Does Swimming in Indoor Pools Cause Asthma? A Critical Review of the State of the Science and Recommendations for a Path Forward Michael Goodman, M.D., M.P.H. - Emory University

The hypothesis that childhood asthma may be caused by exposure to byproducts of water chlorination in swimming pools has recently received a great deal of attention. This hypothesis may have important public health implications as large numbers of children routinely attend chlorinated pools and an increased risk of asthma among these children could translate into a substantial burden of disease. In this meta-analysis, studies on swimming and asthma were divided into four groups: Group I compared frequency of asthma among elite swimmers to that of other athletes; Group II examined the association between asthma and swimming during childhood; Group III evaluated effects of swimming programs on asthma severity and pulmonary function; and Group IV compared immediate respiratory effects of swimming to those of other types of exercise.
In the analysis of studies comprising Group I frequency of asthma among elite swimmers was significantly higher than that of other athletes. The corresponding results reflecting the association between asthma and swimming pool use during childhood showed no discernable effect. In comparison to swimming, running and/or cycling was associated with a significant four to six-fold increase in exercise induced bronchospasm. Although asthma is more commonly found among elite swimmers than among other high-level athletes, it is premature to draw conclusions about the causal link between swimming and asthma because most studies available to date used cross-sectional design, because the association is not confirmed among non-competitive swimmers, and because asthmatics may be more likely to select swimming as the activity of choice because of  their condition.

Biographical Information:

Dr. Michael Goodman is an Assistant Professor at the Department of Epidemiology of the Emory University School of Public Health in Atlanta, GA. Dr. Goodman holds two graduate degrees: a Doctor of Medicine (MD) degree from the Kaunas Medical University in his native Lithuania and a Master of Public Health (MPH) degree from the Johns Hopkins University in Baltimore, Maryland. His areas of research include epidemiology, cancer etiology, prevention and survivorship, children’s health, preventive medicine, and environmental’ health. In addition to teaching epidemiology and conducting original studies, Dr. Goodman has extensive teaching and research experience in comprehensive literature reviews, including meta-analyses.