Centre for Research in Environmental Epidemiology, Barcelona, Spain.
Environ Health Perspect. 2010 Nov;118(11):1538-44. doi: 10.1289/ehp.1001961.
Swimming in chlorinated pools involves exposure to disinfection by-products (DBPs) and has been associated with impaired respiratory health.
We evaluated short-term changes in several respiratory biomarkers to explore mechanisms of potential lung damage related to swimming pool exposure.
We measured lung function and biomarkers of airway inflammation [fractional exhaled nitric oxide (FeNO), eight cytokines, and vascular endothelial growth factor (VEGF) in exhaled breath condensate], oxidative stress (8-isoprostane in exhaled breath condensate), and lung permeability [surfactant protein D (SP-D) and the Clara cell secretory protein (CC16) in serum] in 48 healthy nonsmoking adults before and after they swam for 40 min in a chlorinated indoor swimming pool. We measured trihalomethanes in exhaled breath as a marker of individual exposure to DBPs. Energy expenditure during swimming, atopy, and CC16 genotype (rs3741240) were also determined.
Median serum CC16 levels increased from 6.01 to 6.21 microg/L (average increase, 3.3%; paired Wilcoxon test p = 0.03), regardless of atopic status and CC16 genotype. This increase was explained both by energy expenditure and different markers of DBP exposure in multivariate models. FeNO was unchanged overall but tended to decrease among atopics. We found no significant changes in lung function, SP-D, 8-isoprostane, eight cytokines, or VEGF.
We detected a slight increase in serum CC16, a marker of lung epithelium permeability, in healthy adults after they swam in an indoor chlorinated pool. Exercise and DBP exposure explained this association, without involving inflammatory mechanisms. Further research is needed to confirm the results, establish the clinical relevance of short-term serum CC16 changes, and evaluate the long-term health impacts.
在氯化泳池中游泳会接触到消毒副产物（DBPs），并与呼吸道健康受损有关。
我们评估了几种呼吸生物标志物的短期变化，以探索与泳池暴露相关的潜在肺部损伤的机制。
我们在 48 名健康非吸烟成年人在氯化室内游泳池中游泳 40 分钟前后，测量了肺功能和气道炎症生物标志物[呼出气一氧化氮分数（FeNO）、八种细胞因子和血管内皮生长因子（VEGF）在呼出气冷凝物中]、氧化应激（呼出气冷凝物中的 8-异前列腺素）和肺通透性[表面活性蛋白 D（SP-D）和克拉拉细胞分泌蛋白（CC16）在血清中]。我们还测量了游泳过程中个体暴露于 DBPs 的三卤甲烷在呼出气中的浓度作为标志物。游泳时的能量消耗、特应性和 CC16 基因型（rs3741240）也被确定。
血清 CC16 水平中位数从 6.01 增至 6.21 microg/L（平均增加 3.3%；配对 Wilcoxon 检验 p = 0.03），无论特应性状态和 CC16 基因型如何。在多变量模型中，这种增加既与能量消耗有关，也与不同的 DBP 暴露标志物有关。总的来说，FeNO 没有变化，但在特应性人群中倾向于下降。我们没有发现肺功能、SP-D、8-异前列腺素、八种细胞因子或 VEGF 有显著变化。
我们在健康成年人在室内氯化泳池游泳后，检测到血清 CC16 略有增加，CC16 是肺上皮通透性的标志物。运动和 DBP 暴露解释了这种关联，而不涉及炎症机制。需要进一步的研究来确认这些结果，确定短期血清 CC16 变化的临床相关性，并评估长期的健康影响。
