LAUSR

The clinical significance of this paper is the finding of occupational trichloramine and endotoxin exposure in air in swimming pool facilities in relation to adverse health effects. This is of particular importance in adventure swimming pools where trichloramine exposure is expected to be high, to further emphasize the importance of occupational exposure limits to protect workers' health. Objective: To study occupational exposure totrichloramine and endotoxins in air at adventure and rehabilitation swimming pool facilities from an adverse health effects perspective. Methods: Air concentrations of trichloramine and endotoxins were measured in five adventure and 10 rehabilitation facilities. Respiratory and ocular symptoms were self-reported, and spirometry and fraction of exhaled nitric oxide (FEno) were measured. Results: Compared to rehabilitation facilities, the mean trichloramine concentrations in the adventure facilities were higher, both personal (80 μg/m3 (n = 41) vs 19 μg/m3 (n = 21)) and stationary (183 μg/m3 (n = 51) vs 23 μg/m3 (n = 32)), with higher frequency of ocular and respiratory symptoms. Low stationary endotoxin levels (<0.64 to 25 EU/m3) were found, compared to the reference value (90 EU/m3). Conclusions: Higher trichloramine concentrations in air and more ocular and respiratory symptoms in adventure facilities call for adequate occupational exposure limits.