Is swimming pool chlorine fueling the allergy epidemic?

Swimming in a chlorinated pool may boost the odds that a child susceptible to asthma and allergies will develop these problems, a study released today indicates.

“These new data clearly show that by irritating the airways of swimmers chlorination products in water and air of swimming pools exert a strong additive effect on the development of asthma and respiratory allergies such as hay fever and allergic rhinitis,” Dr. Alfred Bernard, a toxicologist at the Catholic University of Louvain in Brussels, Belgium, noted in an email to Reuters Health.

“The impact of these chemicals on the respiratory health of children and adolescents appears to be much more important — at least by a factor of five — than that associated with secondhand smoke,” Bernard noted.

Taken together with his team’s prior studies, he added, “There is little doubt that pool chlorine is an important factor implicated in the epidemic of allergic diseases affecting the westernized world.”

In the current study, Bernard and colleagues compared the health of 733 adolescents, 13 to 18 years old, who swam in chlorinated outdoor and indoor pools for various amounts of time with that of 114 “control” adolescents who swam mostly in pools sanitized with a concentration of copper and silver.

In children with allergic sensitivities, swimming in chlorinated pools significantly increased the likelihood of asthma and respiratory allergies, the researchers report in the journal Pediatrics.

Among “sensitive” adolescents, the odds for hay fever were between 3.3- and 6.6-fold higher in those who swam in chlorinated pools for greater than 100 hours and the odds of allergic rhinitis were increased 2.2- to 3.5-fold among those who logged more than 1000 hours of chlorinated pool time.

For example, among children and teens who swam in chlorinated pools for 100-500 lifetime hours, 22 children out of 369 (6.0%) had current asthma, compared with those who had spent less than 100 hours (2 of 144, 1.8%). The proportions with asthma rose with longer exposure, to 14 out of 221 (6.4%) who had been swimming for 500-1000 hours, and 17 out of 143 (11.9%) who swam for more than 1000 hours.

The risk of asthma and allergy was not influenced by swimming in copper-silver sanitized pools and children without allergic tendencies were not at increased risk of developing allergies.

“The only plausible explanation” for these observations, the researchers argue, is that the chlorine-based toxic chemicals in the water or hovering in the air at the pool surface cause changes in the airway and promote the development of allergic diseases.

“It is probably not by chance,” Bernard told Reuters Health, “that countries with the highest prevalence of asthma and respiratory allergies are also those where swimming pools are the most popular.”

The current findings, he and colleagues conclude, “reinforce” the need for further study on the issue and to enforce regulations concerning the levels of these chemicals in water and air of swimming pools.

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Early daycare may not lower asthma risk

Contrary to what some previous studies have suggested, children who enter daycare at an early age may not have a reduced risk of allergies and asthma later on, researchers reported Tuesday.

In a study of more than 3,600 children followed from birth, the investigators found that children who entered daycare before the age of 2 were no less likely than their peers to suffer from allergies or asthma at the age of 8.

But early daycare did not appear to raise those risks either, senior researcher Dr. Johan C. de Jongste, of Erasmus University in Rotterdam, the Netherlands, told Reuters Health in an email.

Instead, the findings suggest that daycare has little long-term effect on children’s respiratory health — and that it should not be seen as a way to protect them from allergies and asthma down the road, the researchers report in the journal American Journal of Respiratory and Critical Care Medicine.

The study, de Jongste said, challenges what is known as the “hygiene hypothesis” — the theory that the increasingly germ-free surroundings of modern life are actually contributing to an increase in allergies and asthma.

Some researchers speculate that exposure to viruses and other bugs at daycare may help push a young child’s immune system toward infection-fighting mode, and away from a tendency to over-react to the normally benign substances — the basis of allergic conditions.

Along with daycare attendance, certain other factors that suggest greater early-life exposure to infections — like having older siblings — have also been linked to lower risks of childhood allergies and asthma.

But in the current study, neither daycare nor the presence of older siblings showed long-term effects.

Of the 3,643 children followed from birth to age 8, 30 percent started daycare before age 2. These children were twice as likely as the rest to suffer breathing difficulties in the first year of life.

But the pattern shifted with time, and by the age of 8, early-daycare children were no more — or no less — likely to have episodes of wheezing or other signs or symptoms of asthma. Nor did early daycare affect the risk of showing reactions to airborne allergens during allergy testing.

Children with older siblings were also more likely to have wheezing symptoms in the first year of life, but were no more or no less likely to have signs or symptoms of allergies or asthma at age 8.

The findings, de Jongste’s team writes, suggests that early daycare simply “shifts the burden” of respiratory symptoms to an earlier age, with no tradeoff of protective effects later on.

“Hence,” they conclude, “early daycare should not be promoted for reasons of preventing allergy and asthma.”

SOURCE: American Journal of Respiratory and Critical Care Medicine, September 15, 2009.

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Tag Archives: respiratory health

Is swimming pool chlorine fueling the allergy epidemic?

Is swimming pool chlorine fueling the allergy epidemic?

Early daycare may not lower asthma risk

Early daycare may not lower asthma risk