Valeriani Federica, Protano Carmela, Vitali Matteo, Romano Spica Vincenzo
Public Health Unit, University of Rome "Foro Italico", Rome, Italy.
Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
Pediatr Int. 2017 May;59(5):614-621. doi: 10.1111/ped.13230. Epub 2017 Feb 28.
The association between asthma and swimming pool attendance has not been demonstrated and currently there are conflicting results. In order to clarify the association between asthma diagnosis in children and swimming pool attendance, and to assess the consistency of the available epidemiological studies, we completed a literature analysis on the relationship between the exposure to disinfection by-products in indoor swimming pools during childhood and asthma diagnosis.
Following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) criteria, a systematic review and meta-analysis was performed by searching MEDLINE via PubMed, TOXNET, and Scopus databases (from inception to 20 April 2015) using the key word "Asthma" together with "swimming pool", "disinfection by-products", "indoor air pollution" and "children". Inclusion criteria were: English language, a complete analytic study design involving a cohort of children (0-16 years), a well-defined definition of exposure, and the presence of data on effect and variance. Studies on in vivo, in vitro or professional and accidental exposure were excluded.
After a screening process, seven reports (n = 5851 subjects) were included out of a total of 2928 references. The reported OR of the association between swimming pool attendance and asthma prevalence ranged from 0.58 to 2.30. The present meta-analysis failed to identify a significant difference in asthma development between children attending swimming pools and controls (OR, 1.084; 95% CI: 0.89-1.31).
Swimming in childhood does not increase the likelihood of doctor-diagnosed asthma. Based on this meta-analysis review, the association of the disease with indoor pool attendance is still unclear.
哮喘与去游泳池之间的关联尚未得到证实，目前结果存在矛盾。为了阐明儿童哮喘诊断与去游泳池之间的关联，并评估现有流行病学研究的一致性，我们针对儿童时期接触室内游泳池消毒副产物与哮喘诊断之间的关系进行了文献分析。
按照流行病学观察性研究的Meta分析（MOOSE）和系统评价与Meta分析的首选报告项目（PRISMA）标准，通过PubMed、TOXNET和Scopus数据库（从建库至2015年4月20日）检索MEDLINE，使用关键词“哮喘”以及“游泳池”“消毒副产物”“室内空气污染”和“儿童”进行系统评价和Meta分析。纳入标准为：英文文献、涉及一组儿童（0至16岁）的完整分析性研究设计、明确的暴露定义以及存在效应和方差数据。排除关于体内、体外或职业及意外暴露的研究。
经过筛选过程，在总共2928篇参考文献中纳入了7篇报告（n = 5851名受试者）。报告的去游泳池与哮喘患病率之间关联的OR值范围为0.58至2.30。本次Meta分析未能发现去游泳池的儿童与对照组在哮喘发病方面存在显著差异（OR，1.084；95%CI：0.89 - 1.31）。
儿童时期游泳不会增加医生诊断哮喘的可能性。基于这项Meta分析综述，该疾病与去室内游泳池之间的关联仍不明确。
