Staying Fit
Editor's note: This article, originally published June 17, 2021, has been updated.
Summer travel season is in full swing, and relaxation for some vacationers includes a soak in a hot tub at a hotel, resort or vacation rental. But before you dip your toes in, especially if you're an older adult, consider the health risks of bathing in a public hot tub.
A report from the Centers for Disease Control and Prevention (CDC) found a total of 208 confirmed outbreaks of illness associated with “treated recreational water” — primarily public swimming pools, hot tubs and water playgrounds — between 2015 and 2019. The outbreaks resulted in 3,646 cases of illness, 286 hospitalizations and 13 deaths. Most outbreaks occurred in June, July or August. Health experts suspect the actual numbers are even higher since many illnesses go unreported.
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Hot tubs can be a particular concern for vacationers. During the five-year period, 1 in 3 water-related outbreaks were connected to hotels or resorts, according to the CDC. Of those outbreaks at hotels and resorts, the majority — 70% — were tied to hot tubs.
Here are four health-related reasons you may want to avoid hot tubs if you're an older adult.
1. The water can make you sick
Identifying a Healthy Hot Tub
Use your senses. If a hot tub smells like chlorine, that doesn't mean it's clean. In any treated water in a hot tub, swimming pool or water playground, that distinct smell occurs when chlorine mixes with an excess of urine, sweat and other contaminants.
The sides of a hot tub should not feel sticky or slippery.
Make sure you hear the pumps and filtration systems to ensure that they are working.
Conduct your own inspection. Before going into the water, review the inspection score of a hot tub, either online or physically posted nearby. Alternatively, test strips to check the chlorine, bromine and pH levels can be purchased at hardware, pool supply or similar stores. Follow these guidelines:
- Chlorine should be at least 3 ppm (parts per million) in hot tubs.
- Bromine, an alternative to chlorine, should read at least 4 ppm in hot tubs.
- The pH level represents how effectively germs are killed and should be 7.2 to 7.8.
Remember to shower for one minute before entering a hot tub. Doing so should remove about 70 percent of contaminants from the skin, according to the Centers for Disease Control and Prevention. The CDC provides state-specific information on rules and regulations for pools and hot tubs. It also offers contact details for local health authorities who can assist you with any concerns.
The CDC warns hot tub users to avoid swallowing the water or even getting it in their mouths. Why? Because germs in the water can cause unpleasant and even life-threatening conditions.
Start with cryptosporidium, or crypto for short. The parasite, which lives in fecal matter, can cause gastrointestinal illnesses, including diarrhea. Crypto can be spread by an infected person using a hot tub. Older adults, as well as young children, pregnant women and people with compromised immune systems, are particularly susceptible. Anyone with diarrhea should avoid going into a hot tub to prevent the spread of crypto.
Even more common in hot tubs is Legionella pneumophila, a bacterium that can cause Legionnaires’ disease, a pneumonia-like lung infection that is potentially serious, particularly for those ages 50 and older. Symptoms of Legionnaires’ disease include:
- Cough
- Shortness of breath
- Fever
- Muscle aches
- Headaches
