Abstract
OBJECTIVES: To measure the levels of exposure to nitrogen trichloride (NCl3) in the atmosphere of indoor swimming pools and to examine how they relate to irritant and chronic respiratory symptoms, indices of pulmonary function, and bronchial hyperresponsiveness to methacholine in lifeguards working in the pools. METHOD: 334 lifeguards (256 men; 78 women) recruited from 46 public swimming pools (n = 228) and 17 leisure centre swimming pools (n = 106) were examined. Concentrations of NCl3 were measured with area samplers. Symptoms were assessed by questionnaire and methacholine bronchial challenge (MBC) test by an abbreviated method. Subjects were labelled MBC+ if forced expiratory volume in one second (FEV1) fell by > or = 20%. The linear dose- response slope was calculated as the percentage fall in FEV1 at the last dose divided by the total dose given. RESULTS: 1262 samples were taken in the 63 pools. Mean NCl3 concentrations were greater in leisure than in public pools. A significant concentration-response relation was found between irritant eye, nasal, and throat symptoms-but not chronic respiratory symptoms-and exposure concentrations. Among women, the prevalence of MBC+ was twice as great as in men. Overall, no relation was found between bronchial hyperresponsiveness and exposure. CONCLUSIONS: The data show that lifeguards exposed to NCl3 in indoor swimming pools are at risk of developing irritant eye, nasal, and throat symptoms. Exposure to NCl3 does not seem to carry the risk of developing permanent bronchial hyperresponsiveness, but this association might have been influenced by self selection. The possibility that subjects exposed to NCl3 are at risk of developing transient bronchial hyperresponsiveness cannot be confidently ruled out.
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- ATS statement--Snowbird workshop on standardization of spirometry. Am Rev Respir Dis. 1979 May;119(5):831–838. doi: 10.1164/arrd.1979.119.5.831. [DOI] [PubMed] [Google Scholar]
- Andrew G. M., Becklake M. R., Guleria J. S., Bates D. V. Heart and lung functions in swimmers and nonathletes during growth. J Appl Physiol. 1972 Feb;32(2):245–251. doi: 10.1152/jappl.1972.32.2.245. [DOI] [PubMed] [Google Scholar]
- Armour J., Donnelly P. M., Bye P. T. The large lungs of elite swimmers: an increased alveolar number? Eur Respir J. 1993 Feb;6(2):237–247. [PubMed] [Google Scholar]
- Bakke P. S., Baste V., Gulsvik A. Bronchial responsiveness in a Norwegian community. Am Rev Respir Dis. 1991 Feb;143(2):317–322. doi: 10.1164/ajrccm/143.2.317. [DOI] [PubMed] [Google Scholar]
- Bohadana A. B., Massin N., Wild P., Kolopp M. N., Toamain J. P. Respiratory symptoms and airway responsiveness in apparently healthy workers exposed to flour dust. Eur Respir J. 1994 Jun;7(6):1070–1076. [PubMed] [Google Scholar]
- Burney P. G., Britton J. R., Chinn S., Tattersfield A. E., Papacosta A. O., Kelson M. C., Anderson F., Corfield D. R. Descriptive epidemiology of bronchial reactivity in an adult population: results from a community study. Thorax. 1987 Jan;42(1):38–44. doi: 10.1136/thx.42.1.38. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cerveri I., Bruschi C., Zoia M. C., Maccarini L., Grassi M., Lebowitz M. D., Rampulla C., Grassi C. Smoking habit and bronchial reactivity in normal subjects. A population-based study. Am Rev Respir Dis. 1989 Jul;140(1):191–196. doi: 10.1164/ajrccm/140.1.191. [DOI] [PubMed] [Google Scholar]
- Gagnaire F., Azim S., Bonnet P., Hecht G., Hery M. Comparison of the sensory irritation response in mice to chlorine and nitrogen trichloride. J Appl Toxicol. 1994 Nov-Dec;14(6):405–409. doi: 10.1002/jat.2550140604. [DOI] [PubMed] [Google Scholar]
- Massin N., Bohadana A. B., Wild P., Goutet P., Kirstetter H., Toamain J. P. Airway responsiveness, respiratory symptoms, and exposures to soluble oil mist in mechanical workers. Occup Environ Med. 1996 Nov;53(11):748–752. doi: 10.1136/oem.53.11.748. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Momas I., Brette F., Spinasse A., Squinazi F., Dab W., Festy B. Health effects of attending a public swimming pool: follow up of a cohort of pupils in Paris. J Epidemiol Community Health. 1993 Dec;47(6):464–468. doi: 10.1136/jech.47.6.464. [DOI] [PMC free article] [PubMed] [Google Scholar]
- O'Connor G., Sparrow D., Taylor D., Segal M., Weiss S. Analysis of dose-response curves to methacholine. An approach suitable for population studies. Am Rev Respir Dis. 1987 Dec;136(6):1412–1417. doi: 10.1164/ajrccm/136.6.1412. [DOI] [PubMed] [Google Scholar]
- Paoletti P., Carrozzi L., Viegi G., Modena P., Ballerin L., Di Pede F., Grado L., Baldacci S., Pedreschi M., Vellutini M. Distribution of bronchial responsiveness in a general population: effect of sex, age, smoking, and level of pulmonary function. Am J Respir Crit Care Med. 1995 Jun;151(6):1770–1777. doi: 10.1164/ajrccm.151.6.7767519. [DOI] [PubMed] [Google Scholar]
- Peat J. K., Salome C. M., Berry G., Woolcock A. J. Relation of dose-response slope to respiratory symptoms and lung function in a population study of adults living in Busselton, Western Australia. Am Rev Respir Dis. 1992 Oct;146(4):860–865. doi: 10.1164/ajrccm/146.4.860. [DOI] [PubMed] [Google Scholar]
- Quanjer P. H., Tammeling G. J., Cotes J. E., Pedersen O. F., Peslin R., Yernault J. C. Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl. 1993 Mar;16:5–40. [PubMed] [Google Scholar]
- Rijcken B., Schouten J. P., Weiss S. T., Speizer F. E., van der Lende R. The relationship of nonspecific bronchial responsiveness to respiratory symptoms in a random population sample. Am Rev Respir Dis. 1987 Jul;136(1):62–68. doi: 10.1164/ajrccm/136.1.62. [DOI] [PubMed] [Google Scholar]
- Sherman C. B., Tollerud D. J., Heffner L. J., Speizer F. E., Weiss S. T. Airway responsiveness in young black and white women. Am Rev Respir Dis. 1993 Jul;148(1):98–102. doi: 10.1164/ajrccm/148.1.98. [DOI] [PubMed] [Google Scholar]