Ocular and Respiratory Symptoms Among Lifeguards at a Hotel Indoor Waterpark Resort

Objectives: To determine the cause of eye and respiratory irritation symptoms among lifeguards at an indoor waterpark. Methods: Investigators 1) performed environmental sampling for chloramine, endotoxin, and microbials; 2) administered symptom questionnaires; 3) reviewed ventilation system designs: and 4) reviewed water chemistry. Results: Airborne trichloramine concentrations were found at levels reported to cause irritation symptoms in other studies. Some endotoxin concentrations were found at levels associated with cough and fever in previous studies. Exposed lifeguards were significantly more likely to report work-related irritation symptoms than unexposed individuals. The ventilation system may not have provided sufficient air movement and distribution to adequately capture and remove air contaminants at deck level. No water microbes were detected, and water chemistry met state standards. Conclusions: Indoor waterparks need to control water chemistry and ensure adequate air movement and distribution to control air contaminants and reduce health symptoms.