How To Keep My Hot Tub Water Clean

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If your idea of a relaxing afternoon is sitting back in a burbling hot tub, we're about to, well, burst your bubble. Just because they're smaller and oh-so alluring doesn't mean you shouldn't be as careful as you are at the pool or the beach. From 1990 to 2007, the number of hot tub-related injuries increased by 160%. On average, 17 children die from accidental drowning in hot tubs each year. And lacerations send many adults to the emergency room.

But along with accidental injuries, there are some other scary-sounding health risks. Because the water is much hotter than in pools, chlorine and other disinfectants break down much faster, which can increase your risk for infection. Here's what to be aware of:

1. Hot Tub Rash
Also known as Pseudomonas dermatitis or Pseudomonas folliculititis, Hot Tub Rash is an infection caused from the germ Pseudomonas aeruginosa, which results in an itchy, bumpy red rash and pus-filled blisters. The rash generally pops up after a few days and will go away on its own (if not, see the doctor!). The best way to avoid it: Skip soaking for long periods in a tub that you don't clean or maintain yourself. Or, if you do, shower immediately afterwards and clean your swimsuit.

2. Legionnaires' Disease
Legionella is a germ that causes a severe type of pneumonia, which you can contract from inhaling bacteria from the steam of a contaminated hot tub. Symptoms, such as headache, muscle pain, chills, and fever, usually develop a day or so after a dip. According to the Mayo Clinic, by the second or third day, you might get a cough accompanied with mucus or blood, shortness of breath, chest pain, and confusion. Those who are aged 50 and over, smoke, and have chronic lung conditions are most susceptible to Legionnaires.

3. Irritation from bodily fluids
Sorry, but this one is going to gross you out. Charles Gerba, Ph.D., a professor of microbiology and environmental studies at The University of Arizona, spoke with The Huffington Post about fecal matter bacteria contamination in hot tubs. "The average bather has about a tenth of a gram of feces in his gluteal fold, which is a nice way of saying butt crack. [With five people soaking,] you have a tablespoon of poop in the hot tub," he says.

Urinating in a pool can be bad enough, but it's also bad to pee in chlorine-filled hot tubs, too. When urine, sweat, and feces mix with chlorine, it can create an irritant called chloramine, which can cause mild symptoms like coughing and red, irritated eyes. Rinsing off post-hot tub time is important, but it's even more important to shower before you get in to avoid spreading bacteria.

4. Shigellosis and E. coli
Also spread by poorly maintained pools and dirty bodies getting in and out of them, these common strains of bacteria can cause stomach pain, fever, and diarrhea. Bathers can contract both Shigellosis and E. coli from drinking contaminated water, but both usually treat themselves without medical help.

5. Illnesses from parasites
Crypto is one of the most common waterborne diseases in the U.S. and is caused by ingesting a microscopic parasite called Cryptosporidium. Because the parasite has a hard outer shell, it's tolerant to chlorine. Many people with healthy immune systems can recover without medical intervention but still may suffer from diarrhea, fever, and vomiting, if infected.

Giardia, another common parasite found in contaminated water, are also tolerant to chlorine and can infect patients with giardiasis. Symptoms include diarrhea, dehydration, and stomach and abdominal cramps.

6. Scalding and burns
More thermal burns are associated with water than fire. You would have to sit in 113-degree water for two hours to get severe second degree burns, and water should never exceed 104 degrees. Experts recommend that adults spend no more than 15 minutes, max, in a hot tub at any given time.

7. Pregnancy risks
Sorry, moms-to-be, if the above doesn't scare you off, your OB/GYN is going to. The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women never let their core body temperature rise above 102.2 degrees, which can cause birth defects. The ACOG suggests that pregnant women limit their time in hot tubs to 10 minutes, or they will be at a higher risk for hyperthermia. Oh, and unlike that old wives' tale, you can, in fact, get pregnant in a hot tub.

So, who's ready for a dip?

Photo credit: Photodisc/Getty Images

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