and FEF25–75 decreased in CP swimmers (3.70±0.87 and 3.37±0.67, p = 0.02).ConclusionDespite lung function being similar in both groups, a higher lung permeability in CP compared to OP swimmers was found after a short-term swimming program. Combined chemical treatments for swimming pools such as ozone seem to have less impact on lung epithelial of swimmers compared to chlorinated treated pools.

Factors Influencing the Measurement of Plasma/Serum Surfactant Protein D Levels by ELISA

“…Given that some of the variation seen in the published literature might be explained by the use of different antibodies, we detected SP-D in serum and plasma samples using either the ELISA kit's detection antibody or the polyclonal goat anti-SP-D antibody. While there is no significant difference between detection by the [12,13,[17][18][19]21,25,28,38,[43][44][45]49,50,59,61,77,84,89], BioVendor [14,[31][32][33][34][35][36]46,52,56,64,65,72,75,76,79,80], and Holmskov et al [3,39,[53][54][55]58,62,66,69,70,78,85,86]) were compared. b) The range of healthy control ...…”

“…SP-D levels have also been proposed to correlate with genetic elements [61][62][63], body mass index (BMI) [64][65][66][67][68], age [65], circadian rhythm [69], and with particle exposure [70,71] and cigarette smoking habits [25,27,28,31,37,[72][73][74][75][76][77]. In addition, there have been studies examining the levels of SP-D in subjects with Turner syndrome [78], paraquat intoxication [79], swimming in variably treated waters [80], lung transplant patients [81], patients undergoing neurosurgical operations [82], drowning victims [83], polymyositis/dermatomyositis [84], dementia [85], lupus [86], and sleep apnea [87].…”

Dual-energy X-ray absorptiometry and forced expiratory volumes in sedentary and trained children. [Absorciometria dual de rayos x y volúmenes espirométricos forzados en niños sedentarios y entrenados].

“…This has been shown in other studies where healthy populations have been trained during a short period of time (Fernández-Luna, Gallardo, Plaza-Carmona, García-Unanue, Sánchez-Sánchez, Felipe, Burillo & Ara, 2013) and over a year (Bottai, Pistelli, Di Pede, Carrozzi, Baldacci, Matteelli, Scognamiglio & Viegi, 2002). However, the physical activity could affect negatively to the FEV1/FVC ratio, as a main indicator of respiratory diseases (Mannino, Gagnon, Petty & Lydick, 2000).…”

Upper Airway Mucosal Inflammation : Proteomic Studies after Exposure to Irritants and Microbial Agents

“…Augmented serum levels of SP-A and SP-B have been shown after swimming in chlorinated pools, suggesting increased permeability of the lung barrier [59]. In line, increased plasma levels of CC16, associated with disinfection by-products from the chlorinated water, are shown among swimmers, especially after short-term training [40,60]. However, some studies have instead linked the increase of CC16 in serum and urine to high intensity training, generating higher permeability in the lung epithelium, thereby enabling leakage to the blood stream [59,61].…”

“…Facilities ranging from one rectangular swimming pool to large water parks can be found. Unfortunately, the swimming pool environment is also connected to respiratory problems [39][40]. Several studies have shown that personnel, especially lifeguards, swimming teachers and technicians who spend substantial time in the indoor swimming pool environment suffer from problems.…”