Bath attendants

Abstract

Bath attendants work in indoor or outdoor swimming facilities or, less frequently, at the seaside. Irritant and allergic occupational dermatitis in bath attendants can be induced by water, disinfectants, sunscreens, swimming clothes, or equipment. Especially repeated and prolonged wet work causes skin irritation and impairs the skin barrier function. Contact dermatitis to disinfectants is rarely observed and mainly caused by chlorinated or brominated by-products in the swimming pool water such as trihalomethanes (e.g., trichloromethane, chloroform), haloamines, haloacetic acids and haloketones; substances added to eliminate amines and organic contaminants such as potassium peroxymonosulfate; or disinfectants used to disinfect pool edges, showers, bathrooms or pediluvia such as sodium hypochlorite, aldehydes and quaternary ammonium compounds. Contact dermatitis associated with disinfectants used in swimming pools are rather due to irritancy, but may also be caused by true sensitization. Urticaria induced by swimming in pools can be cold-induced urticaria, aquagenic urticaria, or contact-urticaria to chlorinated water. Rare causes of occupational dermatoses in bath attendants are skin infections due to pathogens in the pool water, aquagenic pruritus, or skin cancer induced by exposure to UV-light during outdoor activities.