HealthLinkBC File #27a, March 2013
Residential Hot Tubs and Pools:
Health and Safety Tips
What are the health concerns of hot tub and pool use?
Hot tubs and pools can provide a breeding ground for a number of bacteria that can cause infection or disease. This includes the Legionella bacteria that cause Legionnaires’ Disease, which can be fatal. As well, the Pseudomonas bacteria can cause a number of serious infections, such as severe skin rashes, eye and ear infections, and pneumonia. These bacteria can be easily controlled and removed by maintaining the disinfectant level of the water.
How can I make sure the water is safe?
To make your hot tub or pool as safe and enjoyable as possible, always consider the following precautions.
If you are unsure of the maintenance or water quality, do not enter the pool or hot tub. "If in doubt, stay out."
Cleanliness and Disinfection
It is the owner's responsibility to ensure the pool or hot tub is clean and the water is properly disinfected to prevent the spread of disease. It is important to maintain the proper level of disinfectant to ensure clean and safe water. Chlorine and bromine are the most commonly used disinfectants. The more a hot tub or pool is used, the faster the disinfectant in the water gets used.
Before and after use you should check and add chlorine or other disinfectant if it is low.
For more information on disinfectants and water quality, see HealthLinkBC File #27b Residential Hot Tubs and Pools: Safe Water Quality.
To help keep hot tubs clean, you should also drain and scrub them with a bleach solution (a capful or 5ml per 4 litres of water) at least monthly, or more often for heavily used hot tubs. Filters and pumping systems should be cleaned and serviced on a regular basis.
Bacteria and dirt on surfaces may enter into the water with you. Always keep surfaces and decks clean. Steam condensing under the lid can be a perfect place for many bacteria to live, so it should be wiped off with a bleach solution.
Always shower or bathe before using a hot tub or pool. Use soap to remove body oils. This helps keep the hot tub free of germs and will use less disinfectant.
The temperature of a hot tub should never exceed 40°C or 104°F. Staying or bathing in hot water for a long time can cause severe heat-related illnesses and even death.
Pregnant women may be at higher risk of overheating when they are in a hot tub or hot water. Generally, pregnant women should stay in a hot tub for only 10 minutes – or less if they start to feel uncomfortable.
Excessive heat and long soaks should be avoided. Make sure to lower the temperature to below 38.9°C or 102°F. Ask an adult to help you in and out of the hot tub. You should get out right away if you feel dizzy or faint or if you have a rapid pulse, irregular heartbeat, stomach pain or tingling in the hands or feet.
Every hot tub and pool is designed for a certain number of bathers at one time. You should know what the number is and not exceed it.
Children are at higher risk
All hot tub and pools should have restricted access to prevent drowning. Access can be restricted by using a fence or lockable gate.
Children must be supervised at all times. Most hot tub accidents involving children occur when the children are not supervised, or while their supervisors are distracted, even for a moment.
Small children are also at higher risk of getting trapped underwater by the suction from an outlet opening. To help prevent this, all pool outlets should have a screen over them. You should know where the shut-off switch to the pump is located so that it can be shut off quickly if needed.
Children are at higher risk of overheating than adults. Children should not stay in hot tubs for more than 5 minutes at a time. Toddlers and babies are most at risk to over-heating and should not go in a hot tub.
Alcohol and drugs
Alcohol and drugs increase risk. Most adult accidents in the pool and hot tub environments are alcohol or drug related. Alcoholic beverages and some drugs can cause drowsiness. They can also lower the body’s resistance to the effects of overheating.
Walk, do not run
Hot tub and pools are slippery places. Do not allow running around the edges. Be careful getting in and out, as many models have very slippery sides.
Properly installed handrails can reduce the risk of injuries from slips or falls. Make sure the handrails cannot trap someone under water.
For more information on the proper care and maintenance of pools and hot tubs, contact your local environmental health officer and/or your pool/hot tub service provider.
For more HealthLinkBC File topics, visit www.HealthLinkBC.ca/healthfiles/ or your local public health unit.
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