Beretta (2011) Swimming pool-induced asthma

Understanding Chlorine-Induced Asthma in Swimmers

This summary delves into a case study reported by Beretta et al. in the “Journal of Investigational Allergology and Clinical Immunology,” focusing on a 13-year-old elite swimmer who developed asthma symptoms triggered by chlorine exposure in indoor swimming pools. The case sheds light on the potential respiratory risks associated with chlorinated water, particularly for young athletes.

Case Overview

The subject, a competitive swimmer without a prior asthma diagnosis, experienced wheezing and respiratory distress following indoor swimming sessions. Initial considerations included hyperventilation syndrome and exercise-induced asthma, but further investigation led to the diagnosis of chlorine-induced asthma. This condition was confirmed through skin prick tests and spirometry, ruling out other potential triggers like exercise-induced asthma and mold allergies.

Chlorine’s Impact on Respiratory Health

Chlorine, widely used to maintain water hygiene in swimming pools, can be detrimental to the respiratory tract. The case study underscores the potential harm from chronic exposure to chlorine and its byproducts, which can irritate the pulmonary epithelium and increase asthma risk among children and adolescents. The phenomenon, known as the “pool chlorine hypothesis,” suggests a link between chlorinated pool attendance and the rising incidence of asthma and other atopic diseases.

Recommendations and Follow-Up

Upon diagnosing chlorine-induced asthma, the patient was advised to train in a non-chlorinated pool. This switch resulted in the absence of wheezing episodes during subsequent training sessions, highlighting the importance of identifying and mitigating environmental triggers in managing asthma.

Discussion and Implications

The case emphasizes the need for awareness regarding the potential respiratory effects of chlorinated pools, particularly for young swimmers. While swimming is often recommended for its low asthma induction risk, the presence of chlorine can counteract these benefits. This report calls for further research into safe swimming environments and the development of non-invasive tests to assess chlorine’s irritating effects on the airways.

Keywords: Chlorine, asthma, swimmers, respiratory health, chlorinated pools, indoor swimming, asthma management.