Swimming Facilities and Work-Related Asthma

Details

• Personal Author:
  Borjan M ; Flattery J ; Harrison, Robert ; Lumia, Margaret ; Millerick-May M ; Reilly MJ ; Rosenman, Kenneth D. ; Stephens AC ; Weinberg J
• Description:
  Background: Exposure to chlorinated water in swimming facilities may aggravate preexisting asthma or cause new onset asthma. This may be a particular problem for individuals who work and therefore spend prolonged time at swimming facilities. Chloramines formed by the interaction of chlorine-based disinfection products with the nitrogen in water from human sweat, urine and skin cells are the suspected causal agents. Methods: Cases were reviewed from the state surveillance systems in California (CA), Michigan (MI) and New Jersey (NJ) to identify individuals with confirmed work-related asthma (WRA) attributed to exposures in swimming pools, water parks or hydrotherapy spas. A standardized method was used to confirm cases. Results: A total of 44 confirmed cases of WRA were identified; 17 from 1994 to 2011 in CA, 15 from 1991 to 2012 in MI and 12 from 1990 to 2011 in NJ. A majority (52.2%) of the cases were new onset; 31.8% secondary to an acute exposure incident and 20.4% to repeated exposure. These represented 0.3-1.6% of all confirmed cases of WRA received during these time periods. Maintenance workers (34.9%) and lifeguards (31.8%) were the most common occupations. Conclusions: Swimming pool workers were identified from three states where the pool environment was either a trigger of preexisting asthma or associated with new onset of WRA. Regulations to require air monitoring and improvements in ventilation are recommended to reduce exposure levels of chloramines, the presumed etiologic agents. Clinical assessment of patients with asthma should include consideration of the effect on respiratory symptoms from exposures in a swimming pool environment. [Description provided by NIOSH]
• Subjects:
  Air Pollutants, Occupational Amines Asthma, Occupational Chlorine Environmental Monitoring Occupational Health Respiratory System Safety Ventilation Workplace
• Keywords:
  Air Monitoring Air Pollutants Author Keywords: Choramines Environmental Trigger Epidemiology Occupational Asthma Occupational Exposure Respiratory Irritants Workplace Monitoring
• ISSN:
  0277-0903
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  California ; Michigan ; New Jersey ; OSHA Region 2 ; OSHA Region 5 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  52-58
• Volume:
  52
• Issue:
  1
• NIOSHTIC Number:
  nn:20054264
• Citation:
  J Asthma 2015 Jan; 52(1):52-58
• Contact Point Address:
  Kenneth Rosenman, MD, FACE, FACPM, Professor of Medicine, Chief of the Division of Occupational and Environmental Medicine, Michigan State University, 909 Fee Road, Room 117 West Fee, East Lansing, Michigan 48824, USA
• Email:
  Rosenman@msu.edu
• CAS Registry Number:
  Chloramine-T (CAS RN 127-65-1) ; Chlorine (CAS RN 7782-50-5)
• Federal Fiscal Year:
  2015
• Performing Organization:
  Michigan State University
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Journal of Asthma
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:c098f872c3011321c898047b422f3b3dd867dc59407ca77c7e5eca78303185859bd793541f8fe321128535cb6ce3560fd6fe9a0e12596d916ae95db326db72c9
• Download URL:
  https://stacks.cdc.gov/view/cdc/216863/cdc_216863_DS1.pdf
• File Type:
  [PDF - 394.43 KB ]