Swimming pool chlorination: a health hazard?

Aiking, H.; Acker, M. B. Van; Scholten, R. J. P. M.; Feenstra, J.F.; Valkenburg, H. A.

doi:10.1016/0378-4274(94)90051-5

Cited by 26 publications

(14 citation statements)

References 5 publications

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“…Mean chloroform concentrations for indoor swimming pools reported in different studies worldwide were therefore used to derive a distribution for the pool chloroform concentration, although ventilation rates and disinfection practices may differ across countries. This resulted in a median pool concentration of 52 µg/L (range, 13-365 µg/L) (Aggazzotti et al 1995(Aggazzotti et al , 1998Aiking et al 1994;Camman and Hübner 1995;Chu and Nieuwenhuijsen 2002;Lévesque et al 1994;Lindstrom et al 1997;Matthiessen and Jentsch 1999;Weisel and Shepard 1994).…”

Section: Methodsmentioning

confidence: 99%

The relationship between water concentrations and individual uptake of chloroform: a simulation study.

Whitaker

Nieuwenhuijsen

Best

2003

Environ Health Perspect

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We simulated the relationship between water chloroform concentrations and chloroform uptake in pregnant women to assess the potential extent of exposure measurement error in epidemiologic studies of the health effects of exposure to water disinfection by-products. Data from the literature were used to assign statistical distributions to swimming pool chloroform concentrations, frequency and duration of swimming, showering and bathing, and average tap water consumption. Measured increases in blood chloroform concentrations after these activities were used to estimate average uptake per microgram per liter chloroform in the water, per minute spent in the activity or per liter consumed. Given average tap water chloroform concentrations from a U.K. epidemiologic study, an average daily uptake over 90 days was simulated for 300,000 mothers. The correlation between simulated uptakes and home tap chloroform concentration was 0.6. Mothers who swam regularly received far greater doses than did nonswimmers. Results suggest there will be considerable attenuation in risk estimates and/or power loss in epidemiologic studies if the putative agent is chloroform.

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Section: Methodsmentioning

confidence: 99%

The relationship between water concentrations and individual uptake of chloroform: a simulation study.

Whitaker

Nieuwenhuijsen

Best

2003

Environ Health Perspect

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“…The authors noted that the possibility of exposure through drinking water was excluded since Modena is supplied with drinking water treated with chlorine dioxide. In addition, Aiking et al (1994 ), Weisel and Shepard ( 1994 ), Cammann and Hubner ( 1995 ) and Matthiessen and Jentsch ( 1999 ) recorded considerable uptake of chloroform during swimming.…”

Section: Routes Of Uptake and Determinants Of Dbps In Swimming Studiesmentioning

confidence: 99%

“…They also measured CDBM, BDCM and bromoform, but these were much lower than the chloroform levels with a maximum of 6.51 g /l of CDBM in water and 22.4 g/m 3 for BDCM in air. In Holland, Aiking et al (1994 ) measured chloroform water concentrations of 18.4 g /l in indoor pools and 24.0 g/l in outdoor pools. Aggazotti et al ( 1987Aggazotti et al ( , 1990Aggazotti et al ( , 1993Aggazotti et al ( , 1995Aggazotti et al ( , 1998 conducted a series of studies in Modena, Italy and found correlations between chloroform concentrations in air and water and the number of swimmers (Aggazotti et al, 1990(Aggazotti et al, , 1995 , and chloroform concentration in water and free and combined chlorine residual and water PH ( Aggazotti et al, 1995 ) , but these were generally only weak to moderate correlations.…”

Section: Dbps In Swimming Poolsmentioning

confidence: 99%

“…Exhaled breath sampling ( Jo et al, 1990b;Aggazotti et al, 1993Aggazotti et al, , 1995Aggazotti et al, , 1998Levesque et al, 1994;Weisel and Shepard, 1994;Weisel and Jo, 1996;Weisel et al, 1999;LeBlanc et al, 1995;Lindstrom et al, 1997;Gordon et al, 1998;Matthiessen and Jentsch, 1999 ), as have serum levels although to a lesser extent ( Aggazotti et al, 1987( Aggazotti et al, , 1990( Aggazotti et al, , 1995( Aggazotti et al, , 1998Aiking et al, 1994;Levesque et al, 1994;Cammann and Hubner, 1995;Matthiessen and Jentsch, 1999 ). As the concentration of a volatile compound in exhaled breath is related to its concentration in the bloodstream, it can be used as a proxy to determine changes in body burden with time.…”

Section: Biomarkers Of Dbp Uptakementioning

confidence: 99%

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Uptake of chlorination disinfection by-products; a review and a discussion of its implications for exposure assessment in epidemiological studies

Nieuwenhuijsen

Toledano²,

Elliott³

2000

J Expo Sci Environ Epidemiol

163

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We have reviewed the relevant issues in the exposure assessment of disinfection by -products ( DBPs ) of chlorination for epidemiological and health risk assessment. Various DBPs can be detected in drinking water and swimming pools, and the reported levels show a considerable range, but were generally below the current health standard for total trihalomethanes ( TTHMs ) ( 100 g / l ) . Relatively little information is available on the correlation between the various DBPs in drinking water and in swimming pools. Chloroform was generally, but not always, the most predominant DBP. In epidemiological studies, TTHM levels have been used as an indicator for total DBP load, even though TTHM levels do not always correlate well with individual DPBs. Factors such as residence time, temperature, pH, organic content, including humic and fulvic acid and bromide levels affect the composition and levels of DBPs. Although there are biomarkers of DBPs, mainly for chloroform and more recently for the other volatile trihalomethanes ( THMs ) and the nonvolatile haloacetic acids ( HAAs ) such as trichloroacetic acid ( TCAA ) and dichloroacetic acid ( DCAA ) , they have not been used in epidemiological studies. The THMs have been measured in exhaled breath and serum, while the HAAs have been measured in urine. These biomarkers have been useful to estimate the actual uptake of the DBPs and the relative contribution of various exposure routes. Physiologically based pharmacokinetic ( PBPK ) models exist for, e.g. chloroform, but their main target organs are the kidney and liver and they have not been used in epidemiological studies. Tap water ingestion, showering, bathing, swimming, boiling water and dishwashing are all activities that have been associated with the uptake of DBPs, and considerable variation in these activities has been observed between people. No studies have reported on the correlation between human uptake of DBPs and water -zone mean estimates, but various studies found a good correlation between THM concentrations in exhaled breath and THM concentrations in water during showering and swimming. In general exposure assessment in epidemiological studies has been limited which complicates the interpretation. These findings have implications for epidemiological studies, particularly with reference to Berkson and classical error type models, study power, attenuation and precision of health -risk estimates and study efficiency. Recommendations are made for further areas of study.

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“…Aiking et al [5] studied the hepatotoxic and nephrotoxic effects of chlorinated compounds in 18 competition swimmers, finding out that B2 microglobulin, and indicator of kidney damage, was significantly higher in the urine samples of younger swimmers.…”

Section: Other Effectsmentioning

confidence: 99%

Potential negative effects of chlorinated swimming pool attendance on health of swimmers and associated staff

Zarzoso¹,

Llana²,

Pérez-Soriano³

2010

Biol Sport

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Swimming pool chlorination: a health hazard?

Cited by 26 publications

References 5 publications

The relationship between water concentrations and individual uptake of chloroform: a simulation study.

The relationship between water concentrations and individual uptake of chloroform: a simulation study.

Uptake of chlorination disinfection by-products; a review and a discussion of its implications for exposure assessment in epidemiological studies

Potential negative effects of chlorinated swimming pool attendance on health of swimmers and associated staff

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