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Airway irritation among indoor swimming pool personnel: trichloramine exposure, exhaled NO and protein profiling of nasal lavage fluids.

https://arctichealth.org/en/permalink/ahliterature123142
Source
Int Arch Occup Environ Health. 2013 Jul;86(5):571-80
Publication Type
Article
Date
Jul-2013
Author
Louise Fornander
Bijar Ghafouri
Mats Lindahl
Pål Graff
Author Affiliation
Occupational and Environmental Medicine, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Source
Int Arch Occup Environ Health. 2013 Jul;86(5):571-80
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Adult
Air Pollutants, Occupational - adverse effects - analysis
Biological Markers - metabolism
Chlorides - adverse effects - analysis
Cross-Sectional Studies
Electrophoresis, Gel, Two-Dimensional
Female
Humans
Immunoblotting
Male
Middle Aged
Nasal Lavage Fluid - chemistry
Nitric Oxide - metabolism
Nitrogen Compounds - adverse effects - analysis
Occupational Diseases - diagnosis - epidemiology - etiology - metabolism
Occupational Exposure - adverse effects - analysis
Prevalence
Proteome - metabolism
Respiratory Tract Diseases - diagnosis - epidemiology - etiology - metabolism
Risk factors
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
Sweden - epidemiology
Swimming Pools
Abstract
Occurrence of airway irritation among indoor swimming pool personnel was investigated. The aims of this study were to assess trichloramine exposure levels and exhaled nitric oxide in relation to the prevalence of airway symptoms in swimming pool facilities and to determine protein effects in the upper respiratory tract.
The presence of airway symptoms related to work was examined in 146 individuals working at 46 indoor swimming pool facilities. Levels of trichloramine, as well as exhaled nitric oxide, were measured in five facilities with high prevalence of airway irritation and four facilities with no airway irritation among the personnel. Nasal lavage fluid was collected, and protein profiles were determined by a proteomic approach.
17 % of the swimming pool personnel reported airway symptoms related to work. The levels of trichloramine in the swimming pool facilities ranged from 0.04 to 0.36 mg/m(3). There was no covariance between trichloramine levels, exhaled nitric oxide and prevalence of airway symptoms. Protein profiling of the nasal lavage fluid showed that the levels alpha-1-antitrypsin and lactoferrin were significantly higher, and S100-A8 was significantly lower in swimming pool personnel.
This study confirms the occurrence of airway irritation among indoor swimming pool personnel. Our results indicate altered levels of innate immunity proteins in the upper airways that may pose as potential biomarkers. However, swimming pool facilities with high prevalence of airway irritation could not be explained by higher trichloramine exposure levels. Further studies are needed to clarify the environmental factors in indoor swimming pools that cause airway problems and affect the immune system.
PubMed ID
22729567 View in PubMed
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Occupational Exposure to Trichloramine and Trihalomethanes in Swedish Indoor Swimming Pools: Evaluation of Personal and Stationary Monitoring.

https://arctichealth.org/en/permalink/ahliterature274123
Source
Ann Occup Hyg. 2015 Oct;59(8):1074-84
Publication Type
Article
Date
Oct-2015
Author
Jessica Westerlund
Pål Graff
Ing-Liss Bryngelsson
Håkan Westberg
Kåre Eriksson
Håkan Löfstedt
Source
Ann Occup Hyg. 2015 Oct;59(8):1074-84
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Air Pollutants - analysis
Air Pollution, Indoor - analysis - prevention & control
Chlorides - adverse effects - analysis
Environmental Monitoring - methods
Humans
Linear Models
Nitrogen Compounds - adverse effects - analysis
Occupational Exposure - analysis - prevention & control
Sweden
Swimming Pools
Trihalomethanes - adverse effects - analysis
Abstract
Chlorination is a method commonly used to keep indoor swimming pool water free from pathogens. However, chlorination of swimming pools produces several potentially hazardous by-products as the chlorine reacts with nitrogen containing organic matter. Up till now, exposure assessments in indoor swimming pools have relied on stationary measurements at the poolside, used as a proxy for personal exposure. However, measurements at fixed locations are known to differ from personal exposure.
Eight public swimming pool facilities in four Swedish cities were included in this survey. Personal and stationary sampling was performed during day or evening shift. Samplers were placed at different fixed positions around the pool facilities, at ~1.5 m above the floor level and 0-1 m from the poolside. In total, 52 personal and 110 stationary samples of trichloramine and 51 personal and 109 stationary samples of trihalomethanes, were collected.
The average concentration of trichloramine for personal sampling was 71 µg m(-3), ranging from 1 to 240 µg m(-3) and for stationary samples 179 µg m(-3), ranging from 1 to 640 µg m(-3). The air concentrations of chloroform were well below the occupational exposure limit (OEL). For the linear regression analysis and prediction of personal exposure to trichloramine from stationary sampling, only data from personal that spent >50% of their workday in the pool area were included. The linear regression analysis showed a correlation coefficient (r2) of 0.693 and a significant regression coefficient ß of 0.621; (95% CI = 0.329-0.912, P = 0.001).
The trichloramine exposure levels determined in this study were well below the recommended air concentration level of 500 µg m(-3); a WHO reference value based on stationary sampling. Our regression data suggest a relation between personal exposure and area sampling of 1:2, implying an OEL of 250 µg m(-3) based on personal sampling.
Notes
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PubMed ID
26155991 View in PubMed
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