The determinants of prevalence of health complaints among young competitive swimmers

Objectives: Chloramines, which are produced by the reaction of chlorine with the organic matter present in indoor pools, are potential airway irritants in swimmers. The objective of this study was to compare the prevalence of health complaints of young swimmers and young indoor soccer players and to evaluate the relationship between chloramine concentrations and the athletes’ health complaints. Methods: Health complaints were first (Part 1) documented by questionnaire in 305 competitive swimmers and 499 indoor soccer players of the Québec City region (Canada). Then, (Part 2) health complaints were documented during five training sessions in 72 competitive swimmers in comparison to 73 soccer players. The chloramines in the swimming pool air and water were measured as well as the peak expiratory flow (PEF) before and after the training session. Results: In Part 1, the swimmers reported more lower (adjusted OR: 1.5; IC95%= 1.0–2.2) and upper respiratory symptoms (adjusted OR: 3.7; IC95%= 2.4–5.8). In Part 2, the swimmers experienced more frequent lower (adjusted OR: 3.5; IC95%= 2.0–6.0) and upper respiratory symptoms (adjusted OR: 3.1; IC95%= 1.8–5.4). Overall, swimmers exposed to the highest levels of chloramines in the air and water had more respiratory complaints. Conclusions: Swimmers exposed to chlorination by-products in both the water and air of indoor swimming pools experience frequent respiratory symptoms that could potentially be reduced by limiting exposure to these products.