Swimming pools and health-related behaviours: results of an Italian multicentre study on showering habits among pool users

Pasquarella, Cesira; Veronesi, Licia; Napoli, Christian; Castaldi, Silvana; Pasquarella, Maria Luisa; Saccani, Elisa; Colucci, Maria Eugenia; Auxilia, F.; Gallé, Francesca; Onofrio, Valeria Di; Tafuri, Silvio; Signorelli, Carlo; Liguori, Giorgio

doi:10.1016/j.puhe.2013.01.014

Cited by 22 publications

(25 citation statements)

References 13 publications

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“…Although showering before swimming is mandatory in some countries, studies have shown that many swimmers are still unaware of the impact their swimming habits can have. Surveys of swimmers in countries where pre-swim showering is encouraged found as much as 50% of swimmers were unware of the correct reasoning behind pre-swim showering (Pasquarella et al, 2013(Pasquarella et al, , 2014. Whilst most swimmers (50.5%) gave the correct reasoning, "to wash oneself", many (44.3%) believed pre-swim showers are encouraged to "get you used to the temperature of the water", with a few (5.2%) indicating both reasons (Pasquarella et al, 2013(Pasquarella et al, , 2014.…”

Section: Swimmers: Activity and Usagementioning

confidence: 99%

Occurrence and formation of disinfection by-products in the swimming pool environment: A critical review

Carter

Joll

2017

Journal of Environmental Sciences

102

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Disinfection of water for human use is essential to protect against microbial disease; however, disinfection also leads to formation of disinfection by-products (DBPs), some of which are of health concern. From a chemical perspective, swimming pools are a complex matrix, with continual addition of a wide range of natural and anthropogenic chemicals via filling waters, disinfectant addition, pharmaceuticals and personal care products and human body excretions. Natural organic matter, trace amounts of DBPs and chlorine or chloramines may be introduced by the filling water, which is commonly disinfected distributed drinking water. Chlorine and/or bromine is continually introduced via the addition of chemical disinfectants to the pool. Human body excretions (sweat, urine and saliva) and pharmaceuticals and personal care products (sunscreens, cosmetics, hair products and lotions) are introduced by swimmers. High addition of disinfectant leads to a high formation of DBPs from reaction of some of the chemicals with the disinfectant. Swimming pool air is also of concern as volatile DBPs partition into the air above the pool. The presence of bromine leads to the formation of a wide range of bromo- and bromo/chloro-DBPs, and Br-DBPs are more toxic than their chlorinated analogues. This is particularly important for seawater-filled pools or pools using a bromine-based disinfectant. This review summarises chemical contaminants and DBPs in swimming pool waters, as well as in the air above pools. Factors that have been found to affect DBP formation in pools are discussed. The impact of the swimming pool environment on human health is reviewed.

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Section: Swimmers: Activity and Usagementioning

confidence: 99%

Occurrence and formation of disinfection by-products in the swimming pool environment: A critical review

Carter

Joll

2017

Journal of Environmental Sciences

102

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“…However, growing studies suggest that exposure to the water in swimming pools may result in a variety of health risks, such as increased asthma and allergy, which are associated with microbial and chemical hazards (Bernard et al 2006;Pasquarella et al 2013Pasquarella et al , 2014. Recent studies have raised concerns on adverse health impacts associated with application of personal care products and disinfection by-products (DBPs) formed in swimming pools (Chowdhury et al 2014;Kim et al 2002;Xiao et al 2012).…”

Section: Introductionmentioning

confidence: 99%

Occurrence and human exposure of parabens and their chlorinated derivatives in swimming pools

Shi

Gao

et al. 2015

Environ Sci Pollut Res

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As an emerging group of endocrine-disrupting chemicals, parabens have attracted growing attention due to their potential effects on human health. In the present study, the occurrence and distribution of eight parabens, four chlorinated parabens, and their common hydrolysis product, phydroxybenzoic acid (PHBA), were investigated in 39 swimming pools in Beijing, China. Methyl paraben and propyl paraben were the predominant compounds in swimming pools, accounting for 91.2 % of the total parabens. It is noteworthy that octyl paraben, a paraben with longer chain, was firstly detected in this study. There were several factors affecting the levels of parabens among the 39 swimming pools. The concentrations of parabens and chlorinated derivatives detected in indoor pools (144 ng L −1 ) were roughly 20-fold higher than those in outdoor pools (6.78 ng L −1 ). Hotel pools appear to present higher level of target compounds (361 ng L −1 ) than that in health club (228 ng L −1 ), municipal (130 ng L −1 ), school (75.6 ng L −1 ), and community pools (63.0 ng L −1 ). Moreover, the level of these compounds in pools during weekends (174 ng L −1 ) was much higher than that during weekdays (52.3 ng L −1 ). The dynamics of target compounds were also investigated to provide a general trend of the level of parabens in a school indoor swimming pool during a 14-week period. Human exposure assessment was conducted to estimate the potential risk of exposure to parabens and their chlorinated derivatives in swimming pools. Considering the total exposure dose of multiple parabens, human exposure to parabens from the water of swimming pools is negligible. However, the threat of these parabens to children in swimming pool should be concerned.

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“…This study also extends the knowledge of previously reported barriers by identifying factors that may be influencing these identified barriers. For example, unhealthy swimming behaviours are a known barrier; 37,38 however, this study identified that these behaviours may be influenced by a lack of translated educational material or generational differences among pool users, both of which have not been reported and would benefit from further investigation. To our knowledge, the finding that the location of showering amenities within the facility does not encourage good bather hygiene has not previously been reported.…”

Section: Discussionmentioning

confidence: 82%

“…Several of these barriers have previously been reported. Many studies have already identified the unhealthy swimming behaviours exhibited by many pool users, such as not showering before swimming and swimming while experiencing symptoms, including vomiting and diarrhoea, of gastrointestinal illness 37,38 . This is an important barrier as human faeces, which may be excreted when exhibiting these unhealthy swimming behaviours, are often implicated or suspected as the source of many swimming pool associated outbreaks of cryptosporidiosis 13–16 .…”

Section: Discussionmentioning

confidence: 99%

Preventing and controlling spp. in aquatic facilities: environmental health practitioners’ experiences in Victoria, Australia

Cullinan

McLean

Dunn

2020

Australian and New Zealand Journal of Public Health

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Objective:To identify barriers and enablers to preventing and controlling Cryptosporidium spp. in aquatic facilities as perceived by environmental health practitioners (EHPs). Methods:A qualitative, constructivist study with a purposive sample of seven EHPs from Victoria, Australia, was conducted. A focus group discussion was guided by a semi-structured interview schedule using open-ended questions. The audio-recorded focus group was transcribed verbatim and analysed using thematic analysis.Results: Five themes represented the perceived barriers and enablers: i) pool water testing methods; ii) resources and training for EHPs; iii) knowledge and behaviour of aquatic facility operators and swimming pool users; iv) regulation; and v) aquatic facility and swimming pool design. Two key barriers within these themes included aquatic facility regulation and unhealthy swimming behaviours. Conclusions:Several barriers and enablers to preventing and controlling Cryptosporidium spp. in aquatic facilities were perceived by EHPs. Suggestions to overcome perceived barriers were also identified. Further research is required to determine the impact of these findings on the incidence of cryptosporidiosis associated with aquatic facilities. Implications for public health:The findings contribute to a greater understanding of the barriers and enablers to Cryptosporidium spp. prevention and control in aquatic facilities, which may improve the effectiveness of current prevention and control strategies.

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Swimming pools and health-related behaviours: results of an Italian multicentre study on showering habits among pool users

Cited by 22 publications

References 13 publications

Occurrence and formation of disinfection by-products in the swimming pool environment: A critical review

Occurrence and formation of disinfection by-products in the swimming pool environment: A critical review

Occurrence and human exposure of parabens and their chlorinated derivatives in swimming pools

Preventing and controlling spp. in aquatic facilities: environmental health practitioners’ experiences in Victoria, Australia

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