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Infections and Health

Hot Tub Lung infection, bacteria

Pleasures and Dangers Of Hot Tub Baths

by Dr. W. Gifford Jones

Monday, October 2, 2006

Have you just checked into a hotel, gone to the health club in dire need of relaxation? So now you're sitting in a hot tub and the world looks a lot better? Unfortunately, you should know there are pleasures and hazards to most things in life and hot tubs are no exception. One of the hazards is "Hot Tub Lung" (HTB) infection, and you may want to think again.

Perhaps as you were reaching to turn on the jets you saw this message out of the corner of your eye, "Persons suffering from heart disease, high blood pressure, diabetes, or other health problems should not enter the spa without prior medical consultation and permission from your doctor". There may also be warnings not to consume alcohol, use temperatures over 104 degrees and if pregnant, to consult a physician.

In today's litigation riddled society this caution helps to ward off law suits. After all, when McDonald's can be successfully sued because you spilled a cup of hot coffee while driving and burned yourself, there's small wonder for such messages. But sad to say there are potential health problems lurking in hot tubs.

It's hard to find a better place to grow bacteria than a hot wet area and one bacterium, Mycobacterium avium, has a special liking for this location. This is particularly true if tubs are not cleaned as recommended by health authorities. And chlorine loses some of its effectiveness at high temperatures.

But how can a germ in the water get into your lungs? Bubbles form in the contaminated water from the force of hot tub jets. These bubbles burst when they rise to the surface dispersing the bacteria into the air.

Mycobacterium avium is related to the class of bacteria that causes tuberculosis, but luckily it's not contagious. It can, however, cause fever or chills, a wet cough, tightness of the chest, fatigue and shortness of breath.

Diagnosis of HTB is made by chest X-rays or CT scan of the lungs. Testing water in the tub will also detect this bacterium. The usual treatment consists of corticosteroids and antibiotics to combat the inflammation and infection. Fortunately, this is not a common infection.

What is the risk of heart attack while using a hot tub? Some authorities are concerned that hot water could cause extra stress on the heart by increasing the heart rate.

Dr. Thomas Allison, a cardiologist at Mayo Clinic, says that the chance of this happening is "pretty rare". But he advises that a stay in the tub should not last more than 15 minutes.

Other cardiologists suggest that patients who are taking beta-blockers and ACE inhibitors which lower blood pressure should use hot tubs cautiously. They should be aware of the risk of fainting after a long hot soak.

Sitting in a hot tub also causes the blood vessels to dilate as the body adjusts to increased heat. This would normally cause a decrease in blood pressure as widened vessels mean less pressure is needed to push blood through the body. But the force of water against the body prevents this from happening. Stepping out of the tub removes this counterforce. In addition, gravity allows blood to drop towards the feet and as the brain loses blood fainting may occur.

Also reported have been deaths due to heat stroke from prolonged hot tub soaks. Being immersed for a long time prevents the body from sweating to remove excess heat.

It's debatable whether hot tubs could cause damage to a developing fetus. But there's been enough concern expressed that in all probability pregnant women should forgo this pleasure.

For the majority of people a few minutes in a hot tub is safe and beneficial. And for those suffering from arthritis it helps to ease stiff joints and tight muscles by increasing blood flow and loosening connective tissue. But enjoy without alcohol. Imbibing makes you more likely to ignore warnings, become overheated and increases the risk of slipping.

Obviously huge numbers of hot tubs are in use and there's no epidemic of hot tub lung infection. So for the majority of people these tubs are safe. But be aware.


W. Gifford-Jones M.D Most recent columns

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: docgiff.com.
Dr. Walker can be reached at info@docgiff.com















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