![[ Visit Client Website ]](images/banner.png)
Abstract: At the end of 2010 a large swimming pool in the Netherlands was closed because of health complaints of life guards and visitors. Untill then no medical doctor was consulted. Soon afterwards the occupational physician consulted an academic expertise center on Occupational Dermatology and Allergology. In a Target Force there was a Babylonic confusion of tongues between technicians, consultants of water laboratories, toxicologist, officials of city, province, public health authorities and occupational dermatologists. Many fantasies were mentioned on possible causes, demonstrating a substantial lack of knowledge on the chemical processes in chlorinated swimming pools and the communication gap between technical and medical professionals. At the end brominated disinfections- byproducts, introduced by using the wrong salts, could be identified as causal agents, responsible for contacturticaria and allergic reactions.
Methods
First and for all it was necessary to find out what were the correct individual medical diagnoses. Next the question whether the symptoms and complaints could be explained by the swimming pool environment. Common factors also lead to a “group diagnosis”. Intensive discussions with toxicologist, officials of public authorities, workplace investigation and coaching of the swim tests resulted in insight of the causal processes of the skin problems, the process diagnosis.
Results
Nine months after closure the situation looks “back to normal” regarding complaints of life guards and visitors. The whole process resulted in many technical, organisational and health care changes. The experience will be used in the WHO Drafting Group on Guidelines for Safe Pools and Spas which started in juli 2011.
Discussion
This casuistic seems to be illustrative for the level of knowledge of occupational health care on swimming pools and spas. The experience will be used in the WHO Drafting Group on Guidelines for Safe Pools and Spas which started in juli 2011.