Respiratory and Ocular Symptoms Among Employees of an Indoor Waterpark Resort – Ohio, 2016

Details

• Journal Article:
  Morbidity and Mortality Weekly Report (MMWR)
• Personal Author:
  Burton, Nancy C. ; Chiu, Sophia K. ; De Perio, Marie A. ; Dunn, Kevin H.
• Description:
  What is already known about this topic? Indoor waterparks are complex environments where problems with air and water quality can result in illness. Chloramines, formed when disinfectant chlorine reacts with nitrogen-containing substances (e.g., urine, sweat) from swimmers' bodies, are known causes of ocular and upper respiratory symptoms in aquatic facilities. What is added by this report? Investigation of reported illness in an indoor waterpark resort in Ohio found that waterpark employees were approximately four times more likely to have work-related ocular and respiratory symptoms than were employees in other resort areas. Environmental assessment found that levels of combined chlorine, of which chloramines are a subset, in water exceeded recommended guidelines, but levels of chlorine and chloroform (a representative disinfection byproduct) in air were low. Improperly functioning ventilation systems, resulting in accumulation of disinfection byproducts and temperature below and relative humidity above recommended ranges, likely contributed to the higher prevalence of symptoms among waterpark employees compared with nonwaterpark employees. What are the implications for public health practice? To prevent recreational water-associated illness caused by endotoxins and disinfection byproducts in indoor waterparks, vigilant monitoring and maintenance of ventilation and water systems are needed. Employees and patrons of indoor waterparks should promptly report symptoms, which might indicate that further attention to water and air quality and ventilation system functioning is needed. Showering before entering the water and taking regular bathroom breaks can reduce levels of disinfection byproduct precursors introduced into the water. [Description provided by NIOSH]
• Subjects:
  Air Pollution Amines Communicable Diseases Disinfectants Endotoxins Eye Humidity Occupational Health Respiratory System Safety Sense Organs Sense Organs / Injuries Temperature Ventilation

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• Keywords:
  Air Quality Chloroform Environmental Monitoring Exposure Assessment Exposure Levels Eye Hazards Eye Irritants Eyes Eyesight Humans Indoor Environments Infection-control Quality Control Relative Humidity Respiratory Function Respiratory Health Respiratory Irritants Temperature Effects Ventilation Systems Water Analysis Water Purification Water Sampling

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• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Publisher:
  Centers for Disease Control and Prevention (CDC) (U.S.)
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Ohio ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies ; DART - Division of Applied Research and Technology
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  4 pdf pages
• Contributor:
  Zabala, Amanda ; McCarty, Carolyn ; Su, Chia-Ping ; Johnson, Candice Y. ; Feldmann, Karl ; Li, Jessica F. ; Booher, Donnie ; Moore, Kevin A. ; Colvin, Michelle J. ; Giglio, Denise ; Banjoko, Kadi ; Walline, Susan ; Richter, John ; Emanuel, Allen ; Nelson, Leigh ; Holbrook, Adam ; Jacobs, Luke ; Lyons, Jeff
• Volume:
  66
• Issue:
  37
• NIOSHTIC Number:
  nn:20050425
• Citation:
  MMWR 2017 Sep; 66(37):986-989
• Email:
  schiu1@cdc.gov
• CAS Registry Number:
  Chlorine (CAS RN 7782-50-5) ; Chloroform (CAS RN 67-66-3)
• Federal Fiscal Year:
  2017
• NORA Priority Area:
  Services
• Peer Reviewed:
  False
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR) National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:ce69561ef974bff970a6d31a1ae6a5685c112de0828960c2eaf1dbe250ad260b0261592656a3e7f80d7d1347ae86634b8474fc34dff1321730b3afc1cf331f96
• Download URL:
  https://stacks.cdc.gov/view/cdc/183280/cdc_183280_DS1.pdf
• File Type:
  [PDF - 82.21 KB ]