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Chemical Irritation of the Eyes and Lungs

Red eyes or irritated nose or throat after swimming? Blame the pee, poop, and sweat!

To help protect swimmers’ health, chlorine is commonly added to the water to kill germs and stop them from spreading 1. But chlorine can also combine with what comes out of or washes off of swimmers’ bodies (for example, pee, poop, sweat, dirt, skin cells, and personal care products) 2,3. This causes two problems:

  • Free chlorine, the form of chlorine that kills germs, gets used up and is no longer available to kill germs 4.
  • Chemical irritants called chloramines (chlor, short for chlorine, and amines, compounds that contain nitrogen) are formed 4.

Healthy pools and other places where we swim in chlorinated water don’t have a strong chemical smell. If you smell “chlorine” at the place you swim, you are probably smelling chloramines. Chloramines in the water can turn into gas in the surrounding air 1,4. This is particularly a problem in indoor pools, which often aren’t as well-ventilated as outdoor pools 5. The chloramines that form in the chlorinated water we swim in are different from the chloramine that is sometimes used to treat drinking water.

What are the health effects associated with chloramines?

Breathing in or coming into contact with chloramines at the places we swim can lead to negative health effects in swimmers and others in the swimming area 5,6 including:

  • Everyone (swimmers and others in the swimming area)
    • Respiratory symptoms such as nasal irritation, coughing, and wheezing. Asthma attacks can be triggered in people who have asthma 1,4,5,7.
  • Swimmers
    • Red and stinging eyes 1,5,7.
    • Skin irritation and rashes 1.

What can I do to reduce chloramine formation?

We all share the chlorinated water we swim in and the surrounding air we breathe. Here are a few easy and effective steps swimmers can take to help protect our health and the health of our family and friends:

Keep pee, poop, sweat, and dirt out of the water!

  • Stay out of the water if you have diarrhea.
  • Use the toilet before getting into the water.
  • Shower before getting into the water. Rinsing off in the shower for just 1 minute removes most of the dirt or anything else on your body. 
  • Wear a bathing cap while in the water.
  • Don’t pee or poop in the water.

Take a break—every hour!

  • Take kids on bathroom breaks.
  • Check diapers, and change them in a bathroom or diaper-changing station to keep pee and poop out of the water 1.

Talk to others.

  • Tell other swimmers and parents of young swimmers about chloramines and the steps they can take to help prevent them.
  • Encourage pool operators to take steps known to prevent and get rid of chloramines.
  • Tell the lifeguard or pool operator immediately if you or your family or friends:
    • See poop in water,
    • Smell chemical odors in the swimming area, or
    • Experience respiratory, eye, or skin irritation that could be linked to the water or the air surrounding the water 4,6.
References
  1. Kaydos-Daniels SC, Beach MJ, Shwe T, Magri J, Bixler D. Health effects associated with indoor swimming pools: A suspected toxic chloramine exposure. Public Health. 2008;122(2):195-200.
  2. Richardson SD, DeMarini DM, Kogevinas M, Fernandez P, Marco E, Lourencetti C, Ballesté C, Heederik D, Meliefste K, McKague AB, Marcos R, Font-Ribera L, Grimalt JO, Villanueva CM. What’s in a pool? A comprehensive identification of disinfection by-products and assessment of mutagenicity of chlorinated and brominated swimming pool water. Environ Health Perspect. 2010;118(11):1523-30.
  3. Zwiener C, Richardson SD, De Marini DM, Grummt T, Glauner T, Frimmel FH. Drowning in disinfection byproducts? Assessing swimming pool water. Environ Sci Technol. 2007;41(2):363-72.
  4. Safranek T, Semerena S, Huffman T, Theis M, Magri J, Török T, Beach MJ, Buss B. Ocular and respiratory illness associated with an indoor swimming pool—Nebraska, 2006. MMWR Morb Mortal Wkly Rep. 2007;56(36):929-32.
  5. Bowen AB, Kile JC, Otto C, Kazerouni N, Austin C, Blount BC, Wong HN, Beach MJ, Fry AM. Outbreaks of short-incubation ocular and respiratory illness following exposure to indoor swimming pools. Environ Health Perspect. 2007;115(2):267-71.
  6. 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):3205-10.
  7. Dziuban EJ, Liang JL, Craun GF, Hill V, Yu PA, Painter J, Moore MR, Calderon RL, Roy SL, Beach MJ. Surveillance for waterborne disease and outbreaks associated with recreational water—United States, 2003-2004. MMWR Surveill Summ. 2006;55(12):1-30.
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