Ecological association between childhood asthma and availability of indoor chlorinated swimming pools in Europe

Nickmilder, M.; Bernard, A.
January 2007
Occupational & Environmental Medicine;Jan2007, Vol. 64 Issue 1, p37
Academic Journal
Background: It has been hypothesised that the rise in childhood asthma in the developed world could result at least in part from the increasing exposure of children to toxic chlorination products in the air of indoor swimming pools. Objectives: Ecological study to evaluate whether this hypothesis can explain the geographical variation in the prevalence of asthma and other atopic diseases in Europe. Methods: The relationships between the prevalences of wheezing by written or video questionnaire, of ever asthma, hay fever, rhinitis, and atopic eczema as reported by the International Study of Asthma and Allergies in Childhood (ISAAC), and the number of indoor chlorinated swimming pools per inhabitant in the studied centres were examined. Associations with geoclimatic variables, the gross domestic product (GDP) per capita, and several other lifestyle indicators were also evaluated. Results: Among children aged 13-14 years, the prevalence of wheezing by written questionnaire, of wheezing by video questionnaire, and of ever asthma across Europe increased respectively by 3.39% (95% CI 1.96 to 4.81), 0.96% (95% CI 0.28 to 1.64), and 2.73% (95% CI 1.94 to 3.52), with an increase of one indoor chlorinated pool per 100 000 inhabitants. Similar increases were found when analysing separately centres in Western or Northern Europe and for ever asthma in Southern Europe. In children aged 6-7 years (33 centres), the prevalence of ever asthma also increased with swimming pool availability (1.47%; 95% CI 0.21 to 2.74). These consistent associations were not found with other atopic diseases and were independent of the influence of altitude, climate, and GDP per capita. Conclusions: The prevalence of childhood asthma and availability of indoor swimming pools in Europe are linked through associations that are consistent with the hypothesis implicating pool chlorine in the rise of childhood asthma in industrialised countries.


Related Articles

  • Childhood Asthma and Environmental Exposures at Swimming Pools: State of the Science and Research Recommendations. Weisel, Clifford P.; Richardson, Susan D.; Nemery, Benoit; Aggazzotti, Gabriella; Baraldi, Eugenio; Blatchley III, Ernest R.; Blount, Benjamin C.; Carlsen, Kai-Håkon; Eggleston, Peyton A.; Frimmel, Fritz H.; Goodman, Michael; Gordon, Gilbert; Grinshpun, Sergey A.; Heederik, Dirk; Kogevinas, Manolis; LaKind, Judy S.; Nieuwenhuijsen, Mark J.; Piper, Fontaine C.; Sattar, Syed A. // Environmental Health Perspectives;Apr2009, Vol. 117 Issue 4, p500 

    OBJECTIVES: Recent studies have explored the potential for swimming pool disinfection by-products (DBPs), which are respiratory irritants, to cause asthma in young children. Here we describe the state of the science on methods for understanding children's exposure to DBPs and biologics at...

  • Chlorinated Pools and the Risk of Asthma. Eggleston, Peyton A. // Environmental Health Perspectives;May2007, Vol. 115 Issue 5, pA240 

    This article presents commentary on a 2006 article that asserts young children using chlorinated pools have an increased risk of developing childhood asthma. The author disputes that contention on the grounds that it contradicts earlier findings where homes cleaned with chlorine bleach had a...

  • URBAN SLUMS AND CHILDREN'S HEALTH IN LESS-DEVELOPED COUNTRIES. Jorgenson, Andrew K.; Rice, James // Journal of World-Systems Research;Jan2012, Vol. 18 Issue 1, p103 

    We utilize first-difference panel regression analysis to assess the direct effect of urban slum prevalence on national level measures of under-5 mortality rates over the period 1990 to 2005. Utilizing data on 80 less developed countries, the results illustrate increasing urban slum prevalence...

  • Chlorinated Pool Attendance, Atopy, and the Risk of Asthma during Childhood. Bernard, Alfred; Carbonnelle, Sylviane; de Burbure, Claire; Michel, Olivier; Nickmilder, Marc // Environmental Health Perspectives;Oct2006, Vol. 114 Issue 10, p1567 

    The pool chlorine hypothesis postulates that the rise in childhood asthma in the developed world could result at least partly from the increasing exposure of children to toxic gases and aerosols contaminating the air of indoor chlorinated pools. To further assess this hypothesis, we explored the...

  • natural swimming pools. Buege, Douglas; Uhland, Vicky // Mother Earth News;Aug/Sep2002, Issue 193, p64 

    Focuses on building a natural swimming pool. Components of the pool; Cheapest way to build a natural pool; Information on water's natural filtration. INSET: Pool Protection.

  • MAROTTA ON MONEY. Marotta, David John // Hudson Valley Business Journal;8/30/2010, Vol. 21 Issue 35, p8 

    In this article the discusses the trend of gross domestic product (GDP) in the developing countries to resolve issues in public debt and economic freedom.

  • natural, chlorine-free swimming pools. French, Roger // Natural Health & Vegetarian Life;Summer2009, p62 

    The article focuses on the use of natural filtration plants in swimming pools in Australia. A brief history on natural filtration is provided. It consists of a swimming pool and an extra pool with water plants that provide the purification. The pool can be small as a plunge pool or big as a...

  • Chapter 6: BMI Global Assumptions.  // UAE Business Forecast Report;2011 3rd Quarter, Issue 3, p47 

    The article focuses on the global assumptions of the Business Monitor International Ltd. (BMI) including the impact of Japan's earthquake and tsunami to the political crisis in the Middle East, the fall of the gross domestic product (GDP) in 2011 in the developed states and a 5.5% growth in...

  • Further Cross-Country Evidence on the Accuracy of the Private Sector's Output Forecasts. Juhn, Grace; Loungani, Prakash // IMF Staff Papers;2002, Vol. 49 Issue 1, p49 

    Evaluates the performance of consensus forecasts of real gross domestic product growth for a number of industrialized and developing countries from October 1989 to December 1999. Accuracy of the private sector forecasts; Comparison of the accuracy with the World Economic Outlook of the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics