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A CUP OF HEALTH WITH CDC
Indoor Pools Can Cause a Serious Health Risk
Ocular and Respiratory Illness Associated with an Indoor Swimming Pool - Nebraska, 2006
October 19, 2007

[Announcer] This podcast is presented by the Centers for Disease Control and Prevention. CDC – safer,
healthier people.

[Ana Benson] Welcome to A Cup of Health with CDC, a weekly broadcast of the
MMWR, the Morbidity and Mortality Weekly Report. I’m Ana Benson, filling in for your
host, Matthew Reynolds.

Swimming is popular in the United States. Pool operators are responsible for ensuring
the health and safety of over 360 million guests who visit recreational water venues
each year, and yet these operators receive very little public health oversight. In fact,
most states don’t even require training or certification for public pool operators. Dr.
Bryan Buss, an epidemiological investigation officer for the CDC, is here to talk about
chloramine exposure, a problem in the enclosed environment of indoor swimming pools.
Welcome to the show, Dr. Buss.

[Dr. Buss] Thank you.

[Ana Benson] Dr. Buss, what are chloramines and why are they such a problem?

[Dr. Buss] Well, chloramines are compounds that form in swimming pools when
chlorine, which is commonly used as a disinfectant, reacts with sweat or urine or other
human waste that accumulate in the water. And when these build up in the water they
can actually leave the water and evaporate into the air above the pool, and when that
happens they can be very irritating to swimmers and people that enter the environment
of the pool.

[Ana Benson] So what symptoms will a person have if they’ve been exposed to high
levels of chloramine?

[Dr. Buss] The first thing somebody would see would probably be burning eyes. I think
a lot of people probably have had that sensation when they’ve been in pools, that their
eyes burn and they think it’s from chlorine. And it is actually from these chloramines and
these compounds that are a problem in the pool. And in addition, they can have watery
eyes, a sore throat, and in severe situations they can actually have breathing problems.
And, then coughing, sneezing, shortness of breath, and in more severe symptoms that
cause difficult breathing.

[Ana Benson] Is there a test to determine the concentration of chloramine in pool
water?

[Dr. Buss] Well, there are tests that can be done and in Nebraska it’s required that the
pool operators test once a week to test for combined chlorine, which is a measure of
these molecules in the water.

[Ana Benson] It sounds like chloramine exposure is relatively simple to prevent then, if
pool operators maintain the quality of the pool water, required everyone to shower
before entering the pool, and ensured proper ventilation of the enclosed environment.
So tell me this - Is there training available for pool operators to prevent and test for
excess chloramine levels?

[Dr. Buss] Well, in Nebraska, the state works with local health departments in a few
areas to offer a course for training for pool operators to be able to detect if there is a
chloramine problem in the pool, and then also give some answers on what they should
do to handle such a problem. Nation wide, there are a number of organizations that do
offer training. The CDC maintains a list of some of these organizations on their healthy
swimming website. That address is www.cdc.gov/healthyswimming/courses.htm. Or
simply, you can go to the CDC site, get on the healthy swimming site, in the middle of
the page there’s topics. Under that it will say “Training and Education” and you can click
on “Pool Operator Training” and that list will be there. Alternately, people can check with
the state and the local health departments or local agencies that regulate pools in their
areas and they can also provide a list of organizations and training courses that they
would accept.

[Ana Benson] Dr. Buss, thanks for taking the time to share this information with our
listeners today.

[Dr. Buss] Well, I appreciate the opportunity. Thank you.

[Ana Benson] That’s it for this week’s show. Don’t forget to join us next week. Until
then, be well. This is Ana Benson for A Cup of Health with CDC.

To access the most accurate and relevant health information that affects you, your family and your
community, please visit www.cdc.gov.