Studying Respiratory Symptoms Related to Swimming Pools Attendance in Young Athletes: The SPHeRA Study

This study investigates the prevalence of respiratory symptoms and the training factors possibly associated with them in a sample of young Italian competitive swimmers. A questionnaire about training information and symptoms was administered to participants during the winter and summer 2021 training seasons. In total, 396 athletes took part in the study. In the winter training subgroup (n = 197), we found significant associations between increasing training hours per session and the presence of nasal congestion/rhinorrhoea (OR = 3.10; p = 0.039) and cough (OR = 3.48; p = 0.015). Total training hours per week were significantly associated with nasal congestion/rhinorrhoea (OR = 1.12; p = 0.010). In the summer group (n = 199), the same factors were not associated with respiratory symptoms. Having an allergy was significantly related to nasal congestion/rhinorrhea in both the logistic models (model 1 OR = 2.69, p = 0.013; model 2 OR = 2.70, p = 0.012), while having asthma significantly increased the risk of coughing (OR = 3.24, p = 0.033). The kind of environment (indoor or outdoor facilities) did not affect the studied symptoms either in summer or winter. Further investigations are needed to better understand the mechanisms involved in the development of respiratory symptoms in swimmers, particularly on how inflammation and remodelling develop and which environmental conditions can favour these processes.