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2.2.04 Swimming pools – health risks posed by pool disinfection

“Swimming is good for you”: this is a commonly used phrase in health care. But does this also unequivocally apply to swimming in pools containing water disinfected with chlorine? Once water has been disinfected with chlorine, disinfection by-products can form – and these can pose a risk to human health. There are still many questions requiring greater scientific clarification regarding the risk posed to children and those suffering from chronic illnesses. A new research project is seeking answers to these questions.

When treating swimming pool water, chlorine must be used as a disinfectant (also see DIN 19643). However, the reactions of chlorine with substances that get into the pool either via the water or the pool users produce unwanted disinfection by-products. It is suspected that these by-products pose a risk to health. This is by no means a new problem, but the effects of pool water on hygiene have recently become the focus of scientific interest.

The results of studies conducted thus far connect respiratory and other chronic illnesses with swimming in chlorinated water. Particularly given the general acceptance of swimming from childhood (“swimming is good for you”), the issue is a hot topic for health policy. The public can often gain the impression that the risks of swimming in chlorinated water outweigh the health benefits. This is a task for health-related environmental research: it must provide reliable data that enables a scientific risk assessment in terms of prevention.

Instigating international momentum

Germany has a leading international role in pool water hygiene. The research work undertaken contributes towards sustainable health care and has an influence on international standards. Noteworthy projects are “Swimming Pool Water Under Aspects of Health and Treatment Technology” (funding reference: 02WT0004) and “Integrated Risk Assessment for the new Generation of Disinfection By-products” (funding reference: 02WU0649). The study involving top swimmers (project with funding reference 02WT0004) was the world’s first population study that assessed the health risk of swimming in pools. It instigated international momentum to conduct similar studies.

On-site measurement to determine the potential risk from disinfection by-products in the pool hall’s air

On-site measurement to determine the potential risk from disinfection by-products in the pool hall’s air
On-site measurement to determine the potential risk from disinfection by-products in the pool hall’s air

Symposium held

A symposium called “Aktuelle Aspekte der Schwimmbeckenwasserhygiene – Pool Water Chemistry and Health” was held in Dessau in March 2009. The event brought leading scientists from around the world together; a survey was conducted and open issues identified. The scientists overwhelming agreed that German research has a clear edge in pool hygiene: all key aspects of risk management have already been examined in terms of their interactions – be it treatment of pool water or hazard assessment and risk evaluation of disinfection by-products.

The two research projects mentioned have shown that there are potential health risks associated with swimming in pools with chlorinated water. The aim of ongoing project “Gesundheitsbezogene Optimierung der Aufbereitung von Schwimm- und Badebeckenwasser (optimizing the treatment of pool water with regard to health) is to work through pending issues that are extremely hot topics in health policy, especially regarding respiratory illnesses and with a particular focus on children. The overriding objective is to define parameters to rule out health risks across a broad consensus of science, authorities, politics, pool operators and the public.

Three questions are of particular interest to the project:

  • Are the discussed exposure paths and associated chronic illnesses (inhalation/asthma, dermal/bladder cancer) relevant potential risks?
  • If so, which exposure scenarios are responsible (chemical substances/treatment)?
  • What options (treatment techniques/range of measures) are available to reduce or eliminate these potential risks?

The key element to the scientific work involved is the establishment of a pool model for conducting controlled tests. The various treatment options are accompanied by extensive chemical and toxicological analyses. The latest procedures were used to do this (e.g. exposure models for inhalation and dermal contaminants).

Bulletin published on baby swimming and disinfection by-products in swimming pools

A risk analysis of disinfection by-products as well as technical and legal measures based on the results is planned with the aim of reducing the build-up of these by-products. One key objective is to drive forward environmental research with regard to health. It is expected that research into pool hygiene will find its way into legal regulations. The first result is the publication of the bulletin entitled “Babyschwimmen und Desinfektionsnebenprodukte in Schwimmbädern” (baby swimming and disinfection byproducts in swimming pools) by the Swimming Pool Water Commission (BWK) of the Federal Ministry of Health, which appeared in the Federal Health Gazette 2011 (54: 142–144). A potential risk was highlighted in terms of the care principle. Another aspect is the availability of equipment to minimise the concentration of TCA in the air of the pool hall through technical rules for treating pool water and for indoor pool ventilation. Current developments show that pool operators and visitors have become clearly conscious of a problem associating baby swimming and asthma as a result of the UBA’s activities. Although the scientific evaluation of the toxicology data from the BWK and the Indoor Air Hygiene Commission’s ad-hoc working group for indoor guidance values is as controversial as ever, the technically feasible guideline stipulated of 0.2 mg/m3 trichloramine within the pool hall’s air means there is now a suitable monitoring parameter available in order to minimise the health risk.

Federal Environment Agency (UBA)
Bad Elster research centre

Dr. Tamara Grummt
Heinrich-Heine-Straße 12
08645 Bad Elster, Germany
Tel.: +49(0)3 74 37/7 63 54
Fax: +49(0)3 74 37/7 62 19
E-mail: tamara.grummt@uba.de
Internet: www.umweltbundesamt.de/index-e.htm
Funding reference: 02WT1092
Ressource Wasser
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