Swimming pools and health-related behaviours: results of an Italian multicentre study on showering habits among pool users

Objectives: Showering before entering a swimming pool is highly recommended to reduce the risk of biological and chemical contamination. This study evaluated the behaviour of indoor swimming pool users; analysed the variables associated with lack of showering; and assessed awareness of the importance of showering. Study design: Cross-sectional study. Methods: Aself-administered questionnaire was used to collect data about users of swimming pools located in five different Italian cities. The association between specific variables and the lack of showering was assessed. P < 0.05 was considered to indicate statistical significance. Results: In total, 4356 questionnaires were analysed. Sixty-five percent of interviewees always showered before entering the pool. The main reason given for pre-swim showering was ‘to wash oneself’ (50.5%); or ‘to get used to the temperature of the water’ (44.3%); and 5.2% answered ‘for both reasons’. Risk factors significantly associated with lack of showering were: female sex (odds ratio (OR) 1.37, 95% confidence interval (CI) 1.2e1.59), age 14e17 years (OR 5.09, 95% CI 3.40e7.64); not reading the swimming pool rules (OR 1.24, 95% CI 1.10e1.41); living in Central Italy (OR 3.3, 95% CI 2.65e4.1) or Southern Italy (OR 1.35, 95% CI 1.18e1.55); and previous/current attendance of a swimming course (OR 1.7, 95% CI 1.48e1.97). Conclusions: The results revealed low compliance with the rule of showering before entering a swimming pool, and little awareness of the preventive role of showering in the hygienic management of swimming pools. There is a need for targeted educational interventions to inform swimming pool users of the reasons for the importance of showering before entering a pool.