Is it safe to swim here? - (6/4/2019)

By Dr. Ron Gasbarro

With the early summer already muggy and hot, the pharmacist prayed that the store’s ill-mannered air conditioning would survive. He looked forward to a dive into his swimming pool after his shift was over. Meanwhile, Mrs. Johnson came into the pharmacy with a prescription for her 11-year old, Timmy. “Show the pharmacist your eye, Timmy,” she said to her son. “Pink eye,” the mom stated. Also called conjunctivitis, pink eye is the most common ocular infection that results from swimming in contaminated water. When this occurs, the eyes become reddish and discharge fluid. Pain, burning, scratchiness, or itchiness may also be part of the clinical picture. While usually caused by bacteria, viruses and allergies can also be the culprit that triggers the affliction. When the cause is a bacterial invasion, the treatment is generally an antibiotic ointment placed directly into the eye. 

The pharmacist asked more about Timmy’s swimming habits. “He goes to the lake down the road with his friend Pauly. His family has a pool but Timmy says the pool chemicals irritate his eyes and make it difficult to breathe,” Mrs. Johnson said. The pharmacist told her that chlorine, a popular chemical used to kill bacteria in pools, could cause skin rashes, allergies, and lung injuries. 

The Centers for Disease Control and Prevention (CDC) say that prolonged contact with chlorine gas could be a factor in a variety of respiratory diseases. The CDC has also connected it to epiglottitis – a potentially life-threatening inflammatory condition of the cartilage ‘lid’ that covers the windpipe. Eye irritations are another side effect of chlorinated water.

Swallowing too much chlorinated water can lead to liver or kidney problems. The sodium hypochlorite found in chlorine has the potential to cause liver cancer. While the liver is a filter for toxins in the body, it cannot always neutralize or dispose of them. Instead, they accumulate in that organ setting the stage for a malignancy. Then, there are increased possibilities of colon cancer – caused by a by-product of chlorine gas that is used in industrial solvents and refrigerants – and skin cancer caused by the mixture of chlorine and ultraviolet rays. 

Remember the children who acquired brain-eating amoebas after swimming in contaminated lake water a few years ago? As the climate changes, the Naegleria fowleri amoeba, which thrives in tepid pond water, is moving farther north. This bug is crafty in that one can swallow it with no problem. But if one dives into the water or otherwise gets it into one’s nasal passages, it can make a beeline to the brain via the sinuses. N. fowleri infections are rare, but they are usually deadly. Some 132 people were infected in the period between 1962 to 2014, but only 3 survived, says the CDC. A medical downer. 

Mrs. Johnson, now focused on the dangers of water in general, said, “We were going to take a trip to the ocean, but it all seems so dangerous. What should I do? Wrap Timmy in bubble wrap?” That might help against jellyfish and small sharks, said the pharmacist, but there are a few actions to minimize harm. Always wear a good pair of eye goggles. Earplugs can help prevent water from getting into the deep interior of the ears. Nose plugs are a good idea if swimming in still waters. Do not swallow the water when swimming. Whether it is the ocean or a pool, take a shower and/or dry the body thoroughly afterward, not only to get dry but also to minimize any absorption of chemicals through the skin. “Maybe we will go to the desert instead,” lamented Mrs. Johnson. The pharmacist did not want to concern her further about other vacation hazards such as the depleting ozone layer or the probability of an errant asteroid squashing her car. So he said, “Have a good time wherever you go!” 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Read more at


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