accessing . . .

accessing . . .

Home Care Library

Hot Tub Health & Safety Issues

Hot tubs and spas can be great sources of enjoyment for you and your family, but it is important to understand their special health and safety issues. This article and video will discuss these issues, and what you can do to keep your hot tub healthy and safe for your family and friends.

We’ll start first by outlining the health and safety issues for your hot tub, and then we’ll go through the specific steps for avoiding hot tub problems.


Hot tub health and safety issues can be thought of in three categories: related illnesses; people who are particularly at risk; and common accidents which need to be avoided.


Let’s start by looking at the illnesses which are likely to strike hot tub users. In many ways, hot tubs are the perfect breeding grounds for bacteria . . . they are hot, moist, well-stirred and aerated, and there are plenty of nutrients for bacteria continually being supplied by dead skin cells and body oils. So it is not surprising that bacteria-caused diseases are a significant risk of hot tub use. Here are some common hot tub related illnesses:


 Folliculitis is a skin rash that is caused by a bacterial infection of the hair follicles of the skin. It causes skin irritation and bumps, and these bumps can sometimes be filled with pus. It especially shows up in the swimsuit areas of the body, where the wet swimsuit can keep the bacteria in close contact with the skin. This illness can show up after several hours, or sometimes several days after hot tub use.

Legionnaire’s Disease.

 This illness is a potentially fatal form of pneumonia which is caused by a type of bacteria that thrives in warm, humid environments. The air and water piping systems for a hot tub provide an ample breeding ground for this bacteria, and then the bubbling action and evaporation of the hot tub gets the bacteria air-borne, where it can then be breathed into the lungs.

Middle Ear Infections.

 The inside passages of the ear canal are very sensitive, and if you put your head underwater in a hot tub, you expose these areas to the bacteria in the water, which can lead to infections. And this is true for your nose and eyes as well.

“Hot Tub Lung.”

 And lastly, a rare but potentially dangerous form of pneumonia called “hot tub lung” can be associated with hot tub use. The process of developing this illness is similar to what we described for Legionnaire's Disease. And the risk of infection from this particular bacteria is higher with indoor hot tubs, especially where there is poor air ventilation.


The next area of hot tub health and safety issues deals with high-risk people who face special problems when using a hot tub:

Heart Problems.

 Heat and increased circulation, combined with medications (especially blood-thinners and certain blood pressure medications) can cause light-headedness and nausea. People with heart problems should consult with their doctor before using a hot tub.


 Hot tubs can cause hyperthermia, a condition of abnormally high body temperature, which can cause risk to an unborn child. In addition, there are also risks from water-borne bacteria. It is typically recommended not to use a hot tub during pregnancy. But if you do, here are some steps you can take to reduce the risk: lower the water temperature; limit to 10 minutes or less; monitor your body temperature to avoid overheating; and watch for warning signs, such as becoming uncomfortable or if you stop sweating.


 Children’s bodies, especially their brains, are less able to tolerate exposure to the high temperatures and bacteria found in a hot tub. Children need to be supervised and have their exposure times limited. And you especially should never allow a child to put their heads under the water in a hot tub.

Open Sores.

 Broken skin is much more susceptible to infection from bacteria. In addition, open sores in a hot tub can spread infections to other users.

Drinking / Drugs.

 The heat and circulation of a hot tub accentuate the effects of drinking and drugs, which can cause increased drowsiness, dehydration, and impaired judgment. . . leading to the increased risks of accidents, overheating and drowning.


 The elderly should consult with their doctor before using a hot tub.

Male Fertility.

 And lastly, you should be aware that exposure to prolonged heat can cause a significant reduction in sperm count.


Next, let’s look at the kinds of accidents that are unfortunately common around hot tubs:


 Accidents from over-exposure can occur from both high temperature and dehydration. Over-exposure can cause nausea, dizziness, and fainting.

Hair Caught in Drain / Drowning.

 The suction drain of a hot tub can suck in hair and cause a head to get stuck underwater and lead to drowning. Drowning accidents, of course, are higher for the high-risk people that we discussed earlier.


 Electricity and water don’t mix. Corded appliances near a hot tub are a frequent cause of accidental electrocutions.

Slips & Falls.

 Like any wet surface, areas around a hot tub need to be respected. This is especially true when getting into a hot tub (where the bubbling water may make it difficult to see the steps), and getting out (when you may feel a bit light-headed and unstable).

Broken Glass.

 And lastly, accidents around a hot tub can occur from broken glasses and bottles that are used in the area.


So now that we have discussed the illnesses, people at particular risk, and common accidents associated with a hot tub, let’s now look at how to avoid these hot tub health and safety problems.

Keeping your hot tub healthy and safe involves three areas: 1) maintaining proper pH and chemical levels; 2) keeping it clean; and 3) enforcing strict rules.


Keeping harmful bacteria under control in your hot tub requires diligently monitoring and adjusting the proper pH and chemical levels of your hot tub. We suggest a three-prong approach for this:

Check once per week.

  It is best to catch problems early, especially with algae, which can be difficult to treat. So at least once a week you should inspect your hot tub’s water and check your pH and chemical levels in accordance with your manufacturer’s recommendations for your particular system. And then adjust your chemical levels as needed.

Check one day before use.

  We suggest that you also check your pH and chemical levels the day right before you plan to use it. This way, if there is an adjustment required, then your hot tub will have 24 hours for the adjustment to take effect before you get in the water.

Check on the day of use.  

Even if you have checked the levels on the prior day, we still recommend that you check the levels on the day you plan to use your hot tub, to ensure that the levels have adjusted to where they are supposed to be.


The other part of the battle with bacteria is fought by keeping your hot tub clean. The cleaner your hot tub is, the fewer nutrients that are there for the bacteria to feed on, and the more often that growths of bacteria and their by-products can be removed (helpful accessory: hot tub system cleaners; hot tub covers). Here are our recommendations for keeping your hot tub clean:

Clean the filter per your manufacturer’s recommendation.

If yours is a stand-alone model that is not part of a swimming pool water system, then every 60-90 days you should completely drain the water from your hot tub, and also clean the inside of the tub.

Regularly scrub deposits and build-up found along the waterline.

Lastly, keep the hot tub covered, as this helps to keep out dirt, bugs, etc. And remember, if you use a cleaner on the top of the cover, be sure that the cleaner does not run down into your hot tub.

And while you are doing your cleaning, it’s a good practice at the same time to inspect for possible hazards such as broken tiles, sharp edges, loose piping or handrails, etc.


And lastly, keeping your hot tub healthy and safe requires enforcing some strict rules:

Shower with soap and water before and after using. Washing well before entering a hot tub brings fewer contaminants into the water. And washing afterward helps remove bacteria that you have picked up from the hot tub (helpful accessory: pH testers).

Use a clock or timer to limit to 20 minutes. It is easy to lose track of time in a hot tub, and as we explained, accidents from over-exposure can be serious (helpful accessory: digital timers).

Never allow anyone to put their head underwater. Putting your head underwater in a hot tub exposes bacteria to sensitive areas, and there is also the risk of getting your hair sucked into the drain.

Use handrails when getting into or out of the hot tub . . . to avoid potential slips and falls (helpful accessory: non-slip strips).

Keep corded electrical devices away . . . as these pose electrocution risks (helpful accessories: electrical wire protectors; electrical outlet with cover).

No glass or bottles.

Supervise and limit children’s time.

No drinking or drugs.

Avoid hot tub use if you have heart problems, pregnancy, open sores, or are elderly . . . unless approved by your doctor.


Hot tubs are a wonderful addition to your home, and great for your family and friends. We hope this article and video has helped you to understand the health and safety issues associated with hot tubs, and has given you what you need to know to keep your hot tub healthy and safe.

Related Articles . . .

Tips for Electric Outlets & Surge Protectors
According to the National Fire Protection Association, there is an average of 81,000 electrical system fires in homes every year. Here are 20 tips about electrical outlets and surge protectors to protect your family and appliances. more
Preventing the 5 Most Fatal Home Accidents
Home accidents cause more deaths each year than any other reason except for motor vehicle accidents. This article and video discuss steps you can take around your home to prevent the 5 leading causes of home accident deaths. more
Avoiding Common Plumbing Problems
Plumbing problems can range from minor visible nuisances, to hidden troubles that can be causing major damage to your home and your family’s health. This article discusses how to avoid common plumbing problems. more
Well Water Safety: DO's and DON'Ts
If your home uses well water, then there are some very important things you need to know and do, that will help keep your water safe for you and your family. This article covers the do's and don'ts, and other considerations. more