Source: Annual Congress 2002 - Exposure to chemicals
Disease area: Airway diseases

Abstract

Irritant symptoms have been described in swimming instructors due to atmospheric nitrogen trichloride (NCL3). Chlorine used for water disinfection reacts with human nitrogeneous compounds and produces chloramines especially NCL3.(Massin et al. Occupational Environ. Med. 1998; 55: 258-263).
We report 5 patients (3 men, 2 women, mean age 35 years), who developed dry cough , breathlessness and dyspnea at work, disappearing off work. One patient was atopic. None had had previous respiratory diseases. Three had positive bronchial metacholine tests (Mch) respectively at 2000, 800 and 400 mcg of Mch. After 2 weeks' eviction, 2 patients had negative Mch tests up to 3200 mcg doses. The 2 others patients exposed to higher chloramine levels, due to failure in ventilation, were treated in an emergency unit for acute symptoms of conjunctivitis, rhinitis, dry cough, dyspnea and wheezing. Despite a 2 months' work eviction and treatment with inhaled corticosteroids, respiratory symptoms (spasmodic cough, dyspnea, wheezing) persisted and Mch tests were positive.
In conclusion , to our knowledge, only irritant symptoms after exposure to chloramines in pools have been described. Our 5 cases suggest the possibility of occupational asthma in 3 patients and RADS in 2 patients, to gaseous chloramines.

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M. C. Kopferschmitt-Kubler, B. Bodhuin, O. Martinet, S. Geny, P. Noos, G. Pauli (Strasbourg, France). Occupational asthma and reactive airways dysfunction syndrome (RADS) in indoor swimming pools. Eur Respir J 2002; 20: Suppl. 38, 856

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