The effect of physical and chemical properties of swimming pool water and its close environment on the development of contact dermatitis in hydrotherapists.

BACKGROUND: The association between physical and chemical parameters in swimming pool water and the incidence of contact dermatitis (CD) in hydrotherapists was studied. METHODS: Chemical and physical parameters characterizing the water and air environment of swimming pools conducting hydrotherapy program were recorded. Differences between the values of these parameters associated with affected and non-affected hydrotherapists employed in 39 pools were tested statistically. RESULTS: No significant difference was found between the means of each of the physical and chemical parameters associated with the affected and the non-affected group of hydrotherapists. The prevalence ratio of the incidence of CD in pools chlorinated by gaseous chlorine was significantly higher than that in pools disinfected by other forms of chlorine compounds (PR = 1.49, CI = 1.17-1.89, P = 0.017). CONCLUSIONS: Dosing the water with larger amounts of gaseous chlorine compared to other disinfectants and a subsequent temporary decrease in the pH of the water may produce a more aggressive environment. It is suggested that combined effect of the various factors concomitantly with the irritating effect of prolonged exposure to water may trigger CD in pools treated with other chlorine-based compounds.

Skin test results and self-reported symptom severity in allergic rhinitis: The role of psychological factors.

BACKGROUND: In allergic conditions, the degree of skin test reactivity does not always correlate with the severity of clinical symptoms. Additional factors may contribute to the reported symptom severity. OBJECTIVES: To investigate the association between the magnitude of the skin prick test (SPT) response and the reported symptom severity in patients with allergic rhinitis and the possible modifying role of psychological factors. METHODS: One hundred four patients with allergic rhinitis and 23 with non-allergic rhinitis, classified according to their SPT response to 19 aeroallergens, were asked to rate the severity of five symptoms and to indicate whether their symptoms intensified on exposure to five common aeroallergens. They also completed a psychological questionnaire. Results Reported symptom severity of allergic rhinitis did not correlate with weal size for any of the aeroallergens tested or with the number of positive responses on SPT. It was not related to patient age, sex, or education. The reported symptoms severity correlated positively (0.29, P < 0.01) with reported symptom intensification on exposure to allergens. Moreover, both outcomes were positively associated with the psychological factors of hypochondriasis (0.20, P < 0.05 and 0.18, P < 0.05, respectively), and somatic awareness (0.24, P < 0.05 and 0.33, P < 0.01, respectively), but not with neuroticism. CONCLUSIONS: The severity of symptoms experienced by patients with allergic rhinitis is apparently not related to the magnitude of SPT response, but rather to psychological factors of hypochondriasis and somatic awareness. Physicians should be aware of the contribution of psychological factors to patient perceptions of the intensity of symptoms and of the intensification of symptoms on their exposure to allergens.