PDF: Lifeguard Lung
This study found that lifeguards in the subject swimming pool developed granulomatous lung disease associated with endotoxin-containing respirable bioaerosols from water spray features, which ventilation system improvements did not prevent.
Attack rates for the outbreaks were between 27% and 65%. Chloramines and other disinfectant by-products (DBPs) caused permanent lung scarring to these lifeguards involved with the study. The study found a direct correlation between the pool air quality and their conditions.