“Lifeguard Lung”: Endemic Granulomatous Pneumonitis in an Indoor Swimming Pool

Details

• Personal Author:
  Beebe JL ; Hoffman, Richard E. ; King TE ; Kreiss, Kathleen ; Martyny JW ; McCammon, Jane B. ; Milton DK ; Newman, Lee S. ; Rose CS
• Description:
  Two sequential outbreaks of respiratory disease among lifeguards at an indoor swimming pool with water spray features were investigated. Questionnaires were administered to recreation center employees following each outbreak. Respondents reporting 2 or more pool-related symptoms were offered clinical evaluation, including bronchoscopy with bronchoalveolar lavage and transbronchial biopsy. Pool air and water were sampled for fungi, bacteria, amoebae, endotoxin, and respirable particulates. Thirty-three lifeguards had noncaseating granulomas on biopsy and/or bronchoalveolar lavage lymphocytosis. Attack rates for the outbreaks were 27% and 65%. Case patients had higher cumulative hours of work and tended to work more hours per week. Analyses indicated increased levels of endotoxin in pool air and water (relative to control pools) and gram-negative bacterial colonization of water sprays. Use of water spray features generated a 5.2-fold increase in the number of respirable particles and up to an 8-fold increase in air endotoxin levels. Lifeguards in this indoor swimming pool developed granulomatous lung disease associated with endotoxin-containing respirable bioaerosols from water spray features, which ventilation system improvements did not prevent. [Description provided by NIOSH]
• Subjects:
  Dust Endotoxins Environmental Monitoring Fungi Lung Diseases Microbiology Occupational Health Particulate Matter Respiratory System Respiratory Tract Diseases Safety

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• Keywords:
  Air Sampling Bacteria Biopsy Humans Lung Disease Microorganisms Particulates Respirable Dust Respiratory Infections Respiratory System Disorders Water Sampling

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• ISSN:
  0090-0036
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Colorado ; Massachusetts ; Ohio ; OSHA Region 1 ; OSHA Region 3 ; OSHA Region 5 ; OSHA Region 8 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies ; DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  88
• Issue:
  12
• NIOSHTIC Number:
  nn:20023473
• Citation:
  Am J Public Health 1998 Dec; 88(12):1795-1800
• Contact Point Address:
  National Jewish Medical and Research Center, Denver, CO 80206, USA
• Federal Fiscal Year:
  1999
• Peer Reviewed:
  True
• Source Full Name:
  American Journal of Public Health
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:e65e1145b84cc3e0a3493e4933d6a82c65b5e5b7ed546d283444d4b062ed80fc37fea53365c0f7153bbd051c4422565b8e1e643343473debcedd4ffb29344e2c
• Download URL:
  https://stacks.cdc.gov/view/cdc/195867/cdc_195867_DS1.pdf
• File Type:
  [PDF - 1.81 MB ]