- Tricks & Tips

Hot Tub Health & Safety Tips


Hot tub health and safety issues can be thought of in three categories:

  • related illnesses;
  • people who are particularly at risk; and
  • common accidents which need to be avoided.


Let’s start by looking at the illnesses which are likely to strike hot tub users. In many ways, hot tubs are the perfect breeding grounds for bacteria . . . they are hot, moist, well-stirred and aerated, and there are plenty of nutrients for bacteria continually being supplied by dead skin cells and body oils. So it is not surprising that bacteria-caused diseases are a significant risk of hot tub use. Here are some common hot tub related illnesses:


Folliculitis is a skin rash that is caused by a bacterial infection of the hair follicles of the skin. It causes skin irritation and bumps, and these bumps can sometimes be filled with pus. It especially shows up in the swimsuit areas of the body, where the wet swimsuit can keep the bacteria in close contact with the skin. This illness can show up after several hours, or sometimes several days after hot tub use.

Legionnaire’s Disease.

This illness is a potentially fatal form of pneumonia which is caused by a type of bacteria that thrives in warm, humid environments. The air and water piping systems for a hot tub provide an ample breeding ground for this bacteria, and then the bubbling action and evaporation of the hot tub gets the bacteria air-borne, where it can then be breathed into the lungs.

Middle Ear Infections.

The inside passages of the ear canal are very sensitive, and if you put your head underwater in a hot tub, you expose these areas to the bacteria in the water, which can lead to infections. And this is true for your nose and eyes as well.

“Hot Tub Lung.”

And lastly, a rare but potentially dangerous form of pneumonia called “hot tub lung” can be associated with hot tub use. The process of developing this illness is similar to what we described for Legionnaire’s Disease. And the risk of infection from this particular bacteria is higher with indoor hot tubs, especially where there is poor air ventilation.


The next area of hot tub health and safety issues deals with high-risk people who face special problems when using a hot tub:

Heart Problems.

Heat and increased circulation, combined with medications (especially blood-thinners and certain blood pressure medications) can cause light-headedness and nausea. People with heart problems should consult with their doctor before using a hot tub.


Hot tubs can cause hyperthermia, a condition of abnormally high body temperature, which can cause risk to an unborn child. In addition, there are also risks from water-borne bacteria. It is typically recommended not to use a hot tub during pregnancy. But if you do, here are some steps you can take to reduce the risk: lower the water temperature; limit to 10 minutes or less; monitor your body temperature to avoid overheating; and watch for warning signs, such as becoming uncomfortable or if you stop sweating.


Children’s bodies, especially their brains, are less able to tolerate exposure to the high temperatures and bacteria found in a hot tub. Children need to be supervised and have their exposure times limited. And you especially should never allow a child to put their heads under the water in a hot tub.

Open Sores.

Broken skin is much more susceptible to infection from bacteria. In addition, open sores in a hot tub can spread infections to other users.

Drinking / Drugs.

The heat and circulation of a hot tub accentuates the effects of drinking and drugs, which can cause increased drowsiness, dehydration, and impaired judgement . . . leading to the increased risks of accidents, overheating and drowning.


The elderly should consult with their doctor before using a hot tub.

Male Fertility.

And lastly, you should be aware that exposure to prolonged heat can cause a significant reduction in sperm count.


Next let’s look at the kinds of accidents that are unfortunately common around hot tubs:


Accidents from over-exposure can occur from both high temperature and dehydration. Over-exposure can cause nausea, dizziness and fainting.

Hair Caught in Drain / Drowning.

The suction drain of a hot tub can suck in hair and cause a head to get stuck underwater and lead to drowning. Drowning accidents of course are higher for the high-risk people that we discussed earlier.


Electricity and water don’t mix. Corded appliances near a hot tub are a frequent cause of accidental electrocutions.

Slips & Falls.

Like any wet surface, areas around a hot tub need to be respected. This is especially true when getting into a hot tub (where the bubbling water may make it difficult to see the steps), and getting out (when you may feel a bit light-headed and unstable).

Broken Glass.

And lastly, accidents around a hot tub can occur from broken glasses and bottles that are used in the area.


So now that we have discussed the illnesses, people at particular risk, and common accidents associated with a hot tub, let’s now look at how to avoid these hot tub health and safety problems. Keeping your hot tub healthy and safe involves three areas:

  • maintaining proper pH and chemical levels;
  • keeping it clean; and
  • enforcing strict rules.


Keeping harmful bacteria under control in your hot tub requires diligently monitoring and adjusting the proper pH and chemical levels of your hot tub. We suggest a three-prong approach for this:

  • Check once per week.
    It is best to catch problems early, especially with algae, which can be difficult to treat. So at least once a week you should inspect your hot tub’s water and check your pH and chemical levels in accordance with your manufacturer’s recommendations for your particular system. And then adjust your chemical levels as needed.
  • Check one day before use.
    We suggest that you also check your pH and chemical levels the day right before you plan to use it. This way, if there is an adjustment required, then your hot tub will have 24 hours for the adjustment to take affect before you get in the water.
  • Check on day of use.
    Even if you have checked the levels on the prior day, we still recommend that you check the levels on the day you plan to use your hot tub, to ensure that the levels have adjusted to where they are supposed to be.


The other part of the battle with bacteria is fought by keeping your hot tub clean. The cleaner your hot tub is, the less nutrients that are there for the bacteria to feed on, and the more often that growths of bacteria and their by-products can be removed. Here are our recommendations for keeping your hot tub clean:

  • Clean the filter per your manufacturer’s recommendation.
    If yours is a stand-alone model that is not part of a swimming pool water system, then..
  • every 60-90 days you should completely drain the water from your hot tub
    and also clean the inside of the tub.  Regularly scrub deposits and build-up found along the waterline.  Lastly,
  • keep the hot tub covered, as this helps to to keep out dirt, bugs, etc.
    And remember, if you use a cleaner on the top of the cover, be sure that the cleaner does not run down into your hot tub. And while you are doing your cleaning, it’s a good practice at the same time to inspect for possible hazards such as broken tiles, sharp edges, loose piping or handrails, etc.  A Hot Tub or Spa Inspection from a qualified Home Inspector can help you identify these and other issues that might affect your maintenance budget for your current of prospective home.


Keeping your hot tub healthy and safe requires enforcing some strict rules:

  • Shower with soap and water before and after using. Washing well before entering a hot tub brings less contaminants into the water. And washing afterwards helps remove bacteria that you have picked up from the hot tub.
  • Use a clock or timer to limit to 20 minutes. It is easy to lose track of time in a hot tub, and as we explained, accidents from over-exposure can be serious.
  • Never allow anyone to put their head underwater. Putting your head underwater in a hot tub exposes bacteria to sensitive areas, and there is also the risk of getting your hair sucked into the drain.
  • Use handrails when getting into or out of the hot tub . . . to avoid potential slips and falls.
  • Keep corded electrical devices away . . . as these pose electrocution risks.
  • No glass or bottles.
  • Supervise and limit children’s time.
  • No drinking or drugs.
  • Avoid hot tub use if you have heart problems, pregnancy, open sores, or are elderly . . . unless approved by your doctor.

About OntarioACHI

Founded in 2012 the Ontario Association of Home Inspectors is a not-for-profit association of members with aims to improve the quality and standing of Home and Property Inspection for the benefit of consumers and our profession. The association is run by, and for, Home & Property Inspectors in Ontario. Our goal is to ensure all Home Inspectors are qualified to the highest standards and comply with the most exacting professional Code of Ethics, Standards of Practice and Duty of Care. A consumer hiring an OntarioACHI qualified Canadian-Certified Home Inspector (CCHI) will know they have they hired a truly Professional Home Inspector.
Read All Posts By OntarioACHI