Weisel Clifford P, Richardson Susan D, Nemery Benoit, Aggazzotti Gabriella, Baraldi Eugenio, Blatchley Ernest R, Blount Benjamin C, Carlsen Kai-Håkon, Eggleston Peyton A, Frimmel Fritz H, Goodman Michael, Gordon Gilbert, Grinshpun Sergey A, Heederik Dirk, Kogevinas Manolis, LaKind Judy S, Nieuwenhuijsen Mark J, Piper Fontaine C, Sattar Syed A
Environmental and Occupational Health Sciences Institute, Robert Wood Johnson Medical School/University of Medicine and Dentistry of New Jersey, Piscataway, New Jersey 08854, USA.
Environ Health Perspect. 2009 Apr;117(4):500-7. doi: 10.1289/ehp.11513. Epub 2008 Sep 30.
Recent studies have explored the potential for swimming pool disinfection by-products (DBPs), which are respiratory irritants, to cause asthma in young children. Here we describe the state of the science on methods for understanding children's exposure to DBPs and biologics at swimming pools and associations with new-onset childhood asthma and recommend a research agenda to improve our understanding of this issue.
A workshop was held in Leuven, Belgium, 21-23 August 2007, to evaluate the literature and to develop a research agenda to better understand children's exposures in the swimming pool environment and their potential associations with new-onset asthma. Participants, including clinicians, epidemiologists, exposure scientists, pool operations experts, and chemists, reviewed the literature, prepared background summaries, and held extensive discussions on the relevant published studies, knowledge of asthma characterization and exposures at swimming pools, and epidemiologic study designs.
Childhood swimming and new-onset childhood asthma have clear implications for public health. If attendance at indoor pools increases risk of childhood asthma, then concerns are warranted and action is necessary. If there is no such relationship, these concerns could unnecessarily deter children from indoor swimming and/or compromise water disinfection.
Current evidence of an association between childhood swimming and new-onset asthma is suggestive but not conclusive. Important data gaps need to be filled, particularly in exposure assessment and characterization of asthma in the very young. Participants recommended that additional evaluations using a multidisciplinary approach are needed to determine whether a clear association exists.
近期研究探讨了作为呼吸道刺激物的游泳池消毒副产物（DBPs）导致幼儿哮喘的可能性。在此，我们描述了关于了解儿童在游泳池接触DBPs和生物制剂的方法以及与儿童新发哮喘的关联的科学现状，并推荐了一个研究议程，以增进我们对该问题的理解。
2007年8月21日至23日在比利时鲁汶举办了一次研讨会，以评估相关文献并制定一个研究议程，以便更好地了解儿童在游泳池环境中的接触情况及其与新发哮喘的潜在关联。参与者包括临床医生、流行病学家、接触科学家、泳池运营专家和化学家，他们查阅了文献，编写了背景总结，并就相关已发表研究、哮喘特征及游泳池接触情况的知识以及流行病学研究设计进行了广泛讨论。
儿童游泳和儿童新发哮喘对公共卫生有明显影响。如果在室内游泳池游泳会增加儿童患哮喘的风险，那么这种担忧是有道理的，采取行动是必要的。如果不存在这种关系，这些担忧可能会不必要地阻碍儿童进行室内游泳和/或影响水的消毒。
目前关于儿童游泳与新发哮喘之间存在关联的证据具有一定提示性，但并不确凿。重要的数据缺口需要填补，特别是在极幼儿童的接触评估和哮喘特征描述方面。参与者建议需要采用多学科方法进行更多评估，以确定是否存在明确的关联。
