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Occupational exposure to trichloramine and endotoxins: Adverse health effects among personnel in adventure and rehabilitation swimming pool facilities
Örebro University, School of Medical Sciences. Department of Occupational and Environmental Medicine.
Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden .
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Occupational and Environmental Medicine.
Örebro University, School of Health Sciences. Department of Occupational and Environmental Medicine.ORCID iD: 0000-0003-0240-9267
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(English)Manuscript (preprint) (Other academic)
National Category
Other Health Sciences
Identifiers
URN: urn:nbn:se:oru:diva-98995OAI: oai:DiVA.org:oru-98995DiVA, id: diva2:1658040
Available from: 2022-05-13 Created: 2022-05-13 Last updated: 2024-03-04Bibliographically approved
In thesis
1. Exposure to trichloramine, trihalomethanes and endotoxins: adverse respiratory and ocular effects among Swedish indoor swimming pool workers
Open this publication in new window or tab >>Exposure to trichloramine, trihalomethanes and endotoxins: adverse respiratory and ocular effects among Swedish indoor swimming pool workers
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Indoor swimming pool facilities often use chlorine for pool water disinfection. Chlorine can also contribute to the formation of unwanted disinfection byproducts (DBPs). Trichloramine and trihalomethanes (THMs) are DBPs formed in swimming pool water and swimming pool air causing occupational exposure. Trichloramine can cause ocular and airway irritation, while some THMs are potentially carcinogenic. Bacterial endotoxins may also cause adverse respiratory effects among swimming pool workers. 

The overall aim of the study was to measure levels of trichloramine, THMs and endotoxins in the air at conventional, habilitation and rehabilitation, and adventure swimming pool facilities, and to investigate adverse ocular and respiratory effects among indoor swimming pool workers.

Trichloramine and THM levels in air were comparable to previous studies. Endotoxin levels in air were low compared to the reference value. Trichloramine concentrations in personal samples were approximately half as high as those measured in stationary samples - an important consideration for a future Swedish occupational exposure limit. The adventure facilities had the highest trichloramine levels while the conventional facilities had the highest THM levels. The adventure workers also reported more ocular and respiratory symptoms compared to referents (office workers) and had a lower FEV1/FVC ratio indicating airway obstruction. Workers both in conventional, and in habilitation and rehabilitation facilities exhibited a difference in FeNO levels compared to referents, implying airway inflammation.

The occupational exposure and adverse health effects found in indoor swimming pool environments emphasizes the importance of a personal based Swedish occupational exposure limit for trichloramine in air.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2022. p. 86
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 264
Keywords
Trichloramine, trihalomethanes, endotoxins, occupational exposure, ocular health effects, respiratory health effects, swimming pool facilities
National Category
Other Basic Medicine
Identifiers
urn:nbn:se:oru:diva-98068 (URN)9789175294490 (ISBN)
Public defence
2022-06-10, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 13:00 (Swedish)
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Supervisors
Available from: 2022-03-15 Created: 2022-03-15 Last updated: 2024-03-04Bibliographically approved

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Westerlund, JessicaFornander, LouiseLöfstedt, Håkan

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