Q: My new neighbours have recently installed a hot tub in their back yard. They have invited my wife and I to come and enjoy it with them. I have never done this before and am a little concerned because I have heard about various health hazards being associated with hot tubs.
A: There is more than one type of risk associated with hot tub use. Many people will immediately think of infections and maybe sexually transmitted diseases such as chlamydia, but surprisingly, the main danger of hot tub and spa use is drowning. Uncovered or inadequately covered tubs may lead to deaths in young children.
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Drowning is not just a problem for unsupervised children. Even adults have been known to be held at the bottom of a tub by the suction from the drains, and hair and body parts can become entangled in the mechanisms.
These accidents are more likely if a person has been drinking alcohol or using drugs.
Prescribed medications may also impair judgment or increase the risks of unconsciousness when associated with the heat.
Certain medications may interfere with the body’s temperature-regulating mechanism, or cause drowsiness. Be careful if you are taking some types of antidepressants, tranquillizers, antiepileptics or heart medications. They may not prevent you from using the spa, but you may have to limit the amount of time you spend in it to 10 minutes and watch that the temperature is not too high.
If you or your wife are taking any prescribed medications or have any chronic health conditions like heart disease or epilepsy, you should check with your family physician before entering the hot tub.
The most common infection associated with hot tub use is a skin condition known as hot tub folliculitis. This is an itchy, bumpy rash on the arms, legs or middle body caused by bacteria creeping into the hair roots or follicles. The rash usually makes an appearance within three days.
The offending bacteria, pseudomonas aeroginosa, will grow if the water is not adequately chlorinated. This is more likely to occur in bigger spas in health clubs than in someone’s backyard tub because air circulation helps eliminate bacterial growth.
Some rarer but more dangerous infections may occur in people with weakened immune systems. These include Legionnaires disease and non-tuberculosis mycobacterial infections. Both are lung diseases that require an assortment of antibiotics to treat.
Women in the early stages of pregnancy or those who are trying to become pregnant should be careful with hot tub use. Higher temperatures of the fetus during the first 25 days of development can interfere with neural tube development, leading to such congenital conditions as spina bifida.
I hope I haven’t put you off the hot tub. Your neighbours’ new tub is unlikely to be contaminated with bacteria, and providing you and your wife are healthy and none of the preceeding situations apply, go ahead and enjoy it.
Clare Rowson is a medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
