Skin irritation in users of brominated pools

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.