CDC: Better Safety Needed at Public Hot Tubs

More Than Half of Public Hot Tub Spas Violate Safety Standards

Medically Reviewed by Brunilda Nazario, MD on July 01, 2004
From the WebMD Archives

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.

Public Spas Frequently Violate Safety Standards

The findings appear in the July 2 issue of the CDC's Morbidity and Mortality Weekly Report.

Researchers analyzed information from 5,200 inspections of public spas located in Florida, Minnesota, California, Wyoming, and Pennsylvania that were conducted between May 1, 2002 and Sept. 1, 2002.

About half of the inspections found one or more violations, and the number of violations ranged from one to eight. Water chemistry problems constituted about 51% of the violations. Other common violations included inadequate filtration or recirculation systems (32%) and lack of training by the operator of the facility (23%).

The location of the facility, such as a hotel or motel, was documented in about half of the inspections.

For those inspections for which the location was known, the highest percentage of violations caused by inadequate levels of disinfectant were found in campgrounds (22%) and hotel/motel spas (20%).

Of those inspections that warranted immediate closure of the facility, the highest number were also in campgrounds (15%) and hotel/motel spas (12%).

"Spa inspection data should be used more effectively for public health decision-making, and public health partnerships are needed to improve the level of training and vigilance by spa operators," write the researchers.

Researchers say spa users can also reduce their risk of illness by following these steps:

  • Shower or bathe with soap before entering the spa.
  • Observe limits, if posted, on the maximum allowable number of bathers.
  • Do not allow children under age 5 to use hot tub spas.
  • If you are pregnant, consult a doctor before using a spa, especially in the first trimester.