13 Incredibly Gross Things You Should Know About Hot Tubs – BuzzFeed News

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Let’s face it: As wonderful as hot tubs feel,
they can get pretty gross.

Let's face it: As wonderful as hot tubs feel, they can get pretty gross.

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Hot tubs or jacuzzis are a great way to soak
and relax, especially when it’s super chilly
outside in the winter. But hot tubs are also
known to carry a ton of germs and transmit
water-borne diseases, and it’s a bit of a
problem in the US. In May, the
CDC published the results of a 2013 survey
involving about 49,000 public aquatic venues.
It found that one in eight inspections resulted
in immediate closure due to serious health

We reached out to
Dr. Pritish Tosh, infectious disease
specialist at the Mayo Clinic in Rochester,
Minnesota, and germ expert
Kelly Reynolds, PhD, director of
environmental health sciences at the University
of Arizona, to find out why hot tubs get so
contaminated and how they can make you sick, so
that you can be more careful and stay healthy.

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1. A lot
of germs and pathogens survive in hot tubs.

A lot of germs and pathogens survive in hot tubs.

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When you get in a hot tub, everything on your
body ends up in the hot tub, too— including
sweat, dirt, oil, grime, bodily fluids. A lot
of this stuff is harmless, but a surprising
number of people carry pathogens, or germs that
cause disease. “People are colonized with
infectious bacteria on their body, meaning it
doesn’t harm them but it can make other people
very sick,” says Tosh.

Examples of bacteria carried on the skin
include Staphylococcus aureus,
methicillin-resistant Staphylococcus
(MRSA), and Pseudomonas.
People can also shed gastrointestinal pathogens
from their feces, such as E. Coli,
Shigella, Vibrio,
Norovirus, and Cryptosporidium.
Even the herpes
virus can survive in hot tubs for up to
four hours. The list of germs that love to hang
out in hot tubs is unfortunately — and
horrendously — long.

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2. The
temperature of hot tubs is actually perfect for
bacteria to grow.

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Hot tubs are usually kept between 100 and 105
degrees fahrenheit, the experts say. That might
feel scalding on your skin if you jump in after
swimming in a cold pool or being in the cold
and snow, but don’t be fooled. The temperature
of hot tub water is definitely not high enough
to kill bacteria and other germs. The warm, wet
environment actually fosters
bacterial growth and survival. “Germs are
perfectly happy living at those temperatures
and can survive for days, even weeks,” says

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3. Hot
tubs are like a big bath where everyone gets a
turn to sit in the same hot water.

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Think about how small a hot tub is compared to
an olympic-sized swimming pool. You can still

transmit bacterial infections and viruses
in large pools, even though the pathogens and
fecal matter have more space to live. So if the
same amount of germs are in a hot tub, the
water is way more concentrated, and the risk of
infection is even higher, experts say.

“Hot tubs are very problematic for this reason
— a small volume of water filled with bodies
makes the chlorine demand impossibly high,”
Reynolds says. One person can contaminate the
entire hot tub by only shedding a small amount
of feces (more on fecal shedding and how it
happens shortly). Basically, soaking in a dirty
hot tub is kind of the same thing as taking an
intimate bath with whoever else used the hot

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4. Hot
tubs are very difficult to keep clean and

Hot tubs are very difficult to keep clean and chlorinated.

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Sure, you can use disinfectants to kill the
germs in a hot tub, but there’s a catch: The
heat actually
breaks down these cleaning chemicals
faster, so you need to replace them more often.
CDC recommends checking and adjusting your
hot tub chemicals every hour when it’s in heavy
use to make sure the chlorine is 2-4 ppm, the
bromine is 4-6 ppm, and pH level is 7.2-7.8.
Not to mention you should regularly scrub off
the slimy bacteria biofilm that tends to coat
hot tubs.

More importantly, most people are not this
crazy strict about cleaning. Ideally, Reynolds
says you would adjust the chlorine in a hot tub
after every single use and replace or clean
your filter frequently, but this usually
doesn’t happen. The bottom line: Hot tubs are
high maintenance and require a lot of knowledge
and care to stay clean.

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5. And
chlorine gets depleted by things like sweat,
sunscreen, and skin or hair products.

And chlorine gets depleted by things like sweat, sunscreen, and skin or hair products.

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Unless you rinse off before you get in a hot
tub, you’ll bring everything that’s on your
body into the water. “The sweat and sunscreen,
shampoo, or conditioner will use up and remove
the chlorine from the water, so there’s a lower
concentration than there needs to be to kill
all the bad bacteria,” Reynolds says. The more
people and the longer you sit in the hot tub,
the more rapidly disinfectant levels decrease,
she says.

Not to mention, skin cells and residual urine
from the body can also interact with chlorine
to produce
chloramines, which irritate your eyes,
skin, and respiratory tract. Unfortunately, the
experts say that most people in America don’t
shower before they get in hot tubs or pools,
even though it’s standard practice in Europe.

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6. Hot
tubs can cause a nasty rash called hot tub

Hot tubs can cause a nasty rash called hot tub folliculitis.

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Hot tub folliculitis is an unfortunately
common consequence of soaking in contaminated
hot tubs. It’s a head-to-toe rash caused by
Pseudomonas aeruginosa bacteria, which
infects the hair follicles, says Tosh. The rash
looks like the chicken pox and it’s very
uncomfortable. “It’s very difficult to treat so
you really just have to wait for it to go away
but it can cause scarring for life,” Reynolds

Pseudomonas aeruginosa is found
naturally in water, Reynolds says, but it grows
readily in the warm aereted (bubbly) water of a
hot tub. Chlorine can kill Pseudomonas
bacteria but only if the concentration is high
enough. “It also forms a protective biofilm on
the filters, making it very hard to control,”
she says.

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7. They
carry bacteria which can cause ingrown hairs
and small cuts to become infected.

They carry bacteria which can cause ingrown hairs and small cuts to become infected.

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About 50% of the population carries
Staphylococcus aureus on their skin. And
yes, enough chlorine will kill the
Staph, but most hot tubs aren’t properly
chlorinated. If someone gets into a
contaminated hot tub with a cut, ingrown hair,
or any other open wound where the water can
enter — they can easily contract a bad staph
infection, which requires further treatment,
Tosh says.

It’s less common, but
MRSA can also survive in hot tubs — this
antibiotic resistant bacteria can cause
potentially fatal skin infections. So besides
keeping your hot tub chlorinated and clean, you
should probably stay out if you have any wounds
where bacteria can enter.

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There’s a lot of poop in hot tubs.

There's a lot of poop in hot tubs.

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Before we give you the facts, remember that
poop is everywhere — including our
smartphones — so don’t panic when you read
these statistics. “Five people in a hot tub
naturally contribute about a tablespoon of
feces to the tub from residual fecal matter on
the skin,” Reynolds says. In a typical busy
public pool or water park, there are several
pounds of feces shed in the pool by the
end of the day, she says. That’s a lot of shit
to deal with.

The truth is that we all have residual feces on
our bodies, Reynolds says, unless we’re
literally soaping up every time we use the
bathroom or a bidet. Adults shed an average of
0.14 grams of feces, which is equivalent to the
weight of one pea, and kids can carry up to 100
times that amount. This is why it’s so
important to keep your hot tub clean, because
if the fecal matter builds up or it contains
any bacteria from a sick person, it can cause

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9. You’re
supposed to wait two weeks after having
diarrhea to go in a hot tub, but most people
don’t — which exposes others to
gastrointestinal bacteria.

You're supposed to wait two weeks after having diarrhea to go in a hot tub, but most people don't — which exposes others to gastrointestinal bacteria.

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Seriously, do not get in a hot tub or pool
after you’ve had a diarrheal disease or
gastrointestinal infection, Tosh says. The CDC
suggests you wait two weeks because that’s how
long it takes your body to fully recover and
stop shedding diarrhea-causing pathogens, which
can make other people sick if they swallow
water. “Even if you feel better and you don’t
have symptoms, you can still be shedding
millions, even billions, of diarrhea germs,”
Reynolds says.

Unfortunately, not many people know about this
rule or understand the risks of leaking a
little diarrhea into the hot tub. So if you
aren’t entirely sure about how clean a hot tub
is, definitely keep your head above the water
and don’t open your mouth underwater… ever.

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10. A
common hot tub parasite, Crypto, is

A common hot tub parasite, Crypto, is chlorine-tolerant.

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Cryptosporidium is a parasite that
causes severe diarrhea lasting for weeks; and
there’s no cure or antibiotic, so you just have
to wait it out. “Crypto is easily passed
through feces and it causes most recreational
water illness outbreaks, and even a few deaths,
each year,” Reynolds says. Crypto is especially
bad because it’s chlorine-tolerant, so it’ll
withstand your typical chemicals for days
before dying off.

The parasite stays in your feces for days or
even weeks after you get sick and even when you
get better, says Tosh. So the people who bring
it into hot tubs probably aren’t even aware —
and it takes only a little bit of feces to
contaminate the whole hot tub with Crypto. The
only good news is that Crypto is spread through
the fecal-oral route, and you’re less likely to
accidentally swallow water in a hot tub than
you are in a pool.

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11. It’s
rare, but hot tubs can also transmit
Legionnaires’ disease, a potentially fatal
respiratory disease.

It's rare, but hot tubs can also transmit Legionnaires' disease, a potentially fatal respiratory disease.

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Legionnaires’ isn’t as common as the other hot
tub infections we’ve mentioned, but it’s
definitely still a concern. It’s caused by the
Legionella bacteria, which thrive in
warm water that isn’t properly cleaned. You can
only get infected by breathing in the mist and
steam from a contaminated hot tub, says
Reynolds, and it causes an upper respiratory
infection similar to pneumonia.

According to the
CDC, each year 8,000 to 18,000 people in
the US are hospitalized with Legionnaire’s but
people who are over 65, immunosuppressed, or
smoke are at higher risk. If you don’t get the
proper antibiotic treatment, it can kill you.
You can avoid Legionella by keeping the
chlorine, bromine, and pH levels high. Also,
you can’t tell if your hot tub has
Legionnaires’ until someone gets sick, Reynolds
says, so it’s a good reason to be super careful
with the chemicals.

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Bacteria will grow overnight if the hot tub
isn’t cleaned beforehand.

Bacteria will grow overnight if the hot tub isn't cleaned beforehand.

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One of the most important practices is adding
enough chlorine before finishing up for the
night, Reynolds says. If you don’t, the hot tub
water will spend hours and hours just sitting
still at a high temperature, allowing the
chlorine and bromine to continue to break down
and more bacteria to grow. Since you probably
aren’t adding chlorine every few hours
throughout the night, it’s important to try to
“shock” the water with a very high amount
before you cover it up for the night.

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Private hot tubs actually tend to be worse than
public ones.

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Okay, hear us out. At a public hot tub or spa,
there’s a lifeguard or staff whose job it is to
routinely check the chlorine levels and adjust
accordingly. There are also more rules at
public hot tubs to keep it clean, such as
showering before entering or not allowing
children in — they do, after all, shed the
majority of fecal matter and germs.

“Private hot tubs are often worse because it’s
up to the owner to be diligent about cleaning
and people get lazy when it’s only family and
friends using the tub,” says Reynolds. And it
doesn’t matter whether it’s your spouse who is
in the hot tub with you or a complete stranger,
because either way you can’t tell if another
person is shedding infectious pathogens or

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Bottom line: Keep your hot tub clean!

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Tagged:germs, bacteria, diarrhea, folliculitis,
tubs, infection, jacuzzi, pool, pool safety,
water-borne disease


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