By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

OBSERVE SAFETY RULES TO MAKE HOT TUBBING A RELAXING EXPERIENCE

Question: I have some mild osteoarthritis and am in my late forties. My husband and I are thinking of getting a hot tub. Are there risks associate with using a hot tub at my age? Are there things I should be careful about?

Answer: Hot tubs are generally safe for healthy people. The most serious risk from “hot tubbing” is drowning. People have been known to drown because they were held underwater by suction drains. This is particularly a problem when a person’s hair gets caught in the suction fitting, causing the victim's head to be held underwater. According to the Consumer Product Safety Commission, there have been 49 such incidents since 1978 -- including 13 deaths. You can reduce the risk of hair entrapment by making sure that your hot tub is fitted with a drain cover that meets CPSC standards. And never use a hot tub with a missing or broken drain cover.

Another cause of hot tub accidents is drinking. Alcohol and hot tubbing are a dangerous combination. This is because heat and alcohol together can cause a person to pass out in the tub and drown. So always exercise caution, as you would around any body of water. Use the buddy system, or at least, let someone know when you are getting into the hot tub so they can check on you. Never let a child use a hot tub without constant adult supervision.

Generally, using a hot tub is fine for any healthy person regardless of age, with a few exceptions. Pregnant women should never use a hot tub. The usual temperature for a hot tub is 104 degrees Fahrenheit, but this can be lowered to accommodate older and younger people. Also, individuals with diabetes, high blood pressure or heart disease should consult with their physician prior to hot tub use.

Skin problems are the most common medical condition associated with hot tub use. Many people have skin damage from prolonged exposure to the hot water, which can cause skin rashes or itching. Skin infections are less common, but can occur. You should not go into a hot tub if you have open skin lesions.

A good first step to prevent skin problems is to be sure to take a shower after using the hot tub to wash off chlorine, salt or other chemicals. You can also lower the temperature and shorten your time in the tub. Using hot tub chemicals that are less irritating can also help. There are a variety of chemicals that can be purchased for your hot tub, and it may take a few tries to find a set of chemicals that keep the hot tub clean and are agreeable to everyone’s skin.

Some women who are prone to bladder infections find that hot tub use causes those infections to flare up. This can be due to the temperature or the chemicals. For some ladies, though, avoiding the hot tub is the best solution.

Developing lung infections from using a hot tub is a less common problem, but it is possible. Older people, who may have a less active immune system, can inhale bacteria from the hot tub vapors and develop pneumonia. This should not occur in a clean hot tub, but it can happen.

The good news is that hot tubs are great for reducing stress, relieving discomfort from sore muscles and lessening pain due to arthritis. Most hot tub owners love them and use them frequently. But moderation is the key. If you limit your time in the hot tub and pay attention to cleanliness and safety, you can make your experience a thoroughly pleasant one.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.