bladder cancer and chlorinated pools

Former Member
Former Member
So here I am 2 months after getting diagnosed with bladder cancer and as you can imagine all sorts of questions come to mind. One of them is "how did I get it"? And of course that will never be answered. I do not fit the usual profile for bladder cancer: I don't smoke and never have. I'm also not a hairdresser nor someone who works with dye. But in my searches for causes and treatments for bladder cancer, I came across the possible link to the byproducts of chlorination. For example, see: aje.oxfordjournals.org/.../aje.kwj364. I know this has come in these forums (sample here: According to new study Chlorinated pools may lead to cancer - U.S. Masters Swimming Discussion Forums), but what I haven't seen are reports of any other swimmers having bladder cancer. Do you know of other swimmers getting bladder cancer? I know this will never prove a link, and certainly by probability there are some of you out there, but I'm curious to know if there are lots of us or just a few. I've been swimming competitively since I was 7 and I'm now in my early 50's. That's a lot of time in the pool. I've mostly been in outdoor pools, but my college years included indoor swimming. Never, in all that time, have I ever heard any other swimmer mention bladder cancer. Am I alone? The good news is that this was caught early and my prognosis is excellent. There is a small chance of progression which I rather not have (who would?!), but I'm lucky to have had it caught and treated early. I'll be competing for a long time to come. 400 IM today, in fact.
Parents
  • Former Member
    Former Member over 10 years ago
    Dear Jswim788, I too was diagnosed with bladder cancer recently. Like you, I didn't have any risk factors either: no smoking, no drinking, long-use of dyes, so on. But swam for 45 years nearly every day in chlorinated pools, most of them indoors (the focus of most research) until recently when I moved to Hawaii where most pools are outdoors and so subject to uv rays, no enclosure, so on. The cancer was successfully treated with a resection (surgical removal of cancer) and BCG (immunotherapy)--instilling TB bacillus in my bladder to trigger my immune system to attack it and everything else in it especially the cancer--so that I'm declared cancer free now. Here's a piece on that issue you raised. There are others that you can get to from there or by Googling. I'll take a look at your sites too. Science News ... from universities, journals, and other research organizations www.sciencedaily.com/.../bookmark.png Save www.sciencedaily.com/.../email.png Email www.sciencedaily.com/.../print.png Print www.sciencedaily.com/.../share.png Share Chemicals in Indoor Swimming Pools May Increase Cancer RiskSep. 14, 2010 — Swimming in indoor chlorinated pools may induce genotoxicity (DNA damage that may lead to cancer) as well as respiratory effects, but the positive health effects of swimming can be maintained by reducing pool levels of the chemicals behind these potential health risks, according to a new study published in a set of three articles online September 12 ahead of print in the peer-reviewed journalEnvironmental Health Perspectives (EHP). This study is the first to provide a comprehensive characterization of disinfection by-products (DBPs) in an indoor pool environment and the first to study the genotoxicity of exposure to these chemicals among swimmers in an indoor chlorinated pool. Share This: 308 DBPs form in pool water from reactions between disinfectants such as chlorine and organic matter that is either present naturally or is introduced by swimmers, such as sweat, skin cells, and urine. Previous epidemiologic studies have found an association between exposure to DBPs in drinking water and risk of bladder cancer, and one such study has found this association for dermal/inhalational exposure such as occurs during showering, bathing, or swimming. The new study details a comprehensive investigation of DBPs and mutagenicity of water samples collected from two indoor pools, one disinfected with chlorine, the other with bromine. In addition, short-term changes in biomarkers of genotoxicity and respiratory effects were studied in swimmers who swam in the chlorinated pool. No previous studies have combined investigations of the mutagenicity (ability to cause permanent DNA mutations) of pool water with a comprehensive chemical characterization of the water and studies of human exposures, the authors stated. Evidence of genotoxic effects were seen in 49 healthy adults after they swam for 40 minutes in the chlorinated pool. Specifically, researchers found increases in two genotoxicity biomarkers relative to the concentration of the most common types of DBPs in exhaled breath, which were used as a measure of the swimmers' exposures. The biomarkers that increased were micronuclei in blood lymphocytes, which have been associated with cancer risk in healthy subjects, and urine mutagenicity, which is a biomarker of exposure to genotoxic agents. Detailed measurements were also made of the most common exhaled DBPs (trihalomethanes) in air around the pool and in exhaled breath of the swimmers before and after swimming. Researchers measured several biomarkers of respiratory effects after swimming and found changes in only one -- a slight increase in serum CC16, which suggests an increase in lung epithelium permeability. This result was explained by the effects of exercise itself as well as exposure to DBPs. Further research is needed to sort out the clinical relevance of this acute change, the researchers stated. In addition, the authors identified more than 100 DBPs in the pool waters, some never reported previously in swimming pool water and/or chlorinated drinking water. In vitro assays showed that the swimming pool water was mutagenic at levels similar to that of drinking water but was more cytotoxic (can kill cells at a lower concentration) than drinking water. The human exposures studied were short-term, and further investigations of genotoxic and respiratory effects of longer-term exposures are needed, the authors stated. Also noted was a need for further research on an array of swimming pools under various conditions of maintenance and use, as well as more complete evaluations of the uptake and potential effects of the wide range of compounds present in pool water. These are preliminary results that should be confirmed in studies with larger sample sizes. This work was supported by the Spanish organizations Plan Nacional and Fondo de Investigación Sanitaria, Instituto de Salud Carlos III; and also by the U.S. Environmental Protection Agency.
Reply
  • Former Member
    Former Member over 10 years ago
    Dear Jswim788, I too was diagnosed with bladder cancer recently. Like you, I didn't have any risk factors either: no smoking, no drinking, long-use of dyes, so on. But swam for 45 years nearly every day in chlorinated pools, most of them indoors (the focus of most research) until recently when I moved to Hawaii where most pools are outdoors and so subject to uv rays, no enclosure, so on. The cancer was successfully treated with a resection (surgical removal of cancer) and BCG (immunotherapy)--instilling TB bacillus in my bladder to trigger my immune system to attack it and everything else in it especially the cancer--so that I'm declared cancer free now. Here's a piece on that issue you raised. There are others that you can get to from there or by Googling. I'll take a look at your sites too. Science News ... from universities, journals, and other research organizations www.sciencedaily.com/.../bookmark.png Save www.sciencedaily.com/.../email.png Email www.sciencedaily.com/.../print.png Print www.sciencedaily.com/.../share.png Share Chemicals in Indoor Swimming Pools May Increase Cancer RiskSep. 14, 2010 — Swimming in indoor chlorinated pools may induce genotoxicity (DNA damage that may lead to cancer) as well as respiratory effects, but the positive health effects of swimming can be maintained by reducing pool levels of the chemicals behind these potential health risks, according to a new study published in a set of three articles online September 12 ahead of print in the peer-reviewed journalEnvironmental Health Perspectives (EHP). This study is the first to provide a comprehensive characterization of disinfection by-products (DBPs) in an indoor pool environment and the first to study the genotoxicity of exposure to these chemicals among swimmers in an indoor chlorinated pool. Share This: 308 DBPs form in pool water from reactions between disinfectants such as chlorine and organic matter that is either present naturally or is introduced by swimmers, such as sweat, skin cells, and urine. Previous epidemiologic studies have found an association between exposure to DBPs in drinking water and risk of bladder cancer, and one such study has found this association for dermal/inhalational exposure such as occurs during showering, bathing, or swimming. The new study details a comprehensive investigation of DBPs and mutagenicity of water samples collected from two indoor pools, one disinfected with chlorine, the other with bromine. In addition, short-term changes in biomarkers of genotoxicity and respiratory effects were studied in swimmers who swam in the chlorinated pool. No previous studies have combined investigations of the mutagenicity (ability to cause permanent DNA mutations) of pool water with a comprehensive chemical characterization of the water and studies of human exposures, the authors stated. Evidence of genotoxic effects were seen in 49 healthy adults after they swam for 40 minutes in the chlorinated pool. Specifically, researchers found increases in two genotoxicity biomarkers relative to the concentration of the most common types of DBPs in exhaled breath, which were used as a measure of the swimmers' exposures. The biomarkers that increased were micronuclei in blood lymphocytes, which have been associated with cancer risk in healthy subjects, and urine mutagenicity, which is a biomarker of exposure to genotoxic agents. Detailed measurements were also made of the most common exhaled DBPs (trihalomethanes) in air around the pool and in exhaled breath of the swimmers before and after swimming. Researchers measured several biomarkers of respiratory effects after swimming and found changes in only one -- a slight increase in serum CC16, which suggests an increase in lung epithelium permeability. This result was explained by the effects of exercise itself as well as exposure to DBPs. Further research is needed to sort out the clinical relevance of this acute change, the researchers stated. In addition, the authors identified more than 100 DBPs in the pool waters, some never reported previously in swimming pool water and/or chlorinated drinking water. In vitro assays showed that the swimming pool water was mutagenic at levels similar to that of drinking water but was more cytotoxic (can kill cells at a lower concentration) than drinking water. The human exposures studied were short-term, and further investigations of genotoxic and respiratory effects of longer-term exposures are needed, the authors stated. Also noted was a need for further research on an array of swimming pools under various conditions of maintenance and use, as well as more complete evaluations of the uptake and potential effects of the wide range of compounds present in pool water. These are preliminary results that should be confirmed in studies with larger sample sizes. This work was supported by the Spanish organizations Plan Nacional and Fondo de Investigación Sanitaria, Instituto de Salud Carlos III; and also by the U.S. Environmental Protection Agency.
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