More Than Half of Public Hot Tub Spas Violate Safety Standards

From WebMD:

CDC: Better Safety Needed at Public Hot Tubs`

By Jennifer Warner WebMD Medical News

Reviewed By Brunilda  Nazario, MD on Thursday, July 01, 2004

July 1, 2004 -- More than half of the public hot tub spas in the U.S. may be unsafe, according to a new report from the CDC.

Researchers found 57% of the more than 5,000 public hot tub inspections across the U.S. had one or more safety violations. Spas located at campgrounds and hotels or motels were the biggest offenders.

Eleven percent of the violations were severe enough to result in the immediate closure of the facility, pending correction of the violation(s).

The most common violation was poor water quality.

Researchers say the findings show that more rigorous safety inspections and improved training of spa operators are needed to reduce the threat to public health posed by public hot tubs.

The high temperature of the water in spas depletes the disinfectant and makes them an ideal environment for bacteria, such as Legionella, and other diseases. During 1999-2000, a total of 13 outbreaks of infectious disease, affecting 183 people, were attributed to public and private spa use.

Comment: My ex-father-in-law (father-ex-in-law? father-in-ex-law?) contracted Legionnaire's Disease, traced back to a wooden hot tub.  That was in the early eighties.  He spent over a week in the hospital on intravenous antibiotics.  Fortunately, the causative agent had been identified by the CDC in 1977, after a long and highly-publicized effort by public health officials.  There had been an outbreak of a mysterious type of pneumonia at an American Legion convention in Philadelphia in 1976, with 34 fatalities. 


Legionnaire's Disease is caused by a genus of bacteria named Legionella.  There are different species, some more dangerous than others.  L. pneumophila  is the  species that most commonly causes illness in humans.  Legionella are gram-negative rods that can be detected using a direct fluorescent antibody test.  Symptoms occur within 2-10 days, and include cough, shortness of breath, high fever (up to 105 degrees Fahrenheit), gastrointestinal symptoms, and muscle pain.  The disease is treated with macrolide or fluoroquinolone antibiotics.  The mortality rate is reported variously as 15-25%.  The real mortality rate is unknown, though, because it is thought that many or the milder cases go unreported. 

More information is at the OSHA  site, the Family Practice Notebook, and e-Medicine, among others.