On a daily basis, pool cleaners handle a variety of entities that are potentially hazardous to the skin. The aquatic environment of the swimming pool exposes workers to potential contact allergens and irritants and aids in the transmission of infectious agents. In addition, ultraviolet radiation and genotoxic substances generated as disinfection by-products may increase the risk of cancer in these individuals.
Sanitizing and pH-stabilizing agents commonly used in swimming pools include chlorine, hypochlorite salts, trichloro-s-triazinetrione (8), muriatic acid, and copper. Several of these chemicals are known to cause irritant dermatitides, and some, such as muriatic acid, may yield severe chemical burns. When mixed improperly with hypochlorite salts, TST can result in explosions, also leading to burns and even fatalities in those who work with the substance. Cases of allergic contact dermatitides following exposure to various pool water chemicals – chlorine included – have also been reported.
Many common viruses, dermatophytes, and bacteria are waterborne and capable of causing cutaneous infection in humans. Tinea pedis, verruca vulgaris, molluscum contagiosum, Pseudomonas folliculitis, and atypical mycobacterial infections are all skin diseases that may be transmitted by contact with infected water and thus have potential to affect pool workers.
Ultraviolet light and water disinfection by-products such as trihalomethanes (THMs) and haloacetic acids can potentially increase cancer risk in swimming pool workers. THMs and chloroform are activated to mutagens by the enzyme glutathione-S-transferase-theta (GSTT1-1). In particular, bladder cancer risk from THMs seems to be higher in subjects with GSTT1-1 gene.
There is a paucity of literature specific to swimming pool workers; therefore, much of this chapter will extrapolate from relevant skin reactions reported in populations with similar exposures. Whenever possible, studies specific to swimming pool workers will be discussed and cited.
Pool cleaners Pool sanitizing agents Ph stabilizers Alkalization agents Algaecides Irritant contact dermatitis Allergic contact dermatitis
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