Massin N, Bohadana A B, Wild P, Héry M, Toamain J P, Hubert G
Institut National de Recherche et de Sécurité, INRS, Service d'Epidémiologie, Vandoeuvre-lès-Nancy, France.
Occup Environ Med. 1998 Apr;55(4):258-63. doi: 10.1136/oem.55.4.258.
To measure the levels of exposure to nitrogen trichloride (NCl3) in the atmosphere of indoor swimming pools and to examine how they relate to irritant and chronic respiratory symptoms, indices of pulmonary function, and bronchial hyperresponsiveness to methacholine in lifeguards working in the pools.
334 lifeguards (256 men; 78 women) recruited from 46 public swimming pools (n = 228) and 17 leisure centre swimming pools (n = 106) were examined. Concentrations of NCl3 were measured with area samplers. Symptoms were assessed by questionnaire and methacholine bronchial challenge (MBC) test by an abbreviated method. Subjects were labelled MBC+ if forced expiratory volume in one second (FEV1) fell by > or = 20%. The linear dose-response slope was calculated as the percentage fall in FEV1 at the last dose divided by the total dose given.
1262 samples were taken in the 63 pools. Mean NCl3 concentrations were greater in leisure than in public pools. A significant concentration-response relation was found between irritant eye, nasal, and throat symptoms-but not chronic respiratory symptoms-and exposure concentrations. Among women, the prevalence of MBC+ was twice as great as in men. Overall, no relation was found between bronchial hyperresponsiveness and exposure.
The data show that lifeguards exposed to NCl3 in indoor swimming pools are at risk of developing irritant eye, nasal, and throat symptoms. Exposure to NCl3 does not seem to carry the risk of developing permanent bronchial hyperresponsiveness, but this association might have been influenced by self selection. The possibility that subjects exposed to NCl3 are at risk of developing transient bronchial hyperresponsiveness cannot be confidently ruled out.
测量室内游泳池空气中三氯化氮（NCl3）的暴露水平，并研究其与刺激性和慢性呼吸道症状、肺功能指标以及在游泳池工作的救生员对乙酰甲胆碱的支气管高反应性之间的关系。
对从46个公共游泳池（n = 228）和17个休闲中心游泳池（n = 106）招募的334名救生员（256名男性；78名女性）进行了检查。用区域采样器测量NCl3浓度。通过问卷调查评估症状，并用简化方法进行乙酰甲胆碱支气管激发（MBC）试验。如果一秒用力呼气量（FEV1）下降≥20%，则将受试者标记为MBC+。线性剂量反应斜率计算为最后一剂时FEV1下降的百分比除以给予的总剂量。
在63个游泳池中采集了1262个样本。休闲中心游泳池的平均NCl3浓度高于公共游泳池。在刺激性眼、鼻和喉症状（而非慢性呼吸道症状）与暴露浓度之间发现了显著的浓度反应关系。在女性中，MBC+的患病率是男性的两倍。总体而言，未发现支气管高反应性与暴露之间的关系。
数据表明，在室内游泳池接触NCl3的救生员有出现刺激性眼、鼻和喉症状的风险。接触NCl3似乎不会带来永久性支气管高反应性的风险，但这种关联可能受到自我选择的影响。不能完全排除接触NCl3的受试者有出现短暂性支气管高反应性的风险。
