The public health impact of carbon monoxide and nitrogen dioxide exposure in indoor ice arenas is well documented. Still, not all states have guidelines regulating ice-resurfacing machine exhaust emissions. The CDC assisted the State of Pennsylvania in an epidemiologic investigation of an incident occurring at a single ice rink to identify risk factors for respiratory and pulmonary illness among amateur hockey players.
We conducted phone interviews to investigate risk factors. A probable case was defined as any hockey player present at the ice rink on 09/29/2002 who reported two or more respiratory symptoms during the game. A confirmed case was a probable case who reported hemoptysis. A NIOSH investigation team undertook environmental sampling and evaluation.
Interviews indicated that 21 of 44 players (48%) were probable cases and 9 (20%) were confirmed cases. Regression analysis indicated that neither confirmed nor probable case status was significantly associated with the amount of time spent on the ice. Probable (OR=28.5; 95%CI = 5.59-145.44), and confirmed (OR = 14.54; 95%CI = 1.65-128.41) cases were significantly more likely to have used the locker room immediately adjacent to the heater room, where the ice resurfacer was parked, and those who spent over 90 minutes inside the locker room were more likely to develop hemoptysis (OR = 6.88; 95%CI = 0.93-50.78). This association was independent of asthma status. The NIOSH evaluation documented a gap in the ventilation system that extracted air from the heater room into the adjacent locker room.
Hockey players are not only at risk of exhaust exposure while on the ice surface, but also in the locker rooms. Air quality monitoring in closed ice arenas should include rooms potentially exposed to emissions from the ice-resurfacing machine.
(1) Centers For Disease Control And Prevention