What is Hot Tub Lung?

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  • Written By: Bronwyn Harris
  • Edited By: O. Wallace
  • Last Modified Date: 28 April 2020
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Hot tub lung, or hypersensitivity pneumonitis, is a disease that has become associated with indoor hot tub use. This disease is fairly rare, and is also known as "lifeguard lung," since it can be connected with indoor pools as well. It is often misdiagnosed as other lung diseases, such as tuberculosis.

Hypersensitivity pneumonitis is caused by inhaling endotoxins, which are fragments of a bacteria (Mycobacterium avium) which have become aerosolized by the steaming and bubbling water. Outdoor spas are much less likely to cause hot tub lung, since there are no issues with ventilation. Even with indoor hot tubs and indoor pools, this condition is rare and usually occurs in people who frequently use the hot tub or pool for a long period of time.

The endotoxins which cause this condition are contained in a certain type of bacteria that can sometimes be harbored in water circulation systems. These systems can have biofilm growing in them if they are not sanitized regularly. If the slimy biofilm is disrupted in any way, such as the pressure from jets in a hot tub, the bacteria are then released into the water and break down, releasing the endotoxins into the water.

Symptoms of hot tub lung include fever, fatigue, coughing, lack of appetite, night sweats, trouble breathing, and weight loss. People suffering from these symptoms should stop using the hot tub or indoor pool immediately. Corticosteroids may be prescribed, as well as supplemental oxygen for extreme cases. Medical professionals do not agree on whether antibiotics cure hypersensitivity pneumonitis or if it is better to let it improve without any antibiotic treatment.

In order to prevent hot tub lung, hot tubs and indoor swimming pools should always have a sufficient level of sanitizer in the water. Ventilation in the area is also important, to make sure that fresh air circulates and dilutes any endotoxins in the air. Water in spas or pools also needs to be changed regularly and have the correct balance and filtration needed. If a spa has not been used for a while, they should be sanitized before being used again. While being sanitized, all jets should be turned on so that the entire water system comes in contact with the sanitizer.

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Post 5

I had hot tub lung and I did shower every time but it was a rental. The owner put chemicals in and after one week he shut down the hot tub for the month and we rented a month later so it had been sitting in the extreme heat. I went in once a day for three days and got extremely sick. I had high fever, chills, and headaches. On the fifth day, I went to the ER. I thought I had the flu. That was Sunday and by Monday night, I needed oxygen. I was in the hospital 9 days and I'm still having problems two years later. Predisone and a zpack helped, but I still need them every 3 or 4 months.

Post 4

I actually had hot tub lung and didn't realize I had it until I was asking the place where we buy our chemicals that it was making me sick. They said it sounds like hot tub lung, and sure enough, I had all the symptoms. It was not fun, especally with the night sweats.

Post 3

@ Parmnparsley- I was intrigued by your question so I did a little research on hot tub lung. I found a CDC case study of a family in Colorado who had all contracted severe cases of hot tub lung.

It took the family about ten months to contract hot tub lung, but their cases were severe. From what I understood the infection started off as mild symptoms; taking months to become severe.

I would guess that the body's immune system could fight off the bacteria assimilated from one soak. Hot tub lung would probably take prolonged exposure to develop.

The CDC did state that the infection is preventable. The center recommends that you shower before entering a hot tub as well as the preventable measures suggested in this article. Showering will prevent the bacteria from contaminating a clean hot tub.

Post 2

Wow, this article makes me wonder how clean the hot tubs and pools in most hotels are. I travel a lot, and I often swim in the hotel pools. I do not think that I have ever had hot tub lung, but it sounds like something I do not want. Can someone contract hot tub lung in one soak in a Mycobacterium Avium contaminated hot tub, or is it something that takes prolonged exposure to contract?

Post 1

I have a problem with my lung. I went to see a doctor and he said that my lung is hot. When I exhale, I feel hot in my mouth and I feel numb on my tongue.

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