Please note: While some information will still be current in a year, other information may already be out of date in three months time. If you are in any doubt, please feel free to ask.

Are swimming pools an unnecessary risk after all?

Dear ECORN Experts,

It seems to be a common view that swimming in well maintained indoor pools is safe for people with CF but I'm starting to wonder if this really is so?

I have discontinued my son's swimming lessons because he regularly had both staph and fungal infections in his upper airways. During the summer breaks, when he would only swim in a lake, the infections went away, but returned as soon the indoor swimming lessons started. The swimming pool is a modern reputable pool.

Incidentally, I've also read that Sydney's newest swimming complex was closed down for an extended period late last year because of hard to treat pseudomonas outbreak. I also read an article about a young girl with CF in Sweden who is a champion swimmer but who was on the lung transplant list because of chronic PA - her twin brother with CF was fine.

All of this makes me wonder if indoor swimming pools are worth the risk for people with CF after all? Whether a pool is well maintained is something that is very hard to acertain. There other as effective and safer forms of excercise such as running.
Dear questioner

Thank you for your question which I will try to answer.
Swimming pools are generally safe provided a recommended programme of maintenance is carried out – but standards vary significantly. In a well maintained public swimming pool the addition of a sufficient amount of chlorine to the water will kill the Pseudomonas bacteria.

Psuedomonas bacteria poses a particular risk in spa pools and outbreaks of infection in non-CF people have been reported. Acquisition of a PA infection by a person with CF from a swimming pool has never been documented to the best of my knowledge.

Therefore whilst in general, swimming pools are safe provided the recommended programme of maintenance is performed there are potential risks which vary according to the location and it is impossible to generalize. For example In a study in Northern Ireland, 38.2% of pools were positive for Psuedomonas bacteria.[1] Well operated pools should not normally contain Psuedomonas bacteria.

The most important thing is that some form of exercise is adhered to and we agree that there is many options including running, walking, cycling and many team sports. We strongly advise patients to discuss with their CF physiotherapist/team on suitable forms of exercise and hopefully they can also advise on the risks associated with local pools as it is quite hard to generalise.

I hope this answers your question
Best wishes

Best wishes
Prof Judy Bradley

Reference List

1. Moore, J.E., et al., Incidence of Pseudomonas aeruginosa in recreational and hydrotherapy pools. Commun Dis Public Health, 2002. 5(1): p. 23-6.

The answer is edited by: Prof Judy Bradley