Lung Ailment Surfacing In Hot Tub Soakers

You've heard of "tennis elbow", "turf-toe" and "swimmer's ear" but how about "hot-tub lung?"

There may be an unseen danger rising in the soothing bubbles of indoor hot tubs. There are now 4.5 million hot tubs in American homes, according to the National Spa & Pool Institute — but the increasing popularity may also increase the incidence of "hot-tub lung," a condition caused by indoor hot tubs releasing an aerosol of bacteria right into the lungs of hot tub soakers, a recent Mayo Clinic study warned.

"Hot tub lung is inflammation in the lung from something inhaled," said Dr. Cecile Rose, a pulmonary specialist at the National Jewish Medical & Research Center in Denver. "In this case, that something is a bug called mycobacterium avium."

Exposure to mycobacterium avium can either give indoor hot tub soakers a serious infection or the persistent condition called hypersensitivity pneumonitis, also known as hot-tub lung.

Symptoms of hot-tub lung include shortness of breath, fatigue, fever or chills, a wet cough and tightness in the chest. Though she has not heard of any deaths associated with the illness, it has the potential to be fatal, Rose said.

The problem does not seem to occur in outdoor hot tubs, which are well-ventilated, Rose said.

Warm temperatures in hot tubs are among the conditions that prompt the bacteria to grow. Many bathers do not realize it, but at temperatures higher than 84 degrees Fahrenheit, chlorine used in hot tub water loses most of its disinfectant properties. The problem worsens when owners do not clean hot tubs or change their filters as often as recommended.

Researchers found that bacteria can multiply if chlorine levels drop and pH rises for as little as 24 hours.

Too Sick for Sports

Several years ago, the Gamble family of Lafayette, Colo., found themselves unable to shake flu-like symptoms and fatigue. Kathy Gamble said symptoms began to appear about a year after they got a hot tub.

Her sons, Tom, Ian and Sam, all big and athletic for their ages, were active in basketball and roller hockey, until they started getting the flu-like symptoms.

"When the symptoms started, they could no longer play," Kathy Gamble said.

After the symptoms began, though, the family continued to jump into the hot tub as a way of relieving their troubled breathing — not realizing that doctors would tell them later that the hot tub was the cause of it all.

"We thought it would act as a big humidifier," Gamble said. It did seem to counteract the effects of the dry air in Colorado.

Constant Exposure to Mist

After a few weeks, the family headed to the doctor's office. Initially, physicians thought they had tuberculosis, but after visiting Rose, the family was told that their soaks in the hot tub were to blame. The family was put on steroids to treat the infection. The recovery was slow but steady. Kathy Gamble said that she and Ian were treated with oxygen for almost a year, but now they are fully recovered.

Last year, she and her son Sam competed in a 5km run.

Rose couldn't say how much hot tub exposure might be too much, but said that using one on a monthly basis will probably not do any harm.

"In the Gambles' case, it was particularly bad because the hot tub was in a central location in the house, and they were constantly exposed to the mist," Rose said.

Patients diagnosed with hot-tub lung are usually put on the steroid prednisone and sometimes antibiotics. In severe cases, the patient needs 24 hour supplies of oxygen.

They are also advised to give up their hot tubs.

The Gambles got rid of the hot tub, and replaced it with plants and a pool table.