Swimming & Coughing

The idea for this discussion arose from the case of a student who experienced a persistent cough after swimming in the school pool. Initially diagnosed with asthma, his symptoms did not improve despite the use of inhalers. After going deeper into his history, I noticed a clear pattern: his coughing and chest tightness worsened following exposure to the pool water. Interestingly, his pulmonary function test came back normal. Once he stopped swimming and avoided pool water, his symptoms completely resolved, and he no longer required cough medication or inhalers.

Swimming pools are often treated with various chemicals to safeguard against waterborne infections, with chlorine being one of the most common. Chlorine is added to pool water to maintain a concentration of 1-4 ppm (parts per million) and acts as a powerful sanitizer by oxidizing contaminants such as algae and bacteria.

However, while chlorine is intended to keep swimmers safe from infections, it can also irritate the skin and respiratory tract. When chlorine irritates the airways, it can lead to a condition known as “chlorine cough.” This cough, caused by exposure to chlorine, is often accompanied by chest tightness, wheezing, difficulty breathing, and sometimes a burning sensation in the throat. The symptoms may last anywhere from a few hours to several days, depending on the duration of exposure. With repeated exposure, the symptoms can become chronic.

Swimmers in indoor pools face a higher risk, as chlorine fumes can linger in enclosed spaces for longer periods, whereas in outdoor pools, the fumes disperse more rapidly into the air. Managing chlorine-induced cough primarily involves treating symptoms like cough and wheezing, but it’s equally crucial to reduce exposure to the chemicals in the first place. If symptoms persist, it’s advisable to consult a healthcare professional for further treatment options.

Author specialises in Family Medicine and is based in USA.

By: Dr Tasaduq Hussain Mir