ArticleOccupational and environmental medicine2007
Ecological association between childhood asthma and availability of indoor chlorinated swimming pools in Europe.
Article in Occupational and environmental medicine, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Swimming training for asthma in children and adolescents aged 18 years and under.The Cochrane database of systematic reviews · 2013Pooled it
- Selective citation in the literature on swimming in chlorinated water and childhood asthma: a network analysis.Research integrity and peer review · 2017Article
- Bacteriological quality of some swimming pools in Alexandria with special reference to Staphylococcus aureus.Environmental monitoring and assessment · 2016Article
- GIS-based Association Between PM10 and Allergic Diseases in Seoul: Implications for Health and Environmental Policy.Allergy, asthma & immunology research · 2016Article
- Health effects from swimming training in chlorinated pools and the corresponding metabolic stress pathways.PloS one · 2015Article
- Exercise and asthma: an overview.European clinical respiratory journal · 2015Article
- Chronic low dose chlorine exposure aggravates allergic inflammation and airway hyperresponsiveness and activates inflammasome pathway.PloS one · 2014Article
- Prevalence of asthma symptoms in schoolchildren, and climate in west European countries: an ecologic study.International journal of biometeorology · 2013Article
- Prevalence of bronchial asthma in Indian children.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2009Article
- Childhood asthma and environmental exposures at swimming pools: state of the science and research recommendations.Environmental health perspectives · 2009Review
- The respiratory health of swimmers.Sports medicine (Auckland, N.Z.) · 2009Review
- The chlorine hypothesis: fact or fiction?Occupational and environmental medicine · 2007Review
- Exercise, Asthma and the Olympics: A 2000-year-old tale.Porto biomedical journalReview
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2 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundIt has been hypothesised that the rise in childhood asthma in the developed world could result at least in part from the increasing exposure of children to toxic chlorination products in the air of indoor swimming pools.
objectivesEcological study to evaluate whether this hypothesis can explain the geographical variation in the prevalence of asthma and other atopic diseases in Europe.
methodsThe relationships between the prevalences of wheezing by written or video questionnaire, of ever asthma, hay fever, rhinitis, and atopic eczema as reported by the International Study of Asthma and Allergies in Childhood (ISAAC), and the number of indoor chlorinated swimming pools per inhabitant in the studied centres were examined. Associations with geoclimatic variables, the gross domestic product (GDP) per capita, and several other lifestyle indicators were also evaluated.
resultsAmong children aged 13-14 years, the prevalence of wheezing by written questionnaire, of wheezing by video questionnaire, and of ever asthma across Europe increased respectively by 3.39% (95% CI 1.96 to 4.81), 0.96% (95% CI 0.28 to 1.64), and 2.73% (95% CI 1.94 to 3.52), with an increase of one indoor chlorinated pool per 100 000 inhabitants. Similar increases were found when analysing separately centres in Western or Northern Europe and for ever asthma in Southern Europe. In children aged 6-7 years (33 centres), the prevalence of ever asthma also increased with swimming pool availability (1.47%; 95% CI 0.21 to 2.74). These consistent associations were not found with other atopic diseases and were independent of the influence of altitude, climate, and GDP per capita.
conclusionsThe prevalence of childhood asthma and availability of indoor swimming pools in Europe are linked through associations that are consistent with the hypothesis implicating pool chlorine in the rise of childhood asthma in industrialised countries.
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