Swimming for Asthma, Indoor Chlorine – A Balancing Act

poolwater
(Photo: Flickr user Marcelo Terraza)

My daughters were born and raised in coastal Florida, right up until we drove halfway across the country to move to Colorado in February 2009. They’re both excellent swimmers even though they’ve never taken a lesson. Instead, they grew up in the Gulf of Mexico and in our backyard pool, where floating in a swim ring gave way to splashing around with arm floats gave way to the little kid’s drowned-rat doggie paddle gave way to actual swimming and, in my firstborn’s case, diving.

Now we’re landlocked for the first time in their lives and mine, and we live somewhere with a true winter. So although I’ve written about the chlorination of indoor pools as a trigger before, I lived in Florida and the issue was objective and intellectual for me rather than personal.

Previously

The Problem with Indoor Chlorinated Pools
My original post, with links to research and a summary of my own position back when AG was nine, in 2008.

Chlorination and Outside Pools
Research suggesting high chlorine levels aren’t just a trigger inside, either.

And to Play Devil’s Advocate, a Meta-Analysis of the Pool/Asthma Studies
In January 2009, I published this article by another writer. In it, he examines a new study giving more insight into the connection between asthma and indoor pools. If you scroll down to the bottom, you’ll find my comment reviewing the review and its relevancy to my kid.

Where I Am Now

The Denver area maintains a massive system of community parks, trails, and recreation centers with indoor pools. While the girls use them occasionally, we don’t swim there year-round the way many families here do.

For one, besides the typical childhood opportunities for team sports or dance lessons, this area offers nothing if not boundless opportunities for outdoor recreation and exercise. The Front Range of the Rocky Mountains lie directly to the west. My house, at the foot of the foothills, is literally a several-minute drive from more hiking trails than you can imagine. And the further west you go, the hills and sandstone cliffs gradually lead to the towering, wide-open mountain ranges and national parks my state is famous for.

Plus, I like living seasonally. It’s one reason I moved here, where winter means sledding, snowboarding, and skiing, and summer holds the promise of hot sunny days and swimming. Kids are all about the instant gratification so mine probably disagree with me on this point.

Finally, if you visit that last link above, you’ll read this – and I apologize for quoting myself here, but there’s no way around it – in my final comment:

I have no way to tell whether that trapped chlorine is inflaming her lungs and setting her up for flares LATER, even if it’s not making her actively flare at the time.

Asthma is different for everyone. What triggers one person’s flare may have no effect at all on another person. If you want to let your asthmatic child try an indoor pool, I’d say your best bet is to try it out with no expectations and go very, very prepared with appropriate medication/inhalers. Maintain informed vigilance. If she never flares, great! And if she does have problems, then you’ve a got a decision to make, whether the year-round pool experience is worth pre-treating and risking flares for, anyway, or if you should just limit swimming to the summer and outdoor pools and/or beaches, rivers, and lakes.

So far, I’ve opted for that last option.

In the Future

Who knows? My asthmatic daughter wants to join a swim team, and I’ll probably let her. A Florida childhood gives her an advantage that has her swimming circles around the other kids, so how can I hold her back?

But when she was younger? And spent most of her days flaring or inflamed already? Adding regular use of a heavily chlorinated indoor pool? Forget about it.

24 responses to “Swimming for Asthma, Indoor Chlorine – A Balancing Act”

  1. Sara C. says:

    what about non-chlorinated indoor pools? My parents have a pool, but they use an ozone system with a bromine boost. (very very little bromine)

    I’ve never noticed a higher incidence of flaring when my daughter is at my parents house, and swimming (they doesn’t always have the pool open)

    I’d LOVE to get a pool, but that’s SO not in the budget in the near, or distant future.

  2. Anne says:

    And this may well be paranoia–but municipal drinking water is also chlorinated. That’s excellent in terms of killing many bugs, but you may want to look into a drinking water filter to remove it from the water your child/family drinks–PUR is one option.

  3. Kelley says:

    Thank you. I think i will let her try, but wait until the outdoor seasonal pool opens or when they open/retract the roof on one of the indoor pools.

  4. Amy says:

    Sara C–Sure, I’d try it. As another commenter mentioned, more and more pools now are using salt-water filtration now, too.

    In south FL, it’s actually really easy to afford pools–it’s so seasonal there, houses across all price ranges often have them, not just the McMansion types, lol.

    A lot depends, too, on chlorine levels–the problem with indoor pools (and possibly to some extent with outdoor ones) is that the chlorine evaporates into a gas that can stay right next to the surface of the water, where you inhale. So the higher the chlorine level–and public pools often over-chlorinate–the higher the possibility. Maybe your parents don’t over-chlorinate? When we had a pool, we used as little as possible to be hygienic and cut flare risk at the same time;.

  5. Jeff Sloan says:

    Amy—

    The irritating smell you describe (in your full comment) isn’t caused by chlorine, but rather by chloramines, which are produced when chlorine reacts with contaminants in the pool. By practicing good pool hygiene (no peeing in the pool) and showering before entering the pool (to reduce levels of body oils, lotions and perspiration in pool water), swimmers can help prevent chloramines forming.

    A properly maintained pool should have no strong chemical odor. It is the pool manager’s responsibility to maintain proper chlorine and pH levels. And indoor pools should be adequately ventilated.

    As Anne stated, chlorine is present in our water, and for a good reason— it’s effective at killing the germs that can make us sick.

    Best,
    Jeff

    Jeff Sloan
    American Chemistry Council

  6. Amy says:

    Unfortunately, expecting that children will not pee in a public pool and that all swimmers will shower first is wildly optimistic and not at all plausible.

    Pool managers should be responsible enough to avoid over-chlorination and ensure adequate ventilation, absolutely, but a disinfection method using something other than chlorine would be even better, as this University of Illinois article on the toxic by-products of chlorination states:

    http://www.aces.uiuc.edu/news/stories/news4724.html

    Ultimately, it would be nice to think I could trust my asthmatic child’s respiratory health to the responsibility of other swimmers and swimming pool managers to do that right thing until a new pool disinfection technology becomes widespread, but clearly, I’m not going to do that.

  7. Noelle says:

    You can’t even expect adults to refrain from peeing in the pool.

    One other thing to look for in a pool is the filtration system. Some newer pools can cycle the entire pool in and out in a matter of hours, and that will cut down on the chemical smell and feel. Your best bet is to try the newest pool you can find, if you’re that lucky. My swim coach / pool manager is awesome about keeping his pool clean because he’s got huge medical issues, but there’s not much he can do with his filter, which takes 9 hours to cycle.

    I remember reading an article in Swimmer magazine about an Olympian who’s asthmatic, but for the life of me, I can’t remember her name. I do remember her saying (or was it him?) that the breath pattern necessary for proper stroke technique helped lung conditions in and out of the pool.

    On another note, I think your girls are lucky that they learned play-based swimming. There are so many swimmers who only learned to compete, and are actually not comfortable in the water because they never learned how to just simply float and play.

  8. Susannah says:

    We belong to a Club which uses a low chlorine high saline mix. Apparently all saline pools needs either Bromine or Chlorine to keep the pipes bacteria free.

    In Palm Springs we also have saline and spa water pools, again very little chlorine.

    I guess we have just hit lucky with this as a real chlorine pool not only wrecks your hair and costume, but makes you cough a whole load too!

    Shop around and see if you can find a saline mix pool somewhere reasonably near to you.

    Susannah

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