Skip to main content
SpringerLink
Log in

Bath Attendants

  • Reference work entry
Kanerva's Occupational Dermatology

  • 188 Accesses

Abstract

Irritant and allergic occupational dermatitis in bath attendants can be induced by water, disinfectants, sunscreens, swimming clothes, or equipment.

Especially repeated and prolonged wet work causes skin irritation and impairs the skin barrier function.

Contact dermatitis to disinfectants is rarely observed and mainly caused by chlorinated or brominated by-products in the swimming pool water, such as trihalomethanes (e.g., trichloromethane, chloroform), haloamines, haloacetic acids, and haloketones or disinfectants used to disinfect pool edges, showers, bathrooms, or pediluvia, such as sodium hypochloride, aldehydes, and quaternary ammonium compounds.

Contact dermatitis associated with disinfectants used in swimming pools are rather due to irritancy, but may also be caused by true sensitization.

Urticaria induced by swimming in pools can be cold-induced urticaria, aquagenic urticaria, or contact urticaria to chlorinated water.

Rare causes of occupational dermatoses in bath attendants are skin infections due to pathogens in the pool water, aquagenic pruritus, or skin cancer induced by exposure to UV-light during outdoor activities.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Alomar A, Vilaltella I (1985) Contact dermatitis to dibutylthiourea in swimming goggles. Contact Dermatitis 13(5):348–349

    Article  PubMed  CAS  Google Scholar 

  • Bentley B 2nd (1993) Cold-induced urticaria and angioedema: diagnosis and management. Am J Emerg Med 11(1):43–46

    Article  PubMed  Google Scholar 

  • Blauvelt A, Duarte AM et al (1992) Pool palms. J Am Acad Dermatol 27(1):111

    Article  PubMed  CAS  Google Scholar 

  • Cammann K, Hubner K (1995) Trihalomethane concentrations in swimmers’ and bath attendants’ blood and urine after swimming or working in indoor swimming pools. Arch Environ Health 50(1):61–65

    Article  PubMed  CAS  Google Scholar 

  • Caro J, Gallego M (2007) Assessment of exposure of workers and swimmers to trihalomethanes in an indoor swimming pool. Environ Sci Technol 41(13):4793–4798

    Article  PubMed  CAS  Google Scholar 

  • Choong KY, Roberts LJ (1999) Molluscum contagiosum, swimming and bathing: a clinical analysis. Australas J Dermatol 40(2):89–92

    Article  PubMed  CAS  Google Scholar 

  • Chu H, Nieuwenhuijsen MJ (2002) Distribution and determinants of trihalomethane concentrations in indoor swimming pools. Occup Environ Med 59(4):243–247

    Article  PubMed  CAS  Google Scholar 

  • Dooms-Goossens A, Gevers D et al (1983) Allergic contact urticaria due to chloramine. Contact Dermatitis 9(4):319–320

    Article  PubMed  CAS  Google Scholar 

  • Fisher AA (1987) Contact dermatitis to diving equipment, swimming pool chemicals, and other aquatic denizens. Clin Dermatol 5(3):36–40

    Article  PubMed  CAS  Google Scholar 

  • Fisher AA (1988) Swimming pool granulomas due to Mycobacterium marinum: an occupational hazard of lifeguards. Cutis 41(6):397–398

    PubMed  CAS  Google Scholar 

  • Fisher AA (1993) Aquagenic pruritus. Cutis 51(3):146–147

    PubMed  CAS  Google Scholar 

  • Fitzgerald DA, Wilkinson SM et al (1995) Spa pool dermatitis. Contact Dermatitis 33(1):53

    Article  PubMed  CAS  Google Scholar 

  • Frances AM, Fiorenza G et al (2004) Aquagenic urticaria: report of a case. Allergy Asthma Proc 25(3):195–197

    PubMed  Google Scholar 

  • Geller AC, Glanz K et al (2001) Impact of skin cancer prevention on outdoor aquatics staff: the pool cool program in Hawaii and Massachusetts. Prev Med 33(3):155–161

    Article  PubMed  CAS  Google Scholar 

  • Goette DK (1984) Raccoon-like periorbital leukoderma from contact with swim goggles. Contact Dermatitis 10(3):129–131

    Article  PubMed  CAS  Google Scholar 

  • Gould D (1983) Dermatoses associated with brominated swimming pools. Br Med J (Clin Res Ed) 287:913

    Article  Google Scholar 

  • Gustafson TL, Band JD et al (1983) Pseudomonas folliculitis: an outbreak and review. Rev Infect Dis 5(1):1–8

    Article  PubMed  CAS  Google Scholar 

  • Hall DM, McCarty F et al (2009) Lifeguards’ sun protection habits and sunburns: association with sun-safe environments and skin cancer prevention program participation. Arch Dermatol 145(2):139–144

    Article  PubMed  Google Scholar 

  • Heitkemper T, Hofmann T et al (2010) Aquagenic pruritus: associated diseases and clinical pruritus characteristics. J Dtsch Dermatol Ges 8(10):797–804

    PubMed  Google Scholar 

  • Hostynek JJ, Patrick E et al (1989) Hypochlorite sensitivity in man. Contact Dermatitis 20(1):32–37

    Article  PubMed  CAS  Google Scholar 

  • Jacobson JA (1985) Pool-associated Pseudomonas aeruginosa dermatitis and other bathing-associated infections. Infect Control 6(10):398–401

    PubMed  CAS  Google Scholar 

  • Kanerva L, Alanko K et al (1997) Occupational allergic contact urticaria from chloramine-T solution. Contact Dermatitis 37(4):180–181

    Article  PubMed  CAS  Google Scholar 

  • Kelsall HL, Sim MR (2001) Skin irritation in users of brominated pools. Int J Environ Health Res 11(1):29–40

    Article  PubMed  CAS  Google Scholar 

  • Loughney E, Harrison J (1998) Irritant contact dermatitis due to 1-bromo-3-chloro-5,5-dimethylhydantoin in a hydrotherapy pool. Risk assessments: the need for continuous evidence-based assessments. Occup Med (Lond) 48(7):461–463

    Article  CAS  Google Scholar 

  • Maibach H (1975) Scuba diver facial dermatitis: allergic contact dermatitis to N-isopropyl-N-phenylpara-phenylenediamine. Contact Dermatitis 1(5):330

    Article  PubMed  CAS  Google Scholar 

  • Massin N, Bohadana AB et al (1998) Respiratory symptoms and bronchial responsiveness in lifeguards exposed to nitrogen trichloride in indoor swimming pools. Occup Environ Med 55(4):258–263

    Article  PubMed  CAS  Google Scholar 

  • Morgan J (1983) Dermatoses associated with brominated swimming pools. Br Med J (Clin Res Ed) 287:913

    Google Scholar 

  • Neering H (1977) Contact urticaria from chlorinated swimming pool water. Contact Dermatitis 3(5):279

    Article  PubMed  CAS  Google Scholar 

  • Osmundsen PE (1978) Contact dermatitis due to sodium hypochlorite. Contact Dermatitis 4(3):177–178

    Article  PubMed  CAS  Google Scholar 

  • Pardo A, Nevo K et al (2007) The effect of physical and chemical properties of swimming pool water and its close environment on the development of contact dermatitis in hydrotherapists. Am J Ind Med 50(2):122–126

    Article  PubMed  CAS  Google Scholar 

  • Penny PT (1991) Hydrotherapy pools of the future–the avoidance of health problems. J Hosp Infect 18(Suppl A):535–542

    Article  PubMed  Google Scholar 

  • Penso-Assathiany D, Flahault A et al (1999) Warts, swimming pools and atopy: a case control study conducted in a private dermatology practice. Ann Dermatol Venereol 126(10):696–698

    PubMed  CAS  Google Scholar 

  • Rycroft RJ, Penny PT (1983) Dermatoses associated with brominated swimming pools. Br Med J (Clin Res Ed) 287(6390):462

    Article  CAS  Google Scholar 

  • Sasseville D, Geoffrion G et al (1999) Allergic contact dermatitis from chlorinated swimming pool water. Contact Dermatitis 41(6):347–348

    Article  PubMed  CAS  Google Scholar 

  • Scheuer E, Warshaw E (2006) Sunscreen allergy: a review of epidemiology, clinical characteristics, and responsible allergens. Dermatitis 17(1):3–11

    Article  PubMed  Google Scholar 

  • Sibbald RG, Black AK et al (1981) Aquagenic urticaria: evidence of cholinergic and histaminergic basis. Br J Dermatol 105(3):297–302

    Article  PubMed  CAS  Google Scholar 

  • Siebenhaar F, Degener F et al (2009) High-dose desloratadine decreases wheal volume and improves cold provocation thresholds compared with standard-dose treatment in patients with acquired cold urticaria: a randomized, placebo-controlled, crossover study. J Allergy Clin Immunol 123(3):672–679

    Article  PubMed  CAS  Google Scholar 

  • Treudler R, Tebbe B et al (2002) Familial aquagenic urticaria associated with familial lactose intolerance. J Am Acad Dermatol 47(4):611–613

    Article  PubMed  Google Scholar 

  • Tuyp E, Mitchell JC (1983) Scuba diver facial dermatitis. Contact Dermatitis 9(4):334–335

    Article  PubMed  CAS  Google Scholar 

  • Valsecchi R, Cassina GP et al (1985) Tego dermatitis. Contact Dermatitis 12(4):230

    Article  PubMed  CAS  Google Scholar 

  • van Joost T, Habets JM et al (1987) Sodium hypochlorite sensitization. Contact Dermatitis 16(2):114

    Article  PubMed  Google Scholar 

  • Zwiener C, Richardson SD et al (2007) Drowning in disinfection byproducts? Assessing swimming pool water. Environ Sci Technol 41(2):363–372

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrueck, Sedanstr. 115, Osnabrueck, 49069, Germany

    Dr. Richard Brans

Authors
  1. Dr. Richard Brans
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Richard Brans .

Editor information

Editors and Affiliations

  1. Department of Dermatology and Allergology, VU University Medical Center, Amsterdam, The Netherlands

    Thomas Rustemeyer

  2. Department of Dermatology, University Hospital Jena, Jena, Germany

    Peter Elsner

  3. Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany

    Swen-Malte John

  4. Department of Dermatology, University of California, San Francisco, CA, USA

    Howard I. Maibach

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this entry

Cite this entry

Brans, R. (2012). Bath Attendants. In: Rustemeyer, T., Elsner, P., John, SM., Maibach, H.I. (eds) Kanerva's Occupational Dermatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-02035-3_123

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-02035-3_123

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-02034-6

  • Online ISBN: 978-3-642-02035-3

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation