July/August 2006 Issue

The Healthy Swimmer: Readers Ask

The November/December 2005 issue of SWIMMER included a question about allergic reactions to chlorine, which triggered several follow-up questions from readers. Mary Pohlmann, assistant professor of clinical medicine at Southern Illinois University School of Medicine and a member of the USMS Sports Medicine Committee, offers additional tips for swimmers who have experienced allergic reactions to pool chemicals.

Q: I generally swim in a pool where the water is treated with chlorine. However, once in a while, I swim in a pool where the water is treated with bromine. I always have a strong allergic reaction to the bromine-treated water (my nose runs, my head is stopped up, I sneeze and cough, and, if I swim long enough, I break out in a rash). Nothing helps. Is there anything that I can do? - Terry Gernstein, Virginia Masters

A: "Both bromine and chlorine are gaseous elements in the chemical family called halogens," explains Pohlmann. "They have similar characteristics, including their ability to sanitize water." Because chlorine is less expensive than bromine, it is used more often in public pools. Bromine is used more frequently in spas and hot tubs than in pools, and it is not used in outdoor pools because sunlight and ultraviolet light destroy it.

"The main advantage of bromine is the lack of chemical odor in water," says Pohlmann, "but because it is so stable it can be difficult to wash the bromine off your skin."

"Nasal, respiratory and skin reactions can occur with either chlorine or bromine," she notes. "Some individuals are more sensitive to irritating agents than others, but most swimmers have from time to time complained about swimming pool irritants. Chemicals in the water are absorbed into your blood through your skin. Good ventilation of the building air, frequent circulation of fresh water and control of the water chemistry are all important in reducing your exposure to these irritants."

Pohlmann offers a few tips for swimmers who have experienced allergic reactions to pool chemicals:

  • Be sure a certified swimming pool operator properly maintains your facility. The records of free available chlorine or free available bromine and pH readings should be available for your inspection.
  • Proper hygiene, especially soap showers before entering the pool, should be required of all swimmers. Bathroom breaks should be considered for groups of young children and all should be taught that their body products don't belong in the pool.
  • If your pool is well maintained and you still experience problems, you may need to change to a pool that uses different reagents for sanitation.
  • For skin irritation and rashes, check with a dermatologist. Some dermatologic problems may be infections rather than allergic reactions. Using a moisturizer after a soapy shower may help. Apply moisturizers after swimming, rather than before.
  • For respiratory problems, check with an allergist. Research suggests that trihalomethanes (chloroform) may actually cause reactive airway disease or asthma. If you already have asthma, these irritants can make matters worse. Swimming in an outdoor pool or an indoor pool with high ceilings and good ventilation will reduce your exposure.
  • For nasal problems, saline, cromolyn sodium (Nasalcrom), and/or steroid nasal sprays may be of help. Oral antihistamines and/or decongestants also may be beneficial. You might also try wearing a nose clip.

Several web sites can help you to become an educated consumer:

> Centers for Disease Control and Prevention
www.cdc.gov/healthyswimming/index.htm
> Water Quality and Health Council
www.waterandhealth.org/healthy_pools
> National Consumers League
www.nclnet.org/news/2004/healthy_pools.htm
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