Disinfection by-products (DBP) are the result of the reaction of disinfectants (such as chlorine) with natural organic matter and are present in swimming pool water and in residential sources such as drinking water, the shower and the bathroom. There are studies which have shown the health effects of exposure to DBP on airway dysfunction and other respiratory complications. It has been documented that these products can irritate both the upper and lower respiratory tract and induce various respiratory symptoms particularly in children and high level swimmers. A natural pool (also called ecological pools, naturalized pools, bio-pools) is a pool where, to achieve the necessary water quality, a natural purification system is used instead of using chemicals. More and more evidence suggests that they can be an alternative to chlorinated swimming pools, eliminating the need for chemical treatment and expenses in mechanical and electrical processes, minimizing pumping requirements and also, reducing the potential irritating effect to the airway.
KEYWORDS
Natural pool, respiratory health, disinfection byproduct.
REFERENCES
Boorman GA. Drinking water disinfection byproducts: review and approach to toxicity evaluation. Environ Health Perspect. 1999;107 Suppl 1(Suppl 1):207-217. doi: 10.1289/ehp.99107s1207.
LaKind JS, Richardson SD, Blount BC. The good, the bad, and the volatile: can we have both healthy pools and healthy people? Environ Sci Technol. 2010;44(9):3205-3210.
Beech JA, Diaz R, Ordaz C, Palomeque B. Nitrates, chlorates and trihalomethanes in swimming pool water. Am J Public Health 1980;70(1):79-82.
Aggazzotti G, Predieri G. Survey of volatile halogenated organics (VHO) in Italy. Levels of VHO in drinking waters, surface waters and swimming pools. Water Res. 1986;20:959-963.
Chu H, Nieuwenhuijsen MJ. Distribution and determinants of trihalomethane concentrations in indoor swimming pools. Occup Environ Med. 2002;59(4):243-247.
Judd SJ, Jeffrey J. Trihalomethane formation during swimming pool water disinfection using hypobromous and hypochlorous acids. Water Res. 1995;29:1203-1206.
IARC. Chlorinated drinking-water; chlorination by-products; some other halogenated compounds; cobalt and cobalt compounds. Lyon, Fran: WHO, IARC; 1997.
Lévesque B, Vézina L, Gauvin D, Leroux P. Investigation of quality problems in an indoor swimming pool: a case study. Ann Occup Hyg. 2015;59(8):1085-1089.
Villanueva CM, Cordier S, Font-Ribera L, Salas LA, Levallois P. Overview of disinfection by-products and associated health effects. Curr Environ Health Rep. 2015;2(1):107-115.
Goodman M, Hays S. Asthma and swimming: a meta-analysis. J Asthma. 2008;45:639-647.
Thickett KM, McCoach JS, Gerber JM, Sadhra S, Burge PS. Occupational asthma caused by chloramines in indoor swimming-pool air. Eur Respir J. 2002;19:827-832.
Beddowes EJ, Faux SP, Chipman JK. Chloroform, carbon tetrachloride and glutathione depletion induce secondary genotoxicity in liver cells via oxidative stress. Toxicology. 2003;187(2-3):101-115.
Yuan J, Wu XJ, Lu WQ, Cheng XL, Chen D, Li XY, et al. Chlorinated river and lake water extract caused oxidative damage, DNA migration and cytotoxicity in human cells. Int J Hyg Environ Health. 2005;208(6):481-488.
Du H, Li J, Moe B, McGuigan CF, Shen S, Li XF. Cytotoxicity and oxidative damage induced by halobenzoquinones to T24 bladder cancer cells. Environ Sci Technol. 2013;47(6):2823-2830.
Pals JA, Ang JK, Wagner ED, Plewa MJ. Biological mechanism for the toxicity of haloacetic acid drinking water disinfection byproducts. Environ Sci Technol. 2011;45(13):5791-5797.
Pals J, Attene-Ramos MS, Xia M, Wagner ED, Plewa MJ. Human cell toxicogenomic analysis linking reactive oxygen species to the toxicity of monohaloacetic acid drinking water disinfection byproducts. Environ Sci Technol. 2013;47:12514-12523.
Kogevinas M, Villanueva CM, Font-Ribera L, Liviac D, Bustamante M, Espinoza F, et al. Genotoxic effects in swimmers exposed to disinfection by-products in indoor swimming pools. Environ Health Perspect. 2010;118(11):1531-1537.
Backer LC, Lan Q, Blount BC, Nuckols JR, Branch R, Lyu CW, et al. Exogenous and endogenous determinants of blood trihalomethane levels after showering. Environ Health Perspect. 2008;116(1):57-63.
Gary GL. Improved exposure assessment on existing cancer studies. Denver, CO: AWWA Research Foundation and American Water Works Association. 2005. p. 88.
Whitaker HJ, Nieuwenhuijsen MJ, Best NG. The relationship between water concentrations and individual uptake of chloroform: a simulation study. Environ Health Perspect. 2003;111(5):688-694.
Karanfil T, Krasner SW, Westerhoff P Xie Y. Avances recientes en la formación de subproductos de desinfección, ocurrencia, control, efectos sobre la salud y regulaciones. ACS Symposium Series. 2008. Vol. 995, pp. 2-19. [14 de noviembre de 2019] Disponible en: https://asu.pure.elsevier.com/en/publications/recent-advances-in-disinfection-by-product-formation-occurrence-c
Ross MK, Pegram RA. Glutathione transferase theta 1-1- dependent metabolism of the water disinfection byproduct bromodichloromethane. Chem Res Toxicol. 2003;16:216-226.
Xu X, Weisel CP. Human respiratory uptake of chloroform and haloketones during showering. J Exp Anal Environ Epidemiol. 2004;15:6-16.
Zwiener C. Drowning in disinfection byproducts? Assessing swimming pool water. Environ Sci Technol. 2007;41:363-372.
Vidarte J, Velez Alvarez C, Cuellar C, Alfonso M. Actividad física: estrategia de promoción de la salud. Hacia la promoción de la salud. 2011;16:202-218.
Font-Ribera L, Kogevinas M, Zock JP, Nieuwenhuijsen MJ, Heederik D, Villanueva CM. Swimming pool attendance and risk of asthma and allergic symptoms in children. Eur Respir J. 2009;34(6):1304-1310.
Schoefer Y, Zutavern A, Brockow I, Schäfer T, Krämer U, Schaaf B, et al. Health risks of early swimming pool attendance. Int J Hyg Environ Health. 2008;211(3-4):367-373.
Bernard A, Carbonnelle S, Michel O, Higuet S, De Burbure C, Buchet JP, et al. Lung hyperpermeability and asthma prevalence in schoolchildren: unexpected associations with the attendance at indoor chlorinated swimming pools. Occup Environ Med. 2003;60(6):385-394.
Li JH, Wang ZH, Zhu XJ, Deng ZH, Cai CX, Qiu LQ, et al. Health effects from swimming training in chlorinated pools and the corresponding metabolic stress pathways. PLoS One. 2015;10(3):e0119241.
Llana-Belloch S, Priego Quesada JI, Pérez-Soriano P, Lucas-Cuevas ÁG, Salvador-Pascual A, Olaso-González G, et al. Disinfection by-products effect on swimmers oxidative stress and respiratory damage. Eur J Sport Sci. 2016;16(5):609-617.
Lomax M. Airway dysfunction in elite swimmers: prevalence, impact, and challenges. Open Access J Sports Med. 2016;7:55-63.
Bonadonna L, La Rosa G. A review and update on waterborne viral diseases associated with swimming pools. Int J Environ Res Public Health. 2019;16(2):166.
Bougault V, Loubaki L, Joubert P, Turmel J, Couture C, Laviolette M, et al. Airway remodeling and inflammation in competitive swimmers training in indoor chlorinated swimming pools. J Allergy Clin Immunol. 2012;129(2):351-358, 358.e1.
HCMA Architecture + Design. Natural swimming pools. The future of public swimming without chlorine. 2016 [18 November 2019] Available in: https://hcma.ca/wp-content/uploads/2016/04/Natural-Swimming-Pools-Report_HCMA.pdf
World Health Organization. Guidelines for safe recreational water environments. Volume 1: Coastal and fresh waters. Geneva: World Health Organization. 2003. [26 December 2019] Available in: pps.who.int/iris/bitstream/handle/10665/42591/9241545801.pdf;jsessionid=4FA44DD9520F50ACA553D2A90B3FB513?sequence=1
NOM-245-SSA1-2010, Requisitos sanitarios y calidad del agua que deben cumplir las albercas. Tomado de: http://dof.gob.mx/nota_detalle.php?codigo=5256066&fecha=25/06/2012 el 27 diciembre de 2019.
Sánchez Rodríguez JJ. Estudio de la implantación de piscinas ecológicas en las piscinas municipales de Cataluña, España [Proyecto final de carrera]. España: Universidad Politécnica de Cataluña; 2011 [17 de diciembre de 2019] Tomado de https://upcommons.upc.edu/bitstream/handle/2099.1/11554/MEMORIA.pdf