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The Six Hot Tub Health Risks You Need to be Aware Of

Many people revel in the thought of soaking in a bubbly hot tub after a workout, while on vacation, or just for fun. Their numbers speak for their popularity: there are about 5 million public and private hot tubs, whirlpools and spas in the United States, according to the U.S. Centers for Disease Control and Prevention.

But while the warm water can be soothing for your muscles as well as your nerves, there are some nasty secrets lurking inside many hot tubs that may make you think twice about taking a dip.

hot tub

Chlorine loses its ability to disinfect at around 84 degrees F, which is why many bacteria can survive in hot tubs, even though the water is chlorinated.

Nearly 60 percent of public hot tubs in the United States may make you sick, according to the CDC. In their study of over 5,000 U.S. public hot tubs, they found that 11 percent were so neglected that they called for immediate closure.

How a Soak in a Hot Tub Can Make You Sick

1. Hot Tub Folliculitis (aka "Hot Tub Rash")

This is caused by pseudomonas, a type of bacteria that thrives in hot tubs without proper chlorine and pH levels. It causes a skin infection that results in red, itchy bumps and blisters. Typically the infection will resolve on its own, but in serious cases it can cause scarring, destruction of your hair follicles (and hair loss), boils under your skin or spreading of the bacterial infection.

Diabetes, skin infections or open sores increase your risk of hot tub folliculitis. The rash is typically more severe in areas where your swimsuit held the chlorinated water against your body.

2. Hot Tub Lung

If a hot tub isn't clean properly, you may inhale a bacteria called Mycobacterium avium (M. avium), which belongs to the same class of bacteria that causes tuberculosis (but without being contagious).

The bacteria are spewed into the air when the hot tub bubbles rise to the surface and burst. As they evaporate, you may breathe them in, which can cause an infection or allergic reaction that results in cough, fever or chills, shortness of breath, fatigue and tightness in your chest. The condition often resolves, as long as you stop using the hot tub, but can be serious, and even fatal.

Hot tub lung is more commonly caused by indoor hot tubs, as the vapors from outdoor hot tubs have more room to disseminate.

3. Genital Herpes

It's possible to contract genital herpes from sitting on a plastic-coated hot tub seat that hasn't been in contact with chlorinated water (such as an upper step or side). Herpes simplex virus, which causes genital herpes, can survive for up to 4.5 hours on such a surface.

hot tub

There is a lower risk of getting a lung infection from an outdoor hot tub, as the vapors are more likely to evaporate or disperse before you breathe them in.

4. Legionnaire's Disease

You can get Legionnaire's Disease, a type of lung infection, in a similar manner as hot tub lung -- by breathing in vapors that contain bacteria, in this case Legionella bacteria. High fever, chills and cough are common symptoms. Though this disease is typically curable with antibiotics, it can cause death in up to 5 percent to 30 percent of cases, according to the CDC.

5. An Increased Risk of Birth Defects

Pregnant women are advised to avoid hot tubs, as exposure to the heat during the first trimester of pregnancy is associated with an increased risk of neural tube defects in the baby, according to a study in the Journal of the American Medical Association.

6. Lowered Sperm Count

Exposure to high heat, including going in hot tubs or saunas, has been found to lower men's sperm production because of the excess heat in the scrotal area, according to the American Society for Reproductive Medicine.

It's worth noting that most healthy people can use a hot tub safely, and even experience benefits. Sitting in a hot tub, particularly one that has water jets to massage you, can reduce your stress levels, increase your blood circulation, dilate your blood vessels, and even lower your blood pressure.

You should always check on the maintenance history of any hot tub before using it to ensure that it's being carefully cleaned and monitored. However, certain groups, including people with compromised immune systems and pregnant women, should be careful about using even hot tubs that are well maintained.

Recommended Reading

Bath or Shower: Which is Better for You and Why?

A Highly Avoidable Tragedy: Preventing Drowning Inside the Home


Morbidity and Mortality Weekly Report July 2, 2004 Folliculitis

Journal of the American Medical Association Vol. 268 No. 7, August 19, 1992

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