Residential Hot Tubs and Pools: Health and Safety Tips

HealthLinkBC File Number: 
Last Updated: 
July 2015

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, Pseudomonas bacteria can cause a number of serious infections, such as severe skin rashes, eye and ear infections, and pneumonia. These bacteria can be controlled and removed by maintaining the disinfectant level of the water.

How can I make sure the water is safe?

If you are unsure of the maintenance or water quality, do not enter the pool or hot tub. “If in doubt, stay out.”

To make your hot tub or pool as safe and enjoyable as possible, always consider the following precautions:

Cleanliness and Disinfection

It is the owner’s responsibility to ensure the hot tub or pool 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 up.

Before and after use you should check the disinfectant level and add chlorine or other disinfectant if it is low. Pool chemicals should always be used and stored safely and away from children, They should be either locked up or out of reach.

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 (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 hot tub or pool cover can be a perfect place for many bacteria to live, so it should be wiped off with a bleach solution.

Always shower or bathe with soap before using a hot tub or pool. This helps keep the water free of germs and body oils and will use less disinfectant. If you have diarrhea, have been vomiting, have an open wound, or any other infection or illness, you should not go in a pool or hot tub until you have been symptom-free for at least 48 hours.

Water temperature

The temperature of a hot tub should never be hotter than 40°C (104°F). Staying or bathing in hot water for a long time can cause severe heat-related illnesses, such as nausea, dizziness or fainting, and even death. Avoid staying in the hot tub for more than 10 minutes at one time. Have a clock visible nearby to keep track of time.

How can I ensure the safety of hot tub users?

It is the owner’s responsibility to ensure the hot tub or pool is safely maintained and free from hazards, entrapments, and other dangers, including keeping bathers informed of all risks.

Pregnant women

Pregnant women may be at higher risk of overheating when they are in a hot tub or hot water. Generally, pregnant women should always consult their health care provider before entering a hot tub or sauna as excessive heat and long soaks should be avoided during pregnancy.

Bather load

Every hot tub and pool is designed for a maximum number of bathers at one time. You should know what the number is and not exceed it.

All hot tub and pools should have restricted access to prevent drowning. Access can be restricted by using a fence or lockable gate. Cover and lock your hot tub when it is not in use.

Children and Supervision

Children must be supervised at all times. Most hot tub or pool accidents involving children occur when the children are not supervised, or while their supervisors are distracted, even for a moment.

Children are at higher risk of overheating than adults. Keep children less than 7 years of age, especially infants, out of hot tubs and spas. Their small bodies overheat too fast.

Physical Hazards

Hot tub users are always at 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

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 tubs and pools are slippery places. Do not allow running around the edges. Be careful getting in and out, as many hot tubs 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. Never dive into a hot tub or shallow pool. Always enter feet first.

For More Information

For more health and safety tips on using pools and hot tubs, contact your local environmental health officer. For more information on proper care and maintenance of your hot tub, contact your service provider or manufacturer.

Is it an emergency?

If you or someone in your care has chest pains, difficulty breathing, or severe bleeding, it could be a life-threatening emergency. Call 9-1-1 or the local emergency number immediately.
If you are concerned about a possible poisoning or exposure to a toxic substance, call Poison Control now at 1-800-567-8911.

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