Dermatitis in Aquatic Therapists
The effect of physical and chemical properties of swimming pool water and its close environment on the development of contact dermatitis in hydrotherapists
By Pardo A, Nevo K, Vigiser D, Lazarov A. from the Department of Occupational Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, Feb 2007
Hydrotherapy exposes the skin to water and its constituent chemicals and contaminants. These may produce irritations which can become dermatitis or fungal infections. The extent to which physiotherapists, hydrotherapists and other aquatic professionals are affected by these is unknown. 
The association between physical and chemical parameters in swimming pool water and the incidence of contact dermatitis (CD) in hydrotherapists was studied.
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.
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 contact dermatitis (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).
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 contact dermatitis (CD) in pools treated with other chlorine-based compounds.