Microscopic organisms contained in aerosols generated by indoor hot tubs can cause lung disease in the people who regularly use them. Investigators treated nine people, including four children, for a lung disease caused by nontuberculosis mycobacteria (NTM). NTM-specifically Mycobacteria avium and fortuitum-were found in the hot tub water and/or in the air of the homes of the people diagnosed. The hot tubs are located inside of homes, near family and living rooms, and bedrooms. The jets from hot tubs aerosolize the bacteria, which is how this becomes a problem. Bubbles-rich with the bacteria-rise up, burst and disperse the bacteria throughout a room.

Unlike its bacterial cousin tuberculosis-transmitted by infected humans-NTM is not contagious. In nature, these organisms live in brackish ocean water, like tide pools. But indoor hot tubs, which generally produce a substantial mist, may be causing this lung disease to become more prevalent. The organisms enter the air when a mist, called aerosolization, is produced and the bacteria are suspended in water droplets.

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People with NTM often suffer from fever, tiredness, night sweats, cough and weight loss. For people with mild cases of NTM, removing the hot tub from the home is the primary treatment. In more severe cases, and those reported on at the ATS conference, treatment involved corticosteroids and/or corticosteroids and antimycobacterial antibiotics. Sometimes three to four antibiotics must be given at once.

This respiratory problem is often misdiagnosed as sarcoidosis-characterized by inflamed, microscopic growths called granulomas most often found in the lungs-or tuberculosis. This disease mimics other granulomatous lung diseases, but few people understand the link between hot tub exposure and the symptoms of disease. In instances when the lung problems are misdiagnosed, and in three cases reported at the ATS conference they were, patients remained in the home, prolonging their exposure to NTM.

For more information on this topic or other lung diseases, call LUNG LINE, (800) 222-LUNG, e-mail, lungline@njc.org or visit, http://www.nationaljewish.org

American Thoracic Society (ATS) 96th International Conference took place in Toronto and brings together more than 15,000 pulmonary and critical care physician scientists, nurses, therapists, health educators and others from throughout the world. May 9, 2000

Original Article

Dr. Mercola's Comments:

Another item to consider if one uses a hot tub. This little pearl may save a huge amount of grief in anyone who reads this. An extension of this issue would be swimming pools. One should NOT swim in pools with chlorine. There are many alternatives. The simplest one would be Baquacil (most pool stores have this in stock), which is a form of hydrogen peroxide. One could also use ozone. Both of these approaches are oxidative therapies that will kill the organisms in the pool similar to chlorine (which also is an oxidative agent). However, the peroxide and ozone are not toxic to human tissues in the concentrations used in the pools. However, my all-time favorite recommendation for swimming would be the ocean. The salt water actually serves to kill many of the parasites that live on our skin and in our nasal passages and eyes and takes a huge stress off our immune system. Additionally, we tend to absorb many of the valuable minerals from the water. Unfortunately, most of us do not have access to the ocean. One of my goals though is to be in the ocean water three months out of the year. Click here to review hygiene article on why this may be helpful.