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Angelo Deus F, Castro CLFE, Oliveira VC, Figueiredo PHS, Costa HS, Xavier DM, Gomes WF, Lima VP. Aquatic exercise for people with asthma: a systematic review with meta-analysis of randomized controlled trials. J Asthma 2024; 61:780-792. [PMID: 38197764 DOI: 10.1080/02770903.2024.2303776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/07/2024] [Indexed: 01/11/2024]
Abstract
INTRODUCTION Aquatic exercises are among the types of exercise most tolerated by people with asthma. Therefore, the objective of this study was to synthesize the evidence on the effects of aquatic exercise on lung function and quality of life in asthmatic patients. DATA SOURCES A systematic search encompassing the Medline, CINAHL, Cochrane Library, Embase, AMED, SPORTDiscus, and Physiotherapy Evidence Database databases was conducted to identify randomized controlled trials assessing the impact of aquatic exercise in comparison to control conditions or land-based exercise on lung function and quality of life in individuals diagnosed with asthma. STUDY SELECTIONS The stages of selection, data extraction and methodological evaluation, and level of evidence of the manuscripts were carried out independently by two authors. RESULTS Ten studies, comprising a total of 393 participants, were incorporated into this systematic review. Very low-quality evidence was found in favor of aquatic exercise in asthmatic patients for forced expiratory volume in 1 s (MD: 0.20 L, 95% CI: 0.02 L-0.38L N: 91) and for forced vital capacity (MD: 0.32 L, 95% CI: 0.08 L-0.56L N: 80). No effect of aquatic exercise was observed on the FEV1/FVC ratio (MD:1.11L, 95% CI: -1.28 L-3.49L N:80) compared with control. Only one study evaluated the effect of aquatic exercise on patients' quality of life. CONCLUSIONS Improvements in lung function and quality of life in asthmatic patients undergoing aquatic exercise are not supported by high-quality evidence. The present findings will need to be confirmed by new, methodologically more rigorous clinical trials.
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Affiliation(s)
- Franciele Angelo Deus
- Posgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | | | - Vinícius Cunha Oliveira
- Posgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
- Postgraduate Program in Rehabilitation and Functional Performance and Postgraduate Program in Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Pedro Henrique Scheidt Figueiredo
- Posgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Henrique Silveira Costa
- Posgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Diego Mendes Xavier
- Posgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Wellington Fabiano Gomes
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Vanessa Pereira Lima
- Posgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
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Lee BA. Effect of exposure to disinfection by-products during swimming exercise on asthma-related immune responses. JOURNAL OF WATER AND HEALTH 2024; 22:735-745. [PMID: 38678426 DOI: 10.2166/wh.2024.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/13/2024] [Indexed: 04/30/2024]
Abstract
Swimming is a widely practiced exercise in modern society, where there is a heightened interest in health. The exceptional benefits of swimming are well-known, yet the issue of water quality management inevitably arises due to its nature as an aquatic exercise. Several studies reported that chlorine disinfectants commonly used in swimming pool water disinfection could degrade into toxic disinfection by-products (DBPs) and suggested that the DBPs might induce respiratory disorders, including asthma. Conversely, there were also reports that the DBPs had no significant effects on respiratory conditions. In this study, we investigated the influence of swimming exercise and DBPs on asthma. The decomposition products had little effect on the number of T cells in various immune organs. However, swimming exercise was found to increase the cell count in proportion to the exercise duration. Nevertheless, there were no significant changes in other immune cells and the secretion of asthma-related cytokines. These findings indicate that the effects of swimming pool DBPs on respiratory conditions during swimming exercise are either negligible or absent, and instead, the immunological benefits gained through consistent swimming exercise outweigh any potential drawbacks.
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Affiliation(s)
- Bo-Ae Lee
- Department of Sport Science, College of Liberal Arts, Dongguk University, 38066 Gyeongsangbuk-do, Gyeongju, South Korea E-mail:
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Klain A, Giovannini M, Pecoraro L, Barni S, Mori F, Liotti L, Mastrorilli C, Saretta F, Castagnoli R, Arasi S, Caminiti L, Gelsomino M, Indolfi C, Del Giudice MM, Novembre E. Exercise-induced bronchoconstriction, allergy and sports in children. Ital J Pediatr 2024; 50:47. [PMID: 38475842 DOI: 10.1186/s13052-024-01594-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 01/09/2024] [Indexed: 03/14/2024] Open
Abstract
Exercise-induced bronchoconstriction (EIB) is characterized by the narrowing of airways during or after physical activity, leading to symptoms such as wheezing, coughing, and shortness of breath. Distinguishing between EIB and exercise-induced asthma (EIA) is essential, given their divergent therapeutic and prognostic considerations. EIB has been increasingly recognized as a significant concern in pediatric athletes. Moreover, studies indicate a noteworthy prevalence of EIB in children with atopic predispositions, unveiling a potential link between allergic sensitivities and exercise-induced respiratory symptoms, underpinned by an inflammatory reaction caused by mechanical, environmental, and genetic factors. Holistic management of EIB in children necessitates a correct diagnosis and a combination of pharmacological and non-pharmacological interventions. This review delves into the latest evidence concerning EIB in the pediatric population, exploring its associations with atopy and sports, and emphasizing the appropriate diagnostic and therapeutic approaches by highlighting various clinical scenarios.
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Affiliation(s)
- Angela Klain
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138, Naples, Italy.
| | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
- Department of Health Sciences, University of Florence, 50139, Florence, Italy
| | - Luca Pecoraro
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126, Verona, Italy
| | - Simona Barni
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
| | - Francesca Mori
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
| | - Lucia Liotti
- Pediatric Unit, Department of Mother and Child Health, Salesi Children's Hospital, 60123, Ancona, Italy
| | - Carla Mastrorilli
- Pediatric and Emergency Department, Pediatric Hospital Giovanni XXIII, AOU Policlinic of Bari, 70126, Bari, Italy
| | - Francesca Saretta
- Pediatric Department, Latisana-Palmanova Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100, Udine, Italy
| | - Riccardo Castagnoli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100, Pavia, Italy
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, 27100, Pavia, Italy
| | - Stefania Arasi
- Translational Research in Pediatric Specialties Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, 00165, Rome, Italy
| | - Lucia Caminiti
- Allergy Unit, Department of Pediatrics, AOU Policlinico Gaetano Martino, 98124, Messina, Italy
| | - Mariannita Gelsomino
- Department of Life Sciences and Public Health, Pediatric Allergy Unit, University Foundation Policlinico Gemelli IRCCS, Catholic University of the Sacred Heart, 00168, Rome, Italy
| | - Cristiana Indolfi
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138, Naples, Italy
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138, Naples, Italy
| | - Elio Novembre
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
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4
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Lee BA. Effects of disinfection by-products in swimming pool environments on the immunological mechanisms of respiratory diseases. JOURNAL OF WATER AND HEALTH 2023; 21:1600-1610. [PMID: 37902213 PMCID: wh_2023_335 DOI: 10.2166/wh.2023.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Swimming in pools is a popular and healthy recreational activity. However, potential adverse health effects from disinfection byproduct (DBP) exposure in pool water are concerning. This study evaluated how such DBP exposure affects the respiratory system. DBP exposure was simulated with an animal-specific pool environment model. Experimental animals were exposed to DBPs for a specified duration and frequency over 4 weeks. The wet and dry weights of murine lungs were measured, with no significant differences observed. There were no significant differences in interkeukin (IL)-2/4/10, and interferon-γ levels. However, IL-6 expression decreased in the experimental group. To investigate the effects of DBP exposure on immune cell response, various samples, such as bronchoalveolar lavage fluid, lymph nodes, spleen, and thymus, were collected for T-cell isolation and fluorescence-activated cell sorting. Asthma-related blood cell distribution was analyzed using a complete blood count test; no significant differences were found. Thus, DBP exposure through this model did not induce substantial lung tissue damage, major alterations in cytokine expression (besides IL-6), significant immune cell responses, or changes in asthma-associated blood cell distribution. However, considering earlier results, future studies should focus on specific types, intensity, and duration of exercise that could affect DBP exposure-related immune-inflammatory responses.
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Affiliation(s)
- Bo-Ae Lee
- Department of Sport Science, College of Liberal Arts, Dongguk University, 38066, Gyeongsangbuk-do, Gyeongju, South Korea E-mail:
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5
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Mitri EJ, Ferhani S, Gao J, Cardenas V, Espinola JA, Mehta G, Hasegawa K, Camargo CA. Chlorinated pool exposure, allergic sensitization, and risk of age 5-year asthma. Pediatr Res 2023; 94:1254-1257. [PMID: 37165036 DOI: 10.1038/s41390-023-02615-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 11/17/2022] [Accepted: 04/07/2023] [Indexed: 05/12/2023]
Affiliation(s)
- Elie J Mitri
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Sabrina Ferhani
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jingya Gao
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Vanessa Cardenas
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Janice A Espinola
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Geneva Mehta
- Division of Allergy and Clinical Immunology, Brigham & Women's Hospital, Boston, MA, USA
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
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Ahmadpour E, Delpla I, Debia M, Simard S, Proulx F, Sérodes JB, Valois I, Tardif R, Haddad S, Rodriguez M. Full-scale multisampling and empirical modeling of DBPs in water and air of indoor pools. ENVIRONMENTAL MONITORING AND ASSESSMENT 2023; 195:1128. [PMID: 37650940 DOI: 10.1007/s10661-023-11619-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 07/19/2023] [Indexed: 09/01/2023]
Abstract
Disinfection by-products (DBPs) are formed in the water in swimming pools due to reactions between disinfectants (chlorine, bromine, ozone) and the organic matter introduced by bathers and supply water. High concentrations of DBPs are also reported in the air of indoor swimming pools. Based on a robust multisampling program, the levels and variations of DBPs in the air (trichloramine [TCAM] and trihalomethanes [THMs]) and water (THM) were assessed, as well as their precursors (total organic carbon, water temperature, pH, free, and total chlorine) and proxies (CO2 and relative humidity) in four indoor chlorinated swimming pools. High-frequency sampling was conducted during one high-attendance day for each pool. This study focused on parameters that are easy to measure in order to develop models for predicting levels of THMs and TCAM in the air. The results showed that the number of bathers had an important impact on the levels of THMs and TCAM, with a two-to-three-fold increase in air chloroform (up to 110 μg/m3) and a two-to-four-fold increase in TCAM (up to 0.52 mg/m3) shortly after pools opened. The results of this study for the first time showed that CO2 and relative humidity can serve as proxies for monitoring variations in airborne THMs and TCAM. Our results highlight the good predictive capacity of the developed models and their potential for use in day-to-day monitoring. This could help optimize and control DBPs formation in the air of indoor swimming pools and reduce contaminant exposure for both pool employees and users.
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Affiliation(s)
- Elham Ahmadpour
- Department of Occupational & Environmental Health, School of Public Health, Universite de Montreal, 2900, Boulevard Edouard-Montpetit, Montreal, QC, H3T 1J4, Canada
| | - Ianis Delpla
- Ecole superieure d'amenagement du territoire et de developpement regional (ESAD), Université Laval, Pavillon F-A. Savard, 2325, rue des Bibliothèques, local 1612, Quebec, QC, G1V 0A6, Canada.
| | - Maximilien Debia
- Department of Occupational & Environmental Health, School of Public Health, Universite de Montreal, 2900, Boulevard Edouard-Montpetit, Montreal, QC, H3T 1J4, Canada
| | - Sabrina Simard
- Ecole superieure d'amenagement du territoire et de developpement regional (ESAD), Université Laval, Pavillon F-A. Savard, 2325, rue des Bibliothèques, local 1612, Quebec, QC, G1V 0A6, Canada
| | - François Proulx
- Ecole superieure d'amenagement du territoire et de developpement regional (ESAD), Université Laval, Pavillon F-A. Savard, 2325, rue des Bibliothèques, local 1612, Quebec, QC, G1V 0A6, Canada
| | - Jean-Baptiste Sérodes
- Ecole superieure d'amenagement du territoire et de developpement regional (ESAD), Université Laval, Pavillon F-A. Savard, 2325, rue des Bibliothèques, local 1612, Quebec, QC, G1V 0A6, Canada
| | - Isabelle Valois
- Department of Occupational & Environmental Health, School of Public Health, Universite de Montreal, 2900, Boulevard Edouard-Montpetit, Montreal, QC, H3T 1J4, Canada
| | - Robert Tardif
- Department of Occupational & Environmental Health, School of Public Health, Universite de Montreal, 2900, Boulevard Edouard-Montpetit, Montreal, QC, H3T 1J4, Canada
| | - Sami Haddad
- Department of Occupational & Environmental Health, School of Public Health, Universite de Montreal, 2900, Boulevard Edouard-Montpetit, Montreal, QC, H3T 1J4, Canada
| | - Manuel Rodriguez
- Ecole superieure d'amenagement du territoire et de developpement regional (ESAD), Université Laval, Pavillon F-A. Savard, 2325, rue des Bibliothèques, local 1612, Quebec, QC, G1V 0A6, Canada
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7
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Abilleira E, Goñi-Irigoyen F, Aurrekoetxea JJ, Cortés MA, Ayerdi M, Ibarluzea J. Swimming pool water disinfection by-products profiles and association patterns. Heliyon 2023; 9:e13673. [PMID: 36865475 PMCID: PMC9970905 DOI: 10.1016/j.heliyon.2023.e13673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/07/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
The aim of this work was to determine and study the concentration of different groups of disinfection by-products (DBPs): trihalomethanes, haloacetic acids, haloacetonitriles, haloacetones and combined chlorine (as an indicator of chloramine levels), in the water of 175 public swimming pools in Gipuzkoa (Basque Country, Spain). The study included chlorinated and brominated pools, indoor and outdoor, used for recreational and sports purposes, and filled with water from calcareous and siliceous soils. The most abundant were haloacetic acids, followed by trihalomethanes, with chlorinated or brominated forms predominating depending on whether the pools were disinfected by chlorination or bromination, respectively. All the 75th percentiles of DBPs were below the limits established by the European Chemical Agency (ECHA), although the maximum values of trihalomethanes exceeded them. The same was true for dichloroacetonitrile in chlorinated pools and dibromoacetonitrile in brominated pools. All families of DBPs showed positive associations with each other, all being significant except for combined chlorine. Their mean levels were higher in outdoor pools than in indoor pools, significantly so in all except combined chlorine. Recreational pools showed higher levels of haloacetic acids and combined chlorine than sports pools. The concentrations of the different groups of DBPs were higher in the pools than in the mains water that fed them. This increase, especially that of the haloacetonitriles, as well as the high concentrations of brominated forms in the pools disinfected by bromination, make it necessary to focus on their toxicological implication. The differences in the DBP profiles of the filling network water were not transferred to the pool water.
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Affiliation(s)
- Eunate Abilleira
- Ministry of Health of the Basque Government, Public Health Laboratory in Gipuzkoa, Av. Navarra, 4, 20013 Donostia-San Sebastián, Spain,Epidemiology of Chronic and Comunnicable Diseases Area, Biodonostia Health Research Institute, P° Dr. Beguiristain s/n, 20014, Donostia-San Sebastián, Spain,Corresponding author. Ministry of Health of the Basque Government, Public Health Laboratory in Gipuzkoa, Av. Navarra, 4, 20013, Donostia-San Sebastián, Spain.
| | - Fernando Goñi-Irigoyen
- Ministry of Health of the Basque Government, Public Health Laboratory in Gipuzkoa, Av. Navarra, 4, 20013 Donostia-San Sebastián, Spain,Epidemiology of Chronic and Comunnicable Diseases Area, Biodonostia Health Research Institute, P° Dr. Beguiristain s/n, 20014, Donostia-San Sebastián, Spain,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain
| | - Juan J. Aurrekoetxea
- Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, P° Dr. Beguiristain s/n, 20014, Donostia-San Sebastián, Spain
| | - María A. Cortés
- Ministry of Health of Basque Government, Public Health Subdirectorate of Gipuzkoa, Av. Navarra, 4, 20013, Donostia-San Sebastián, Spain
| | - Mikel Ayerdi
- Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, P° Dr. Beguiristain s/n, 20014, Donostia-San Sebastián, Spain,Ministry of Health of Basque Government, Public Health Subdirectorate of Gipuzkoa, Av. Navarra, 4, 20013, Donostia-San Sebastián, Spain
| | - Jesús Ibarluzea
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain,Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, P° Dr. Beguiristain s/n, 20014, Donostia-San Sebastián, Spain,Ministry of Health of Basque Government, Public Health Subdirectorate of Gipuzkoa, Av. Navarra, 4, 20013, Donostia-San Sebastián, Spain,Facultad de Psicología de la UPV-EHU, Campus Gipuzkoa, Av. Tolosa, 70, 20018, Donostia-San Sebastián, Spain
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8
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Zaccarin M, Zanni S, Gallè F, Protano C, Valeriani F, Liguori G, Romano Spica V, Vitali M. Studying Respiratory Symptoms Related to Swimming Pools Attendance in Young Athletes: The SPHeRA Study. TOXICS 2022; 10:toxics10120759. [PMID: 36548592 PMCID: PMC9784475 DOI: 10.3390/toxics10120759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/30/2022] [Accepted: 12/03/2022] [Indexed: 05/14/2023]
Abstract
This study investigates the prevalence of respiratory symptoms and the training factors possibly associated with them in a sample of young Italian competitive swimmers. A questionnaire about training information and symptoms was administered to participants during the winter and summer 2021 training seasons. In total, 396 athletes took part in the study. In the winter training subgroup (n = 197), we found significant associations between increasing training hours per session and the presence of nasal congestion/rhinorrhoea (OR = 3.10; p = 0.039) and cough (OR = 3.48; p = 0.015). Total training hours per week were significantly associated with nasal congestion/rhinorrhoea (OR = 1.12; p = 0.010). In the summer group (n = 199), the same factors were not associated with respiratory symptoms. Having an allergy was significantly related to nasal congestion/rhinorrhea in both the logistic models (model 1 OR = 2.69, p = 0.013; model 2 OR = 2.70, p = 0.012), while having asthma significantly increased the risk of coughing (OR = 3.24, p = 0.033). The kind of environment (indoor or outdoor facilities) did not affect the studied symptoms either in summer or winter. Further investigations are needed to better understand the mechanisms involved in the development of respiratory symptoms in swimmers, particularly on how inflammation and remodelling develop and which environmental conditions can favour these processes.
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Affiliation(s)
- Matteo Zaccarin
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Stefano Zanni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy
| | - Carmela Protano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence:
| | - Federica Valeriani
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy
| | - Vincenzo Romano Spica
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
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Young I, Robillard P, Loeffler P, Sekercioglu F. Determinants of bather hygiene in public swimming pools: a mixed-methods analysis of online discussion comments. JOURNAL OF WATER AND HEALTH 2022; 20:877-887. [PMID: 35768964 DOI: 10.2166/wh.2022.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Swimming in public pools can expose bathers to microbiological (e.g., Cryptosporidium) and chemical (e.g., disinfection by-product) hazards, which can lead to recreational water illness. Adequate hygienic behaviours among bathers are important to reduce these risks. However, prior studies have found low compliance with pre-swim showering and avoidance of urinating in pools. We conducted a mixed-methods analysis of online discussion comments to identify key determinants of these two behaviours. We identified relevant discussion threads on Reddit, Quora, and swimming forums. Identified comments were classified as having a positive or negative sentiment towards the behaviour, and they were thematically analyzed according to the Theoretical Domains Framework (TDF). We analyzed 986 comments from 45 threads; 49.8% of comments were classified as expressing a positive sentiment towards the behaviour. Positive sentiments were more commonly expressed towards pre-swim showering compared to avoidance of urinating in pools (60.1 vs. 47.1%). Eleven themes were identified across the following eight TDF domains: beliefs about consequences (n = 362 comments), social influences (n = 298), beliefs about capabilities (n = 240), social/professional role and identity (n = 144), knowledge (n = 138), emotions (n = 137), reinforcement (n = 78), and environmental context and resources (n = 33). Results can help to inform targeted educational and outreach strategies with bathers to encourage increased adoption of hygienic behaviours.
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Affiliation(s)
- Ian Young
- School of Occupational and Public Health, Toronto Metropolitan University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada E-mail:
| | - Paige Robillard
- School of Occupational and Public Health, Toronto Metropolitan University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada E-mail:
| | - Pauline Loeffler
- School of Occupational and Public Health, Toronto Metropolitan University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada E-mail:
| | - Fatih Sekercioglu
- School of Occupational and Public Health, Toronto Metropolitan University, 350 Victoria Street, Toronto, Ontario M5B 2K3, Canada E-mail:
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10
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Costa C, Assunção R, Sequeira D, Esteves F, Valdiglesias V, Laffon B, Teixeira JP, Madureira J. From trihalomethanes chronic daily intake through multiple exposure routes to cancer and non-cancer health risk assessment: Evidence from public Portuguese indoor swimming pools facilities using a probabilistic approach. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 818:151790. [PMID: 34808171 DOI: 10.1016/j.scitotenv.2021.151790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/27/2021] [Accepted: 11/14/2021] [Indexed: 06/13/2023]
Abstract
This study aimed to estimate chronic daily intake (CDI) and to predict the attributable lifetime cancer risk (LCR) and hazard index (HI) from concurrent exposure to four trihalomethanes (THMs; chloroform, bromodichloromethane, dibromochloromethane and bromoform), via multiple exposure routes (oral ingestion, dermal contact and inhalation), among 238 non-competitive attendees of 10 Portuguese public indoor swimming pools (SPs), using a probabilistic approach based on Monte Carlo simulations. Exposure parameters of study participants were collected via questionnaires and THMs levels in SPs water were determined according the respective normative standards. The CDI for total THMs calculated for male and female participants considering all routes was 7.52 and 8.97 mg/kg/day, respectively. SP attendees presented higher CDI through inhalation than via the other two exposure routes, and chloroform was the compound contributing the most to total THMs CDI. The risk analysis indicated that the total LCR and HI from the targeted THMs were higher than the negligible risk levels (1 × 10-6 and 1, respectively) in the scenarios examined (central tendency exposure and reasonable maximum exposure), and the health risk for females was slightly higher than for males. This study suggests that there are possible adverse health risks, thus, to protect pool attendees, adequate mitigation measures, and comprehensive regulatory guidelines on individual THMs concentrations are needed.
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Affiliation(s)
- Carla Costa
- Environmental Health Department, National Institute of Health, Rua Alexandre Herculano 321, 4000-055 Porto, Portugal; EPIUnit-Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Ricardo Assunção
- CESAM-Centre for Environmental and Marine Studies, University of Aveiro, 3810-193 Aveiro, Portugal; Food and Nutrition Department, National Institute of Health, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Diana Sequeira
- EPIUnit-Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Filipa Esteves
- Environmental Health Department, National Institute of Health, Rua Alexandre Herculano 321, 4000-055 Porto, Portugal; EPIUnit-Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Vanessa Valdiglesias
- Universidade da Coruña, Grupo DICOMOSA, Centro de Investigaciones Científicas Avanzadas (CICA), Departamento de Biología, Facultad de Ciencias, Campus A Zapateira s/n, 15071 A Coruña, Spain; Instituto de Investigación Biomédica de A Coruña (INIBIC), AE CICA-INIBIC, Oza, 15071 A Coruña, Spain
| | - Blanca Laffon
- Instituto de Investigación Biomédica de A Coruña (INIBIC), AE CICA-INIBIC, Oza, 15071 A Coruña, Spain; Universidade da Coruña, Grupo DICOMOSA, Centro de Investigaciones Científicas Avanzadas (CICA), Departamento de Psicología, Facultad de Ciencias de la Educación, Campus Elviña s/n, 15071 A Coruña, Spain
| | - João Paulo Teixeira
- Environmental Health Department, National Institute of Health, Rua Alexandre Herculano 321, 4000-055 Porto, Portugal; EPIUnit-Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal.
| | - Joana Madureira
- Environmental Health Department, National Institute of Health, Rua Alexandre Herculano 321, 4000-055 Porto, Portugal; EPIUnit-Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal
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11
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Mustapha S, Jimoh T, Ndamitso M, Abdulkareem SA, Taye SD, Mohammed AK, Amigun AT. The Occurrence of N-nitrosodimethylamine (NDMA) in Swimming Pools: An Overview. ENVIRONMENTAL HEALTH INSIGHTS 2021; 15:11786302211036520. [PMID: 34376989 PMCID: PMC8335839 DOI: 10.1177/11786302211036520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 07/12/2021] [Indexed: 05/23/2023]
Abstract
The occurrence of several disinfectant byproducts has been investigated in swimming pools. Until now, there are only a few studies on nitrosamine, particularly N-nitrosodimethylamine in swimming pool water. This could be due to the lack of a suitable method that is sensitive enough for the measurement of N-nitrosodimethylamine in pool waters. Other disinfectant byproducts formed in pool water widely documented are trihalomethanes, haloacetic acids, halonitromethanes, and chloramines but inadequate information on N-nitrosodimethylamine. This paper provides a review of the nitrogenous disinfectant byproduct in swimming pools and its health implications. Anthropogenic substances introduced by swimmers such as sweat, lotions, and urine contribute to the formation of N-nitrosodimethylamine. The reaction of secondary amines such as dimethylamine with mono/dichloroamines produced dimethyl hydrazine and further undergo oxidation to form N-nitrosodimethylamine. The reaction of chlorine and other disinfectants with these anthropogenic sources in swimming pools cause cancer and asthma in human tissues. Thus, the assessment of N-nitrosodimethylamine in the swimming pool is less well documented. Therefore, the health consequences, mutagenic, and genotoxic potentials of N-nitrosodimethylamine should be the focus of more research studies.
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Affiliation(s)
- Saheed Mustapha
- Department of Chemistry, Federal University of Technology, Minna, Nigeria
- Nanotechnology Research Group, Center for Genetic Engineering and Biotechnology, Federal University of Technology, Minna, Niger, Nigeria
| | - Tijani Jimoh
- Department of Chemistry, Federal University of Technology, Minna, Nigeria
- Nanotechnology Research Group, Center for Genetic Engineering and Biotechnology, Federal University of Technology, Minna, Niger, Nigeria
| | - Muhammed Ndamitso
- Department of Chemistry, Federal University of Technology, Minna, Nigeria
- Nanotechnology Research Group, Center for Genetic Engineering and Biotechnology, Federal University of Technology, Minna, Niger, Nigeria
| | - Saka Ambali Abdulkareem
- Nanotechnology Research Group, Center for Genetic Engineering and Biotechnology, Federal University of Technology, Minna, Niger, Nigeria
- Department of Chemical Engineering, Federal University of Technology, Minna, Niger, Nigeria
| | - Shuaib Damola Taye
- Department of Chemistry, Illinois Institute of Technology, Chicago, IL, USA
| | - Abdul Kabir Mohammed
- Department of Chemistry and Biochemistry, North Carolina Central University, Durham, NC, USA
| | - Azeezah Taiwo Amigun
- Department of Chemical and Geological Sciences, Al-Hikmah University, Ilorin, Nigeria
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12
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Sciuto EL, Corso D, Libertino S, van der Meer JR, Faro G, Coniglio MA. A Miniaturized Microbe-Silicon-Chip Based on Bioluminescent Engineered Escherichia coli for the Evaluation of Water Quality and Safety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147580. [PMID: 34300030 PMCID: PMC8304097 DOI: 10.3390/ijerph18147580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 01/24/2023]
Abstract
Conventional high throughput methods assaying the chemical state of water and the risk of heavy metal accumulation share common constraints of long and expensive analytical procedures and dedicated laboratories due to the typical bulky instrumentation. To overcome these limitations, a miniaturized optical system for the detection and quantification of inorganic mercury (Hg2+) in water was developed. Combining the bioactivity of a light-emitting mercury-specific engineered Escherichia coli—used as sensing element—with the optical performance of small size and inexpensive Silicon Photomultiplier (SiPM)—used as detector—the system is able to detect mercury in low volumes of water down to the concentration of 1 µg L−1, which is the tolerance value indicated by the World Health Organization (WHO), providing a highly sensitive and miniaturized tool for in situ water quality analysis.
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Affiliation(s)
- Emanuele Luigi Sciuto
- Azienda Ospedaliero Universitaria Policlinico “G. Rodolico-San Marco”, Via S. Sofia 78, 95123 Catania, Italy;
| | - Domenico Corso
- Istituto per la Microelettronica e Microsistemi–Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy
- Correspondence: (D.C.); (S.L.); (M.A.C.)
| | - Sebania Libertino
- Istituto per la Microelettronica e Microsistemi–Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy
- Correspondence: (D.C.); (S.L.); (M.A.C.)
| | - Jan Roelof van der Meer
- Department of Fundamental Microbiology, Bâtiment Biophore, University of Lausanne, 1015 Lausanne, Switzerland;
| | - Giuseppina Faro
- Azienda Sanitaria Provinciale di Catania, Via S. Maria La Grande 5, 95124 Catania, Italy;
| | - Maria Anna Coniglio
- Azienda Ospedaliero Universitaria Policlinico “G. Rodolico-San Marco”, Via S. Sofia 78, 95123 Catania, Italy;
- Istituto per la Microelettronica e Microsistemi–Consiglio Nazionale delle Ricerche (CNR-IMM), Ottava Strada 5, 95121 Catania, Italy
- Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis, Catania, Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, Via Sofia 87, 95123 Catania, Italy
- Correspondence: (D.C.); (S.L.); (M.A.C.)
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13
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Wang G, Han D, Jiang Z, Li M, Yang S, Liu L. Association between early bronchiolitis and the development of childhood asthma: a meta-analysis. BMJ Open 2021; 11:e043956. [PMID: 34049905 PMCID: PMC8166632 DOI: 10.1136/bmjopen-2020-043956] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE Early life bronchiolitis has been hypothesised to be associated with the subsequent risk of persistent wheezing or asthma. However, the link remains controversial. The objective of our study was to evaluate the association between bronchiolitis before 2 years of age and the late-onset wheezing/asthma. DESIGN Systematic review and meta-analysis. METHODS PubMed, Embase and Web of Science databases were systematically searched for studies published between 1955 and January 2020. Meanwhile, we also checked through the reference lists of relevant articles to see whether these references included reports of other studies that might be eligible for the review. Cohort and case-control studies assessing the association between early-life bronchiolitis and late-onset wheezing/asthma were included in this meta-analysis. Data were extracted by two independent reviewers. Results were pooled using a random-effects model or fixed-effects model according to the heterogeneity among studies. RESULTS 32 original articles with 292 844 participants, which met the criteria, were included in this meta-analysis. Bronchiolitis before 2 years of age was associated with an increased risk of subsequent wheezing/asthma (relative risk=2.46, 95% CI 2.14 to 2.82, p<0.001). After categorising studies into different groups based on age at the end of follow-up, geographical region and study quality, the association still remained significant. CONCLUSIONS The meta-analysis indicates an association between bronchiolitis before 2 years of age and the wheezing/asthma in later life. Well-designed and highly standardised prospective studies that better address bias due to potential confounding factors are needed to validate the risk identified in our meta-analysis.PROSPERO registration numberCRD42018089453.
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Affiliation(s)
- Guizuo Wang
- Department of Respiratory and Critical Care Medicine, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Dong Han
- Department of Respiratory and Critical Care Medicine, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Zhengdong Jiang
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Manxiang Li
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shumei Yang
- Department of Respiratory and Critical Care Medicine, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Lu Liu
- Department of Respiratory and Critical Care Medicine, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
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14
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LORENSIA AMELIA, MUNTU CYNTHIAMARISCA, SURYADINATA RIVANVIRLANDO, SEPTIANI ROSLIN. Effect of lung function disorders and physical activity on smoking and non-smoking students. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E89-E96. [PMID: 34322622 PMCID: PMC8283647 DOI: 10.15167/2421-4248/jpmh2021.62.1.1763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 01/04/2021] [Indexed: 11/16/2022]
Abstract
Background The number of young smokers is increasing, and hence their risk of respiratory problems. This risk is exacerbated by their low level of physical activity, which also reduces lung function. This study aimed to determine differences in lung function and levels of physical activity between smokers and non-smokers. Method This research was conducted from October 2019 to January 2020. The research design was cross-sectional, and a purposive sampling method was used. Pulmonary function was measured by means of spirometry, while physical activity was measured through a modified International Physical Activity Questionnaire (IPAQ). Results We enrolled 124 university students: 62 smokers and 62 non-smokers. A significant difference in lung function values (< 70 vs ≥ 70) was observed between smokers and non-smokers (p = 0.00). No difference (p = 0.907) in the level of physical activity was seen between smokers and non-smokers, with most subjects in both groups displaying moderate levels. Conclusions Students who smoked had more respiratory problems than those who did not. Although the level of physical activity did not correlate with respiratory problems, these problems were more common in the vigorous catgory.
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Affiliation(s)
- AMELIA LORENSIA
- Department of Clinical-Community Pharmacy, Faculty of Pharmacy, Universitas Surabaya (UBAYA), Indonesia
- Correspondence: Amelia Lorensia, Fakultas Farmasi Universitas Surabaya (UBAYA), Jl. Raya Kalirungkut Surabaya 60293, Indonesia - E-mail: -
| | - CYNTHIA MARISCA MUNTU
- Department of Pharmaceutical, Faculty of Pharmacy, Universitas Surabaya (UBAYA), Indonesia
| | | | - ROSLIN SEPTIANI
- Bachelor Student of Faculty of Pharmacy, Faculty of Pharmacy, Universitas Surabaya (UBAYA), Indonesia
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15
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Ramachandran HJ, Jiang Y, Shan CH, Tam WWS, Wang W. A systematic review and meta-analysis on the effectiveness of swimming on lung function and asthma control in children with asthma. Int J Nurs Stud 2021; 120:103953. [PMID: 34051586 DOI: 10.1016/j.ijnurstu.2021.103953] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/02/2021] [Accepted: 04/14/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Swimming has been considered the most appropriate activity for children with asthma for its lower asthmogenicity compared to land-based activities. However, the benefits of swimming have been hampered by reports of increased asthma risks, airway inflammation and bronchial hyper-responsiveness from exposure to chlorine by-products in swimming pools. Thus, the role of swimming for children with asthma remains unclear. OBJECTIVES To determine the effectiveness of swimming as an intervention on lung function and asthma control in children below the age of 18 years. Any adverse effects from swimming on asthma were also examined. METHODS Searches were performed across six databases systematically (PubMed, CINAHL, Embase, CENTRAL, Scopus, and PsycINFO). Randomized controlled trials (RCTs), quasi-experimental studies and interventional studies with at least one control/comparator group that were published in English were included. All eligible studies were screened with risk of bias examined by two independent reviewers. Meta-analyses were conducted using Review Manager 5.4 software while narrative syntheses were performed where meta-analysis was inappropriate and heterogeneity was present. RESULTS 1710 records were retrieved from the search. A total of 9 studies with 387 participants were included in this review after screening. Swimming was found to have favourable effects on forced expiratory volume in one second (L) and forced vital capacity (%), but not for forced expiratory volume in one second (%) and peak expiratory flow (%). Narrative synthesis on asthma control and adverse effects were in favour of the swimming group. CONCLUSION Future studies that are adequately powered, involve swimming interventions of sufficient intensity, frequency and duration, examine cumulative exposures to chlorine by-products and take into account potential cofounders are warranted.
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Affiliation(s)
- Hadassah Joann Ramachandran
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
| | - Ying Jiang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
| | - Coral Hui Shan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
| | - Wilson Wai San Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
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16
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Irahara M, Yamamoto-Hanada K, Yang L, Saito-Abe M, Sato M, Inuzuka Y, Toyokuni K, Nishimura K, Ishikawa F, Miyaji Y, Fukuie T, Narita M, Ohya Y. Impact of swimming school attendance in 3-year-old children with wheeze and rhinitis at age 5 years: A prospective birth cohort study in Tokyo. PLoS One 2020; 15:e0234161. [PMID: 32516323 PMCID: PMC7282662 DOI: 10.1371/journal.pone.0234161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/19/2020] [Indexed: 11/18/2022] Open
Abstract
Background In Japan, swimming school attendance is promoted as a form of therapy or as a prophylactic measure against asthma in young children. However, the putative beneficial effects have not been sufficiently verified. Objective The aim of the present study was to clarify whether or not swimming school attendance at age 3 years affects the onset and/or improvement of wheeze and rhinitis at age 5 years. Methods This study was a single-center, prospective, general, longitudinal cohort study (T-CHILD Study). Between November 2003 and December 2005, 1776 pregnant women were enrolled, and their offspring were followed up until age 5 years. Swimming school attendance at age 3 years and the presence of wheeze and/or rhinitis in the previous one year were examined using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The relationship between swimming school attendance and wheeze and/or rhinitis was analyzed using multivariable logistic regression analysis. Results Data on the 1097 children were analyzed. At age 3 years, 126 (11.5%) children attended a swimming school, and at age 5 years, the prevalence of wheeze was 180 (16.4%) while that of rhinitis was 387 (35.3%). Swimming school attendance at age 3 showed no significant relationship with the development of either wheeze (aOR 0.83, 95% CI (0.43–1.60) or rhinitis (aOR 0.80, 95% CI (0.43–1.60) at age 5. Conclusions Swimming school attendance at age 3 years showed neither a preventive nor therapeutic effect on wheeze or rhinitis at age 5 years. There is thus no scientific evidence yet that swimming school attendance has a positive impact on the development of childhood wheeze or rhinitis.
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Affiliation(s)
- Makoto Irahara
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | | | - Limin Yang
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Mayako Saito-Abe
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Miori Sato
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yusuke Inuzuka
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kenji Toyokuni
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Koji Nishimura
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Fumi Ishikawa
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yumiko Miyaji
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tatsuki Fukuie
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Masami Narita
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
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17
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Lagière J, Labarthe S, Dubourg K, Bauduer F. Influence of hydrotherapy pool water recirculation regime on Staphylococcus species concentration at subsurface: Preliminary experimental data from a pilot. ENVIRONMENT INTERNATIONAL 2020; 136:105382. [PMID: 31884410 DOI: 10.1016/j.envint.2019.105382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/31/2019] [Accepted: 12/01/2019] [Indexed: 06/10/2023]
Abstract
Pools are prone to contamination from microbial pathogens from human external microbiota, including mainly Staphylococcus species. These bacteria originate mainly from the skin and rhinopharynx and tend to concentrate at the surface/subsurface. Being protected by films derived from mucus and sebum, they are markedly resistant to biocides. Our study aimed to evaluate the respective impact of mixed and reverse hydraulicity techniques on the concentration of Staphylococcus species at the subsurface following bathing by four individuals in an experimental pool. Disinfection, filtration and water renewal of the pool were stopped in order to study only the influence of the water recirculation regime. We found a significant reduction of 31.7% (Test 1), 50.9% (Test 2) and 41.9% (Test 3) in total Staphylococcus species counts at the subsurface when using reverse versus mixed hydraulicity. However, this reduction is not a pollution cut but a pollution shift, resulting from an increase in the outlet water flow rate by overflow channel from 49.3 to 100%. This experimental model was far removed from real life conditions and associated with a series of limitations. However, it seems that the type of water recirculation regime is a critical factor in the bacterial quality of pool water. These preliminary findings need to be confirmed in additional studies using more realistic conditions.
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Affiliation(s)
- Joël Lagière
- Institut du Thermalisme, Université de Bordeaux, 8, Rue Ste Ursule, 40100 Dax, France
| | - Sébastien Labarthe
- Institut du Thermalisme, Université de Bordeaux, 8, Rue Ste Ursule, 40100 Dax, France.
| | - Karine Dubourg
- Institut du Thermalisme, Université de Bordeaux, 8, Rue Ste Ursule, 40100 Dax, France
| | - Frédéric Bauduer
- Institut du Thermalisme, Université de Bordeaux, 8, Rue Ste Ursule, 40100 Dax, France
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18
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Heaney LM, Kang S, Turner MA, Lindley MR, Thomas CLP. Evidence for alternative exhaled elimination profiles of disinfection by-products and potential markers of airway responses to swimming in a chlorinated pool environment. INDOOR AIR 2020; 30:284-293. [PMID: 31814168 DOI: 10.1111/ina.12630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 10/28/2019] [Accepted: 12/04/2019] [Indexed: 06/10/2023]
Abstract
Chlorine-based disinfectants protect pool water from pathogen contamination but produce potentially harmful halogenated disinfection by-products (DBPs). This study characterized the bioaccumulation and elimination of exhaled DBPs post-swimming and investigated changes in exhaled breath profiles associated with chlorinated pool exposure. Nineteen participants provided alveolar-enriched breath samples prior to and 5, 90, 300, 510, and 600 minutes post-swimming. Known DBPs associated with chlorinated water were quantitated by thermal desorption-gas chromatography-mass spectrometry. Two distinct exhaled DBP elimination profiles were observed. Most participants (84%) reported peak concentrations immediately post-swimming that reduced exponentially. A sub-group exhibited a previously unobserved and delayed washout profile with peak levels at 90 minutes post-exposure. Metabolomic investigations tentatively identified two candidate biomarkers associated with swimming pool exposure, demonstrating an upregulation in the hours after exposure. These data demonstrated a hitherto undescribed exhaled DBP elimination profile in a small number of participants which contrasts previous findings of uniform accumulation and exponential elimination. This sub-group which exhibited delayed peak-exhaled concentrations suggests the uptake, processing, and immediate elimination of DBPs are not ubiquitous across individuals as previously understood. Additionally, non-targeted metabolomics highlighted extended buildup of compounds tentatively associated with swimming in a chlorinated pool environment that may indicate airway responses to DBP exposure.
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Affiliation(s)
- Liam M Heaney
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Shuo Kang
- Centre for Analytical Science, Department of Chemistry, Loughborough University, Loughborough, UK
| | - Matthew A Turner
- Centre for Analytical Science, Department of Chemistry, Loughborough University, Loughborough, UK
| | - Martin R Lindley
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- Translational Chemical Biology Research Group, Loughborough University, Loughborough, UK
| | - Charles L Paul Thomas
- Centre for Analytical Science, Department of Chemistry, Loughborough University, Loughborough, UK
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19
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Margarucci LM, Romano Spica V, Gianfranceschi G, Valeriani F. Untouchability of natural spa waters: Perspectives for treatments within a personalized water safety plan. ENVIRONMENT INTERNATIONAL 2019; 133:105095. [PMID: 31518929 DOI: 10.1016/j.envint.2019.105095] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/09/2019] [Accepted: 08/11/2019] [Indexed: 06/10/2023]
Abstract
Natural SPA waters and their environments were known since ancient times and used for health or recreational purposes in different societies, worldwide. The composition and uses of these spring waters may not allow standard disinfection in pools, representing a challenge for hygiene management. Several safety and quality procedures were proposed, but a systematic approach is still needed. Here, we focus on alternative strategies to provide hints for developing a sustainable Water Safety Plan, based on intrinsic water properties and photocatalytic materials. The antimicrobial activity of four different SPA waters with high mineral content and one drinkable spring water with a low mineral content, was assessed and then tested for the additional bactericidal activity of Titanium Dioxide (TiO2) nanomaterials and/or light exposure at different wavelengths (200-635 nm). A native antibacterial activity was observed in all high mineral content waters, with a CFU reduction of 75-80%. The bactericidal action of TiO2 showed an additional incremental effect, with a reduction of over 99% within 2-5 h. Interestingly, the antibacterial photocatalytic effect was detected also in the visible light range, with a possible pick around 450-455 nm, blue-light. Based on observed results, we propose a model for developing a water safety plan, considering water properties and bather exposure. This candidate approach is personalized on water composition and pool use, trying to avoid chemical disinfectants. Photocatalytic nanotechnologies represent one of the promising alternative treatments and can provide novel perspectives for a sustainable managing of natural SPA water hygiene.
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Affiliation(s)
- Lory Marika Margarucci
- University of Rome "Foro Italico", Department of Movement, Human, and Health Sciences, Rome, Italy
| | - Vincenzo Romano Spica
- University of Rome "Foro Italico", Department of Movement, Human, and Health Sciences, Rome, Italy
| | - Gianluca Gianfranceschi
- University of Rome "Foro Italico", Department of Movement, Human, and Health Sciences, Rome, Italy
| | - Federica Valeriani
- University of Rome "Foro Italico", Department of Movement, Human, and Health Sciences, Rome, Italy.
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20
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Biosensors in Monitoring Water Quality and Safety: An Example of a Miniaturizable Whole-Cell Based Sensor for Hg2+ Optical Detection in Water. WATER 2019. [DOI: 10.3390/w11101986] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Inorganic mercury (Hg2+) pollution of water reserves, especially drinking water, is an important issue in the environmental and public health field. Mercury is reported to be one of the most dangerous elements in nature since its accumulation and ingestion can lead to a series of permanent human diseases, affecting the kidneys and central nervous system. All the conventional approaches for assaying Hg2+ have some limitations in terms of bulky instruments and the cost and time required for the analysis. Here, we describe a miniaturizable and high-throughput bioluminescence sensor for Hg2+ detection in water, which combines the specificity of a living bacterial Hg2+ reporter cell, used as sensing element, with the performance of a silicon photomultiplier, used as optical detector. The proposed system paves the basis for portable analysis and low reactants consumption. The aim of the work is to propose a sensing strategy for total inorganic mercury evaluation in water. The proposed system can lay the basis for further studies and validations in order to develop rapid and portable technology that can be used in situ providing remote monitoring.
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Gouveia P, Felgueiras F, Mourão Z, Fernandes EDO, Moreira A, Gabriel MF. Predicting health risk from exposure to trihalomethanes in an Olympic-size indoor swimming pool among elite swimmers and coaches. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2019; 82:577-590. [PMID: 31262237 DOI: 10.1080/15287394.2019.1634383] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Disinfection by-products (DBP) such as trihalomethanes (THM) are formed when chlorine and bromine interact with natural organic materials in chlorine-treated swimming pools. Epidemiological evidence demonstrated an association between exposure to swimming pool environment and adverse health effects. Therefore, this study aimed to assess carcinogenic and non-carcinogenic risk of long-term exposure of elite swimmers and their coaches. In an Olympic-size indoor chlorinated swimming pool, THM levels were determined in water (21-69 µg/L), in the boundary layer above the water surface (59-397 µg/m3), and in the air surrounding the pool (28-390 µg/m3). These values were used to predict multi-pathway chronic daily intake (CDI), cancer risk (CR) and hazard index (HI). Oral and dermal CDI for swimmers were 2.4 × 10-6 and 2.0 × 10-8, respectively. The swimmers' inhalation CDI (1.9 × 10-3 mg/kg/day) was estimated to be sixfold higher than levels obtained for coaches (3.3 × 10-4 mg/kg/day). According to guidelines, the HI was acceptable, but CR exceeded the recommended limit for both, coaches (CR: 5.5 × 10-7-8.5 × 10-5; HI: 6.5 × 10-4-1 × 10-1) and swimmers (CR: 1.4 × 10-5-3.6 × 10-4 HI: 1.6 × 10-2-4.3 × 10-1). Our findings provide further support to the need to develop comprehensive guidelines to safeguard the health of individuals involved in elite swimming.
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Affiliation(s)
- Pedro Gouveia
- a Faculty of Medicine, University of Porto , Porto , Portugal
| | - Fátima Felgueiras
- b Institute of Science and Innovation in Mechanical and Industrial Engineering , Porto , Portugal
| | - Zenaida Mourão
- b Institute of Science and Innovation in Mechanical and Industrial Engineering , Porto , Portugal
| | | | - André Moreira
- a Faculty of Medicine, University of Porto , Porto , Portugal
- d Serviço de Imunoalergologia, Centro Hospitalar São João , Porto , Portugal
- e EPIUnit - Instituto de Saúde Pública, Universidade do Porto , Porto , Portugal
| | - Marta Fonseca Gabriel
- b Institute of Science and Innovation in Mechanical and Industrial Engineering , Porto , Portugal
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Dundar A, Kocahan S, Arslan C. Effects of different loading exercises on apelin levels and physical and hematologic parameters of swimmers. Horm Mol Biol Clin Investig 2019; 38:/j/hmbci.ahead-of-print/hmbci-2018-0070/hmbci-2018-0070.xml. [DOI: 10.1515/hmbci-2018-0070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 12/13/2018] [Indexed: 11/15/2022]
Abstract
Abstract
Background
The purpose of this study was to investigate the effects of different exercise loads (short, medium and long swimming distances) on apelin levels and some physical and hematologic parameters of male professional swimmers.
Materials and methods
Apelin levels, hematologic parameters, whole blood values and physical measurements, including body mass index (BMI), aerobic power values and anaerobic power values, were also obtained.
Results
It was determined that the thrombocyte, erythrocyte and leukocyte values from the hematologic parameters increased after exercise (p < 0.05). According to the results, there were significant differences (p < 0.05) between the pretest apelin level (2090.75 pg/mg) and the apelin levels taken after swimming M 200 m (4260.43 pg/mg) and after swimming L 400 m (3694.4 pg/mg).
Conclusions
The different exercise loads had significant effects on the hematologic parameters and apelin values in the swimmers. The study also determined the relationships between swimming exercises and aerobic and anaerobic capacity and BMI.
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Effecting Partial Elimination of Isocyanuric Acid from Swimming Pool Water Systems. WATER 2019. [DOI: 10.3390/w11040712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
It is essential to disinfect the water in swimming pools in order to deactivate pathogenic microorganisms. Chlorination of swimming pool water provides rapid and long-lasting disinfection, but leads to the formation of potentially toxic compounds, including isocyanuric acid, that are used to stabilize chlorine in pool water. Hygiene and health guidelines require an isocyanuric acid concentration in swimming pools of 25 to 75 ppm and that there be no level in excess of 100 ppm. This paper provides a new method to partially remove isocyanuric acid from the water of swimming pool systems with the use of melamine-based reagents. A melamine-photometry process stabilizes the isocyanuric acid. The melamine-based reagent that is added to the raw water reacts with the isocyanuric acid and forms a precipitated salt. The reaction also creates turbidity that is proportional to the isocyanuric acid concentration in the water. It was noted in this study that the optimum functioning range of melamine doses in the raw water was 0.04 to 0.06 g/L and that the reduction of isocyanuric acid in raw water increased as the dose of melamine was increased. Thus, it is necessary to obtain an estimate of the dose of melamine that is necessary to reduce the isocyanuric acid in the water without needing to add fresh water from the network to dilute it. Finally, it can be stated that eliminating isocyanuric acid that has accumulated in a pool’s water by treatment with melamine provides an efficient process, as it eliminates the amount of isocyanuric acid that is necessary to conform to the human health criteria of the European Union Directive 2006/7/EC. Treatment with melamine also reduces water network consumption and sewer discharge by successive purges that eventually will become unnecessary. Therefore, this proposed method is environmentally and economically beneficial.
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Pándics T, Hofer Á, Dura G, Vargha M, Szigeti T, Tóth E. Health risk of swimming pool disinfection by-products: a regulatory perspective. JOURNAL OF WATER AND HEALTH 2018; 16:947-957. [PMID: 30540269 DOI: 10.2166/wh.2018.178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
While disinfection of swimming pools is indispensable for microbiological safety, it may lead to the formation of disinfection by-products. Most studies agree that inhalation exposure is the predominant pathway of the associated health risks, but assumptions are based on concentrations measured in water and evaporation models. Pool water and air were sampled in 19 swimming pools. Trihalomethanes were detected in all sites; chloroform being the most abundant species. Concentrations ranged between 12.8-71.2 μg/L and 11.1-102.2 μg/m3 in pool water and air, respectively. The individual lifetime carcinogenic risk associated with chloroform in swimming pools exceeded 10-6 in all age groups for recreational swimmers and 10-5 for elite swimmers and staff, even if the pool complied with the national standards. Inhalation exposure was estimated and found to be the most relevant, however, different mass transfer models from water measurements significantly under- or overestimated the health burden compared to direct calculation from the concentration in air. The observed health risks call for defining regulatory values and monitoring requirement of indoor air quality in swimming pools.
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Affiliation(s)
- Tamás Pándics
- National Public Health Institute, Public Health Directorate, Albert Flórián út 2-6., H-1097 Budapest, Hungary E-mail:
| | - Ádám Hofer
- National Public Health Institute, Public Health Directorate, Albert Flórián út 2-6., H-1097 Budapest, Hungary E-mail:
| | - Gyula Dura
- National Public Health Institute, Public Health Directorate, Albert Flórián út 2-6., H-1097 Budapest, Hungary E-mail:
| | - Márta Vargha
- National Public Health Institute, Public Health Directorate, Albert Flórián út 2-6., H-1097 Budapest, Hungary E-mail:
| | - Tamás Szigeti
- National Public Health Institute, Public Health Directorate, Albert Flórián út 2-6., H-1097 Budapest, Hungary E-mail:
| | - Erika Tóth
- Department of Microbiology, Eötvös Loránd University of Sciences, Pázmány Péter sétány 1/C, H-1117, Hungary
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Abstract
Background: Cleaning and disinfecting agents are widely used in modern life, in homes, schools, public places, and workplaces as well as in recreational facilities such as swimming pools. Use has been for sanitizing purposes and to assist in reduction of infection as well as for deodorizing purposes. However, adverse respiratory effects have been associated with use of cleaning products ranging from effects in infancy and early childhood up to adults at home and work. Methods: This review summarizes recent published literature on the effects of cleaning agents used pre-natally, in childhood and adult life, at home, work, and in swimming pools. Results: Several studies have indicated that there is an increased risk of developing asthma among adults with frequent exposure to cleaning products at work and in the home. Potential mechanisms include sensitization and respiratory irritant effects. Exposure to irritant chlorine by-products from swimming pools have also been associated with respiratory effects and increased risk of asthma. Potential effects from maternal exposures to cleaning products on infants, and effects on early childhood atopy are less clear. Conclusions: Exposure to cleaning agents increases relative risks of asthma among workers, and adults using these agents in the home. Risks are also increased with exposure to chlorinated by-products from swimming pools, both in adults and children. Further studies are needed to understand the mechanisms of these associations.
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Valeriani F, Margarucci LM, Romano Spica V. Recreational Use of Spa Thermal Waters: Criticisms and Perspectives for Innovative Treatments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2675. [PMID: 30487383 PMCID: PMC6313452 DOI: 10.3390/ijerph15122675] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 11/20/2018] [Accepted: 11/23/2018] [Indexed: 01/01/2023]
Abstract
Natural spa springs are diffused all over the world and their use in pools is known since ancient times. This review underlines the cultural and social spa context focusing on hygiene issues, public health guidelines and emerging concerns regarding water management in wellness or recreational settings. The question of the "untouchability" of therapeutic natural waters and their incompatibility with traditional disinfection processes is addressed considering the demand for effective treatments that would respect the natural properties. Available strategies and innovative treatments are reviewed, highlighting potentials and limits for a sustainable management. Alternative approaches comprise nanotechnologies, photocatalysis systems, advanced filtration. State of the art and promising perspectives are reported considering the chemical-physical component and the biological natural complexity of the spa water microbiota.
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Affiliation(s)
- Federica Valeriani
- Public Health Unit, University of Rome "Foro Italico", Rome 00135, Italy.
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Bonini M, Silvers W. Exercise-Induced Bronchoconstriction: Background, Prevalence, and Sport Considerations. Immunol Allergy Clin North Am 2018; 38:205-214. [PMID: 29631730 DOI: 10.1016/j.iac.2018.01.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The transient airway narrowing that occurs as a result of exercise is defined as exercise-induced bronchoconstriction (EIB). The prevalence of EIB has been reported to be up to 90% in asthmatic patients, reflecting the level of disease control. However, EIB may develop even in subjects without clinical asthma, particularly in children, athletes, patients with atopy or rhinitis, and following respiratory infections. The intensity, duration, and type of training have been associated with the occurrence of EIB. In athletes, EIB seems to be only partly reversible, and exercise seems to be a causative factor of airway inflammation and symptoms.
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Affiliation(s)
- Matteo Bonini
- Airways Disease Section, National Heart and Lung Institute (NHLI), Royal Brompton Hospital, Imperial College London, Dovehouse Street, London SW3 6LY, UK.
| | - William Silvers
- University of Colorado School of Medicine, 13001 E 17th Place, Aurora, CO 80045, USA
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Valeriani F, Protano C, Vitali M, Romano Spica V. Swimming pool attendance during childhood and development of asthma: Reply. Pediatr Int 2017; 59:847-848. [PMID: 28745462 DOI: 10.1111/ped.13311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 04/10/2017] [Indexed: 01/19/2023]
Affiliation(s)
| | - Carmela Protano
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
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