This study investigated adverse skin and eye effects in swimmers using pools with three different disinfection systems (chlorine, chlorine/ozone and bromine/ozone) and monitored water quality parameters that may be related to adverse health effects. A cross-sectional study of 770 children swimming in three school pools was carried out over a 4 week period in November 1994 using a postal questionnaire. Physico-chemical and bacteriological parameters of water quality were monitored on a weekly basis. Responses were obtained for 385 swimmers. Skin rashes with an onset less than 24 h after swimming in the school pool were reported by 4‐8% of swimmers. Compared with the bromine/ozone pool, the odds ratio (OR) of having a rash that started less than 24 h after pool use was 1.91 (CI 0.71‐5.10) for the chlorine pool and 1.88 (CI 0.61‐5.81) for the chlorine/ozone pool. Adjustment for possible confounders made no significant differences to these results. Eye redness, itch or irritation was reported by 23‐33% of swimmers and 24% of non-swimmers, and wearing swimming goggles had a protective effect (OR 0.40; CI 0.24, 0.65). Disinfectant levels were more consistently maintained in the pools with automatically controlled systems. The bromine disinfection system was not associated with a greater risk of the development of skin rashes than other disinfection systems, but the numbers were small, and need to be interpreted with caution.
Skin irritation in users of brominated pools
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