Outbreaks of Short-Incubation Ocular and Respiratory Illness Following Exposure to Indoor Swimming Pools

Details

• Alternative Title:
  Environ Health Perspect
• Personal Author:
  Bowen, Anna B. ; Kile, James C. ; Otto, Charles ; Kazerouni, Neely ; Austin, Connie ; Blount, Benjamin C. ; Wong, Hong-Nei ; Beach, Michael J. ; Fry, Alicia M.
• Description:
  Objectives
  
  Chlorination destroys pathogens in swimming pool water, but by-products of chlorination can cause human illness. We investigated outbreaks of ocular and respiratory symptoms associated with chlorinated indoor swimming pools at two hotels.
  
  Measurements
  
  We interviewed registered guests and companions who stayed at hotels X and Y within 2 days of outbreak onset. We performed bivariate and stratified analyses, calculated relative risks (RR), and conducted environmental investigations of indoor pool areas.
  
  Results
  
  Of 77 guests at hotel X, 47 (61%) completed questionnaires. Among persons exposed to the indoor pool area, 22 (71%) of 31 developed ocular symptoms [RR = 24; 95% confidence interval (CI), 1.5–370], and 14 (45%) developed respiratory symptoms (RR = 6.8; 95% CI, 1.0–47) with a median duration of 10 hr (0.25–24 hr). We interviewed 30 (39%) of 77 registered persons and 59 unregistered companions at hotel Y. Among persons exposed to the indoor pool area, 41 (59%) of 69 developed ocular symptoms (RR = 24; 95% CI, 1.5–370), and 28 (41%) developed respiratory symptoms (RR = 17; 95% CI, 1.1–260) with a median duration of 2.5 hr (2 min–14 days). Four persons sought medical care. During the outbreak, the hotel X’s ventilation system malfunctioned. Appropriate water and air samples were not available for laboratory analysis.
  
  Conclusions and relevance to professional practice
  
  Indoor pool areas were associated with illness in these outbreaks. A large proportion of bathers were affected; symptoms were consistent with chloramine exposure and were sometimes severe. Improved staff training, pool maintenance, and pool area ventilation could prevent future outbreaks.
  
  
• Subjects:
  Adolescent Adult Child Child, Preschool Chloramines Cohort Studies Disease Outbreaks Environmental Exposure Eye Diseases Female Humans Male Middle Aged Research Respiration Disorders Risk Factors Swimming Pools Water Microbiology Water Pollutants, Chemical

  More +
• Source:
  Environ Health Perspect. 2007; 115(2):267-271.
• Document Type:
  Journal Article
• Volume:
  115
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:9b61c1d5a7366133814c9b2929331b09edc2bbe356893870bec0cf1da5274ab92a096b0ed65e4b6a3e6552089d85b3302a9d9c0a482366f8180d09ce660b840e
• Download URL:
  https://stacks.cdc.gov/view/cdc/3896/cdc_3896_DS1.pdf
• File Type:
  [PDF - 528.33 KB ]