Your hot tub is immense fun – but it can also be dangerous if you take your eye off the health and safety ball. More than 300 people die in hot tubs each year. Here in the UK we experienced a dramatic increase in hot tub insurance claims during lockdown, three times the usual number, probably because Brits were stuck at home using their hot tubs more often.
Other countries have similar issues. In New Zealand a woman died in 2019 after drinking too much before a hot tub session then carrying on drinking while in it. Poor Matt Perry died in his hot tub. While it’s lovely enjoying a glass of something refreshing while you relax, being utterly off your face is never a good idea when there’s water and heat involved.
So here are our expert hot tub health and safety tips. Here’s how to have the time of your life safely, healthily, and sensibly.
Common hot tub accidents and health risks to watch out for
Slips and falls are the most common hot tub accidents of all. The tub itself if slippery. The areas around it are often wet too, and they get slippery.
Some people get injured by the suction action of the machinery, others faint when the water gets too hot. It’s possible to drown. And the chemicals that keep the water safe and clean can make us feel poorly if they’re out of balance.
A hot tub that isn’t kept clean enough can develop colonies of nasty invisible pathogens, causing diseases like legionnaires, infections of the blood, infections of the urinary tract and Hot Tub Rash, also called pseudomonas folliculitis, Jacuzzi folliculitis or just hot tub folliculitis.
About hot tub rash
The bacterium that causes it is a lover of moist, warm conditions called Pseudomonas aeruginosa. It gives you a bumpy, red, often itchy rash anywhere or everywhere on the body, often in places where your swimwear or shorts cling. The infection arises from your hair follicles, hence the name.
The lumps either turn up a few hours after you get out of the tub or several days later. The bumps are pus-filled and look a bit like acne. The rash can turn dark red and painful, and you might feel grotty for a few days with a sore throat, earache or headaches. Luckily it doesn’t spread from person to person.
The infection lurks in hot tubs that aren’t treated regularly or thoroughly enough, and anyone can catch it, but some people are more at risk: those with a compromised immune system, people who already suffer from acne or dermatitis, and people who’ve just shaved or waxed their bodies.
About hot tub lung
Hot Tub Lung is a kind of hypersensitivity pneumonitis that happens when the lungs swell up in reaction to contaminated droplets in the air. The usual symptoms are a cough and shortness of breath, which turn up soon after you’ve been exposed to contaminated water. It’s often caused by something called ‘non-tuberculous mycobacterium’, responsible for lung disease but not TB, and the commonest variant of all is called Mycobacterium avium. Like hot tub rash, it doesn’t spread from person to person.
About cryptosporidiosis in hot tubs
The Cryptosporidium parasite infects the bowels to cause cryptosporidiosis, a form of gastroenteritis that leads to gut pain, diarrhoea and vomiting, affecting animals as well as humans. In a hot tub context it’s spread by water containing infected poo particles and it’s resistant to the chlorine levels usually found in hot tubs. The best prevention method is to keep your hot tub as clean and hygienic as possible at all times.
Young children are most likely to be infected and it can last two weeks or longer. If your immune system isn’t working properly it can be very serious and it can kill. While there’s no treatment, the best thing is to rest and take in plenty of fluids. It’s vital not to use the hot tub for at least 14 days after your symptoms disappear.
Luckily, once you get into the rhythm of maintaining and cleaning your hot tub as regularly and thoroughly as you need to, it won’t take much effort to keep it clean, fresh and safe.
About Legionnaires disease in hot tubs
Legionnaires’ disease is a lung infection caught by breathing in droplets of infected water. Hot tubs are at risk because of the high water temperature, the relatively small volume of intensively aerated water they contain, and the water mist they generate. The pipework systems the water is pushed and pulled through are also at risk of contamination. The bacteria feed on nasties like dead skin cells, hair, body oil and sweat.
Once the temperature falls below 20C, the bacteria go dormant. The die above 60C and thrive at temperatures between 20-45C. Hot tubs are usually set between 37-40C, comfortably within the at-risk band.
You don’t even need to be in the hot tub to catch it. The bacteria float around in the mist and find their way into the lungs, where they can either cause an illness a lot like pneumonia, or the less-serious Pontiac fever. The key to staying healthy is to keep the water and the associated systems clean and disinfected to stop a biofilm of bacteria building up in the first place.
Sensible hot tub safety measures
You can check out our hot tub insurance article (link to the article here) to find out about protecting the financial side of your investment. In the meantime, as far as safety goes, there’s plenty to think about.
For a start, don’t set the temperature too high. Aim for an absolute maximum of 104F or 40C to stay awake and conscious. Because hot tubs are hot, you’ll also feel dehydrated unless you take care, so make sure to drink plenty of water.
As we’ve mentioned, alcohol is OK but if you’re starting to feel wobbly, it’s best to get out of the tub and if you want to, carry on drinking on dry land. You know your own limits so stick well within them, and keep an eye on everyone else just in case they overdo it without realising.
As far as drugs go… just don’t take them in a hot tub!
The more you use the tub, the better you’ll be at judging the most enjoyable way to use it. If you’ve chosen the maximum recommended temperature and you’re a novice, 10-15 minutes will feel about right. If you want to stay in the water for longer, reduce the temperature.
If you start to feel dizzy or light headed, sick, your skin goes red or you find it hard to breathe, get out immediately and find somewhere comfy to cool off and calm down. Many hot tubs have a nice, wide edge you can sit on with your feet in the water, which means you won’t feel too left out if the others are staying in for a bit longer.
The hot tub timer is there for a good reason, automatically turning off the jets once the time is up. It’s the most reliable way to know for sure you’re not going to over-do it and put yourself and others at risk.
You know the saying ‘out of the frying pan, into the fire’? It applies to hot tubs: don’t go straight from the hot tub into cold water unless you want your blood pressure to spike dramatically.
You might feel squeaky clean when you get out but you’ll want to take your bathers off and wash your skin and hair thoroughly to get rid of the hot tub chemicals.
Can everyone enjoy a hot tub?
Some people should steer clear of hot tubs. If you have heart disease bear in mind the hot water can affect your heart rate and blood pressure. It’s beneficial to some people with cardiovascular issues but a very bad idea for others. If you suffer from low blood pressure, for example, the heat could lower it even more, leaving you at serious risk. It’s best to check with your doctor first.
It’s unwise to get overheated when you’re pregnant, so if you do go hot tubbing when expecting a child, keep the water temperature well below the maximum and don’t stay in for long.
People with skin injuries like cuts, scrapes, open spots and rashes should wait until they heal, simply because broken skin gives bacteria and other pathogens an easy route into your body. And if you tend to faint easily it’s probably best to only go in a hot tub when the water’s cool-ish, and never use it on your own.
If you have a Urinary Tract Infection or UTI, hot tubbing can make it worse.
Physical safety measures to take when hot tubbing
We’ve talked about the tub and the immediate area around it getting wet and slippery. This means it’s best to place it away from dangerous things like glass doors, drops and slopes, rocks and other sharp objects in the first place, to avoid injuries.
You might want to fit handrails or safety rails to help people get in and out safely, and create a floor surface that won’t hurt too much if anyone falls or trips – the material they use for kids’ playgrounds could be a good move.
Keeping your hot tub covered when not in use means it’s clean, fresh and ready to use whenever you are.
Don’t let children or anyone else fiddle with the controls. Keep any electricity cables out of the way or, if you can’t avoid them snaking across the garden, use a cable cover like they have in offices to reduce the trip hazard.
Next, buy your hot tub!
Now you know the ins and outs of hot tub health and safety, you’re in a good position to start thinking about buying one. Take a look at ours, see what you think. Fabulous or what?
