Expert: Marc Rubin, RPh Asthma Educator - 2/11/2009

Question
My 10 year old daughter has never had any asthma symptoms.  She has been
on a swim team last year and half of this season so far.  She had the flu last
week, and 3 days later began coughing and complaining of tightness and
stinging in chest.  Her oxygen at dr's was 99, and dr did not hear anything
problematic with stethoscope.  She decided to try the albuterol nebulizer, and
was surprised to hear it made a difference, and my daughter felt better.  Her
oxygen went up to 99/100.  She did a chest x-ray, which showed some
flattening and trapped air pockets.  She has put her on zithromax, flovent and
albuterol for one week, and flovent alone for 2nd week.  She is saying it is
"reactive airways" and says if she has this again, she would call it asthma.  My
6 year old has asthma, diagnosed at 3.  It seems unlikely my 10 year old
would start displaying symptoms out of the blue.  I have been researching
the studies showing correlation to inhaled chlorine by=products in indoor
pools, especially in most active swimmers.  They are saying it causes
increased lung permeability and may damage the lungs as much as heavy
smoking.  Is this true?  I am feeling as though I have caused my daughter to
have asthma because of her high-level competitive indoor swimming.  If this
is likely, why isn't this information more widely disseminated?

Answer
Hi Paula,

Chlorine is a major lung irritant (when there are railway accidents with chlorine cars, the towns are evacuated). It is critical that 1)the level of chlorine in the pool is closely monitored, and 2) the pool area needs considerable ventilation.

While swimming is a great sport for asthmatics, poor control on the part of the maintenance staff can certainly cause this problem. There are specific guidelines that MUST be followed, but sometimes public pools get overdosed due to fear from contaminants. Definitely speak to the administration regarding this, since in addition to harming people, there are legal implications.

This info is distributed through sites regarding lung health, but that doesn't mean enough people read it.

Good luck, and look up the swimmer AmyVanDyken.

Sincerely,

Marc