Respiratory symptoms
Cold and sneezing are the most frequent self-reported complaints (65.4% and 52.6%, respectively) while only 7.5% of the total indoor swimming-pools workers reported an asthmatic condition13. It is discussed whether recreational swimming or working in indoor swimming-pools may aggravate asthma or actually cause it16. Irritant-induced asthma (IIA) is defined as development of asthma, nonspecific bronchial hyperresponsiveness (BHR), and airway inflammation induced by irritant mechanisms, as opposed to occupational asthma (OA) caused by immunologic mechanisms17. Three cases of OA in swimming-pool workers have been documented18, two of them had a positive bronchial provocation test to chloramine. Another study with a large sample of swimming-pool workers (n=624) also showed increased risk of respiratory symptoms indicative of asthma upon NCl3exposure14.