Association between swimming pool attendance and allergic diseases: An updated systematic review and meta-analysis

Recently, increasing epidemiological studies have suggested a potential association between swimming pool attendance and allergic outcomes with inconsistent findings. This systematic review and meta-analysis aims to elucidate the association between swimming pool attendance and the risk of allergic diseases. We systematically searched PubMed, Web of Science, Scopus, and Embase to identify relevant studies published up to August 8, 2025, and performed a meta-analysis of the extracted data. Furthermore, subgroup analyses, sensitivity analyses, and assessments of publication bias were also conducted. A total of 23 studies involving 54,153 participants were included. The combined data showed a positive correlation between swimming pool attendance and asthma [OR = 1.14, 95% CI: (1.08-1.21)], but no significant link with allergic rhinitis, atopic dermatitis, hay fever, or wheezing. Subgroup analyses indicated stronger associations in children [asthma: OR = 1.14, 95% CI: (1.08-1.21)] and among those with early-life exposure [asthma: OR = 1.13, 95% CI: (1.06-1.20)]. Interestingly, early swimming pool attendance was negatively associated with allergic rhinitis in children [OR = 0.78, 95% CI: (0.63-0.97)]. In conclusion, swimming pool attendance was significantly associated with asthma, highlighting potential public health implications and the need for further research into relevant environmental exposures.