Health News Digest

July 10, 2006

Relaxing Hot Tub—Or Breeding Ground?Hot tub

By  Michael D. Shaw

Here’s a health warning you can use, although I know that many readers—including some considering themselves fitness buffs—will not like to hear it. This one comes directly from your backyard or local fitness center.

That expensive, relaxing hot tub, the one with multiple jets and customized features, can also be a breeding ground for nasty bacteria and various airborne illnesses. In fact, the use of whirlpools and spas far too often presents a serious medical and public hygiene issue. The irony is that just as these products began to emerge as the equivalent of suburban comfort and economic status, the incidence of bacterial infections and respiratory problems began to rise exponentially.

Put another way, the famed comedian Jerry Seinfeld once labeled these hot tubs as nothing more than a “bacterial frappe,” a swirling and temperature-controlled invitation for all manner of complaints. These observations are not, however, a laughing matter. Bacteria, including E. coli and various species of Pseudomonas often flourish in whirlpools, and can easily infect people of all ages.

While many look forward to the warm soak, and regard hot tubs as a form of physical therapy, a modern technology with medically recuperative properties, the plain truth can be a whole lot different. The roiling water will surely recirculate soap debris, bacteria, sloughed off hair and skin, and other assorted debris, pushing this lovely mix back through the very jets that create that massage-like sensation.

The immediate challenge is changing the perception, and this will have to overcome perhaps thousands of years of historical “therapeutic” bathing. Baths and whirlpools in one’s home or health club have a decidedly private connotation, as if they are immune from the same dangers that would plague more extensively public, but similar facilities.

Then, there is also the matter of the churning water aerosolizing the pathogens. In a typical scenario, while relaxing in the warm water of a hot tub, bathers will breathe in deeply, to, uh, “clear their sinuses.” What a perfect way to introduce such baddies as Legionella spores, happily waiting in the ventilation ducts until being stirred up, right into their lungs.

Biologist Rita B. Moyes, Ph.D. of Texas A&M University notes that:

If you think about taking a bath in a whirlpool tub, you should realize that warm water is going to open up your pores and the whirlpool action is going to create an aerosol that can then enter your lungs. Lung infections, urinary tract infections, and skin infections have already been documented in hot tubs…”

The problem with a [residential] bathtub is, you [generally] only have one or two users, and if you get an infection the doctor will just treat it and not try to find the source—opposed to an outbreak associated with a hot tub on a cruise ship for instance.”

Pathogens commonly found in hot tubs can cause: septicemia, urinary tract infections, intestinal infections, infections of the respiratory tract, bacteremia, endocarditis, gastroenteritis, Legionnaire’s disease, Pontiac fever, impetigo, folliculitis, furuncles, carbuncles, scalded skin syndrome, toxic shock syndrome, food poisoning, pneumonia, empyema, osteomyelitis, and septic arthritis.

The purpose of this article is not to scare, but to inform. Users of hot tubs must recognize that these dangers exist, and if they suffer from recurring infections, the culprit may be the whirlpool bath they frequent. It should go without saying that gyms and spas must maintain fastidious stewardship of all of their wet facilities. Sadly, this is often neglected, and this neglect is by no means limited to lower-end establishments.

As in all matters related to our health and well-being, we must be vigilant and use common sense, or suffer the consequences.