Table 2

Verrucas and swimming

CitationStudy groupStudy type (level of evidence)OutcomeKey resultsComments
Bunney (1972)68 matched pairs of swimmers. One of the pair wore “Plastsocks” and the other bare feet (control group)Paired (level 2b)Incidence of new plantar warts in the “Plastsocks” group versus the control groupDuring the study period the sock group was entirely free from plantar warts, while the control group developed 9 new plantar warts (p<0.01)The study did not look at the effectiveness of “Plastsocks” in preventing the transmission of infection
Johnson (1995)146 adolescents aged 10–18 who used locker roomsComparison of 80 pupils who only used locker rooms, with 66 members of a swim club who used locker rooms plus communal showers (level 4)Incidence of plantar wartsSignificant difference in prevalence between those who used public shower rooms and locker rooms (27%) compared to those who used only locker rooms (1.25%) (χ2=15.46, df=1, p=0.001)Shower rooms proposed as a risk factor, with the warm, moist environment important for viral transmission. Author states that he is conducting a follow up study to determine whether the incidence of plantar warts among shower room users (swimmers) can be reduced by limiting foot-to-floor contact, but subsequent paper not found in search
Allen (1968)14075 pupils from 40 primary and secondary schoolsRandom sample of 40 schools in Hertfordshire (level 4)Prevalence of plantar wartsPrevalence of 2.9% for secondary schools and 1.8% for primary schoolsPrevalence appeared greater in those using heated covered pools (4.02%), compared to those using pools, which were not covered and heated either at school (2.91%) or public pools (2.10%). Authors concluded that difference may be due to differing periods of exposure. No statistically significant difference was found between the groups that did gymnastics in barefoot compared to plimsolls
Tranter (1969)Pupils from 6 junior schoolsJunior schools chosen at random (level 4)Incidence of plantar warts and the amount of swimming undertakenCorrelation coefficient was calculated giving a significant positive value at the 5% level suggesting a positive relationship between the amount of swimming and the incidence of warts
Correlation coefficient showed no relation between the amount of barefoot physical exercise and the incidence of plantar warts
Evidence suggested that if a school has its own pool, used only by its pupils and if they were examined twice/term and children with plantar warts excluded the incidence of warts will decline. If the school uses a communal pool the incidence will not decline
Gentles (1973)773 bathers at a public swimming bathRandom sample: 9.3% of bathers (level 2c)Incidence of verrucasOverall incidence of verrucas was 4.8%, with 0.76% in adults, 6.9% in juveniles. Incidence of 10.2% during school swimming sessions and 5.1% during public swimming sessions (p<0.05)The incidence of veruccas was noted to be higher than previously recorded. Authors conclude swimming baths are involved in the “vicious circle” of infection and floor contamination