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Benefits of swimming pools in two remote Aboriginal communities in Western Australia: intervention study

BMJ 2003; 327 doi: (Published 21 August 2003) Cite this as: BMJ 2003;327:415
  1. Deborah Lehmann, epidemiologist (deborahl{at},
  2. Mary T Tennant, research assistant1,
  3. Desiree T Silva, paediatrician1,
  4. Daniel McAullay, research officer1,
  5. Francis Lannigan, otorhinolaryngologist2,
  6. Harvey Coates, otorhinolaryngologist2,
  7. Harvey Coates, otorhinolaryngologist2,
  8. Fiona J Stanley, director1
  1. 1Centre for Child Health Research, University of Western Australia, Telethon Institute for Child Health Research, PO Box 855, West Perth, WA 6872, Australia
  2. 2Princess Margaret Hospital for Children, Subiaco, WA 6008, Australia
  1. Correspondence to: D Lehmann


    Objective To determine the health impact of swimming pools built with the aim of improving quality of life and reducing high rates of pyoderma and otitis media.

    Design Intervention study assessing prevalence of ear disease and skin infections before and at six monthly intervals after opening of swimming pools.

    Setting Two remote Aboriginal communities in Western Australia.

    Participants 84 boys and 78 girls aged < 17 years.

    Main outcome measures Changes in prevalence and severity of pyoderma and perforation of tympanic membranes with or without otorrhoea over 18 months after opening of pools.

    Results In community A, 61 children were seen before the pool was opened, and 41, 46, and 33 children were seen at the second, third, and fourth surveys. Equivalent figures for community B were 60, 35, 39, and 45. Prevalence of pyoderma declined significantly from 62% to 18% in community A and from 70% to 20% in community B during the 18 months after the pools opened. Over the same period, prevalence of severe pyoderma fell from 30% to 15% in community A and from 48% to 0% in community B. Prevalence of perforations of the tympanic membrane fell from 32% in both communities to 13% in community A and 18% in community B. School attendance improved in community A.

    Conclusion Swimming pools in remote communities were associated with reduction in prevalence of pyoderma and tympanic membrane perforations, which could result in long term benefits through reduction in chronic disease burden and improved educational and social outcomes.


    • Contributors FJS and DL initiated the project. DL, MTT, DMcA, and DTS developed the study design. MTT, DTS, DMcA, and DL conducted the field work. HC and FL provided ear, nose, and throat examination, training, and advice. MTT and DL did the data analysis. All authors contributed to writing the paper. DL is the guarantor

    • Funding Western Australian department of housing and works and Western Australia Health Promotion Foundation (Health-way). The guarantor accepts full responsibility for the conduct of the study, had access to the data, and controlled the decision to publish.

    • Competing interests None declared.

    • Ethical approval The ethics committee of Princess Margaret Hospital for Children and the Western Australian Aboriginal health information ethics committee approved the study.

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