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 users of indoor swimming pools, analysed the variables associated with lack of showering, and assessed awareness of the importance of showering. Study design: Cross-sectional study. Methods: A self-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.