Authors Conditions Biomarkers Main findings
Carbonnelle et al. 2002 (30)
Chlorinated-pool (NCl3 mean concentration: 490 µg/m3) for recreational swimmers. Chlorinated-pool (NCl3 mean concentration: 355 µg/m3) Vs copper/silver pool for trained swimmers
Serum SP-A, SP-B and CC16
CC16 was not increased in recreational swimmers In trained swimmers CC16 peaked immediately after strenuous exercise, both in the copper/silver and in the chlorinated pools SP-A and SP-B were unaffected by strenuous exercise in the copper/silver pool SP-A and SP-B were significantly increased in a time-dependent manner in recreational and trained swimmers attending the chlorinated-pool
Carbonnelle et al. 2008 (91)
Chlorinated-pool (NCl3 concentration: 160-280 µg/m3 ) Vs copper/silver-pool (NCl3 <20 µg/m3)
FeNO; serum SP-A, SP-B, CC16, KL-6
FeNO increased in the copper/silver pool, whereas it did not change in the chlorinated-pool, suggesting that chlorination might inhibit NO-induced vasodilation in exercise Serum pneumoproteins were unchanged excepted SP-A which decreased after exercise in the chlorinated pool (P < 0.05)
Font-Ribera et al. 2010 (92)
Chlorinated indoor pool
FeNO; serum SP-D and CC16; 8-isoprostane, several cytokines* and VEGF in EBC
CC16 slightly increased after a swimming session No significant changes in lung function, SP-D, 8-isoprostane, cytokines, or VEGF.
Fernández-Luna et al. 2013 (93)
Chlorinated-pool Vs ozone-treated pool
Serum SP-D and CC16
No change was observed in lung function and SP-D in swimmers attending both pools CC16 was significantly increased in subjects attending the chlorinated-pool but not in those using the ozone-treated pool
Font-Ribera et al. 2019 (94)
Chlorinated-pool (NCl3 mean concentration: 473 µg/m3)
Serum CC16; exhaled breath THMs; urinary TCAA; genotoxicity biomarkers#
Creatinine-adjusted urinary TCAA increased by 3.1 μmol/mol Urine mutagenicity, MN-PBL, MN-Ret and serum CC16 levels remained unchanged after swimming No correlation between CBP exposure and MN-PBL, urine mutagenicity and CC16 Moderate associations observed for MN-Ret and CBP exposure