The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts


Michael Pajewski1, Scott T. Dwyer1, John F. Hunt1, Alison Montpetit2, Thomas N. Pajewski3, Michael D. Davis2,1; 1Division of Pediatric Respiratory Medicine, University of Virginia, Charlottesville, VA; 2Adult Health and Nursing Systems, Virginia Commonwealth University, Richmond, VA; 3Anesthiology, University of Virginia, Charlottesville, VA

Background: Chlorine-releasing compounds are the most common sanitizing agents used in swimming pools to help prevent the transmission of infectious diseases by destroying a wide range of potentially dangerous bacteria and viruses. The chlorine that is dissolved in pool water releases gas into the atmosphere. The chlorine gas is concentrated just above the surface of a chlorinated pool and is especially so in indoor pools. Inhaled chlorine gas goes into solution in the airway lining fluid to form hypochlorous and hydrochloric acids. These together cause acidic and oxidative injuries to the cells and proteins of the airway, which can cause pulmonary dysfunction. Objective: We hypothesized that lung function would be adversely affected by swimming because of the inhalation of chlorine and resulting changes in airway chemistry. Methods: After obtaining baseline exhaled breath condensate (EBC) and spirometry, subjects swam for 2.25 hours (6,250 – 7,300 yards). Immediately following the swimming session, EBC and spirometry were re-obtained. Nitrite (NO2-), nitrate (NO3-), and gas-standardized pH levels were measured in EBC. Results were analyzed using paired t-test. Results: All subjects (5 male, 1 female, age 15-17 years) have tolerated the study without adverse events of any kind. pH, NO2-, and NO3- were measurable in EBC of all subjects. No statistically significant changes occurred in spirometry, EBC pH, or EBC NO3-. EBC NO2- increased by a median of 0.441 mM and approached statistical significance (p = 0.057). Conclusion: Preliminary data suggests a possible increase in EBC NO2- after exercising in chlorinated water. Our ongoing subject enrollment will further define this issue, which may result in a better understanding of the impact of chlorinated water on lung function. Sponsored Research - None Mean EBC and Spirometric Values Pre/Post Swimming