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After swimming in indoor swimming pools I have red eyes and often an inflamed nasal mucosa. What causes these symptoms?
 

Water in indoor swimming pools mostly is disinfected by adding chlorine (Cl2) or the chlorine-containing sodium hypochlorite (NaOCl). Similar to their reactions with microorganisms, the disinfecting agents interact with organic substances as e.g. urea which originates from the traces of urine in the water. In this case, also the aggressive and volatile trichloramine (NCl3) develops which, among others, is responsible for the typical "chlorine odour" in swimming pools.

Skin and mucous membrane surfaces are affected by the disinfecting agents in the water. This can lead to irritations of the eyes and in the case of competitive swimmers with their faces consistently submerged in water even persistent inflammations of the nasal membrane can appear.

In the beginning, the sensitive nasal membranes react with sneezing fits and an increased disposition to nose bleeding. Subsequently the nose becomes increasingly sensitive to house and wood dusts as well as pollen (hay fever). The frequency of the exposure to chlorine water also plays a significant role. It has been variously discussed that chlorine water also could trigger asthma however an explicit causal relationship could not be established yet. It is a well-known fact though that chronic hay fever often leads to asthma.

What can be done?

Protecting the skin surface with a skin protection cream before swimming is not beneficial since the cream components also are affected and rinsed off by the water.

Irritated eyes can be avoided with small and tightly fitting swim goggles.

Less known are swim goggles with nose protections or so-called swim masks. The mask protects nose and nostrils against the penetration of chlorinated water. In contrast to the normal diving goggles, it even is possible to exhale under water via the nose without getting in contact with water.

An additional tip concerning the above mentioned hay fever: In the case of sensitivity, a granulated-pollen based product sold in health food stores (1 to 2 teaspoons a day) can help to desensitize the body. If necessary, begin with small amounts in order to adjust the body to the product. It should however be mentioned that this specific kind of desensitization demands for some patience since it may even take several years. However, it is worth the effort because pharmaceutical drugs as for instance antihistamines can be spared and even completely avoided in the long run. An additional teaspoon of a local bees honey may be beneficial as an adjuvant therapy however experience has shown that honey by itself will not be sufficient.

Dr. Hans Lautenschläger

Please note: The contribution is based on the state of the art at the revision date.

 
 
 
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Revision: 03.05.2014