1. G. Fantuzzi, E. Righi, and G. Aggazzotti EXPOSURE ASSESSMENT TO TRIHALOMETHANES IN SWIMMING POOLS Università di Modena e Reggio Emilia – Italy

2. Guglielmina Fantuzzi Associate Professor of Hygiene, Faculty of Sciences Elena Righi Fellowship in Environmental Epidemiology, Faculty of Medicine Gabriella Aggazzotti Full Professor of Epidemiology, Faculty of Medicine

3. Trihalomethanes: Chloroform Bromodichloromethane Dibromochloromethane Bromoform Disinfection by-products

4. Hazard identification Dose-response relationship Exposure assessment Risk characterization Health risk assessment

5. Water Ambient air Alveolar air Blood Exposure assessment to THMs Environmental monitoring Biological monitoring

6. Environmental monitoring: THMs in pool water  g/l Swimming pools

7. Environmental monitoring: THMs in ambient air  g/m 3 Swimming pools

8. Indoor swimming pools Biological monitoring: chloroform in plasma  g/l

9. Chloroform in plasma  g/l

10.  g/m3 Indoor swimming pools Biological monitoring: chloroform in alveolar air

11. Chloroform in ambient air 3002001000 Chloroform in alveolar air 200 100 0 y= 9.06 + 0.555x n=16 r= 0.804 p<0.001  g/m 3

12. 0 20 40 60 80 100 120 competitivelearnersvisitors Chloroforminalveolar air  g/m 3

13. Chloroform uptake U= (C amb - C alv ) x t x V

14. Subjects 1 2 3 4 5 Before swimming 28 27 28 24 22 After swimming 209 202 193 134 146 Chloroform uptake (µg/h)

15. Time after exposure min Kinetics of chloroform elimination  g/m 3

16. Attending swimming pools, mainly indoor ones, causes exposure to THMs which are present in water and air. Conclusions 1

17. Conclusions 2 As chloroform represents about 95% of the total amount of THMs, biological monitoring can be performed only on this compound.

18. Conclusions 3 Chloroform in plasma and in alveolar air depends on environmental levels and is influenced by the intensity of the physical activity.

19. Conclusions 4 Agonistic swimmers are more exposed than non agonistic ones and visitors: however chloroform elimination via exhaled breath usually stops within ten hours.