Combined Chemical, Physical, and Climatic Exposures and Their Objective–Subjective Assessment in Indoor and Therapy Pool Employees

The working and health conditions of employees in indoor and therapy pools are influenced by a large number of simultaneously acting technical, chemical, and physical–climatic factors. The aim of this study was to systematically investigate combined exposure situations and their association with subjectively perceived stress and health-related outcomes among employees. As part of the study, 70 employees from nine selected swimming pool facilities participated in a standardised written survey focusing on perceived working and health conditions. In parallel, measurements of airborne hazardous substances - particularly trichloramine (NCl 3 ) - as well as physical and climatic environmental conditions were conducted under real operational conditions. All measured chemical and physical exposure levels were below applicable limit or assessment values. Nevertheless, the employee survey revealed pronounced subjective stress, particularly related to noise and thermal conditions. The findings indicate that even when individual limit values are met, combined exposure situations may contribute to increased perceived stress. The results highlight the importance of considering combined occupational stressors and subjective perception in occupational risk assessments and preventive workplace design in indoor and therapy pools. • The study investigated the combined effects of physical, climatic, and chemical exposures on employees in indoor and therapy pools under real working conditions. • All facilities complied with state of the art technical standards and showed trichloramine concentrations the assessment standard. • Nevertheless, noise and heat were identified as key predictors of perceived stress, indicating relevant psychophysiological strain even below exposure limits. • The results demonstrate that technical compliance alone is insufficient; integrative prevention measures should also address organisational and perceptual factors.