Research articleHot Tub, Whirlpool, and Spa-Related Injuries in the U.S., 1990–2007
Introduction
In the U.S., private sales of hot tubs, whirlpools, and spas (for the purpose of this paper, hot tubs will refer to hot tubs, whirlpools, and spas) began increasing in the early 1980s. In 1988, there were an estimated 1.8 million hot tubs in use in the U.S., with approximately 250,000 spas being sold annually across the nation.1 Today, hot tubs are a ubiquitous feature in homes, hotels, fitness centers, health spas, and pools. Previous studies of hot tubs have predominantly focused on infectious diseases associated with use such as Pseudomonas aeruginosa dermatitis, folliculitis, and “hot tub lung” caused by aerosolized Mycobacterium avium complex.2, 3, 4, 5
In addition to the risk of infection, use of hot tubs carries the risk of unintentional injury. Some of the most severe injuries associated with hot tubs include hair entanglement, body entrapment, disembowelment or evisceration, and drowning.6 These severe injuries are predominantly seen in the pediatric population and are typically associated with suction drain covers. From 1980 through 1996, the U.S. Consumer Product Safety Commission (CPSC) reported more than 700 deaths associated with hot tubs, with approximately one third of those incidents occurring in children aged <5 years.6 The CPSC recorded 35 body entrapment incidents involving a spa drain from 1990 to 2002 in children aged 2–14 years, with at least five of those cases resulting in drowning.6, 7 The CPSC reported 49 incidents between 1980 and 1996 related to hair entanglement in a drain suction cover for a hot tub.6
Despite the increasing demand for hot tubs and the risk potential for injury, little research has been conducted to determine national estimates and trends associated with hot tub–related injuries. The objective of this research is to determine national scope, distribution, and trends of hot tub–related nonfatal injuries for people of all ages treated in emergency departments between January 1, 1990, and December 31, 2007.
Section snippets
Methods
The National Electronic Injury Surveillance System (NEISS) of the CPSC is a stratified probability sample of ∼100 U.S. emergency departments, including seven children's hospitals, representing 6100 hospitals with at least six beds and a 24-hour emergency department. This data set provides high-quality data on consumer product–related and sports and recreation activity–related injuries treated in emergency departments.8 At NEISS hospitals, emergency department medical charts are reviewed by
Results
From 1990 through 2007, an estimated 81,597 patients (95% CI=63,700 to 99,494) were treated in U.S. emergency departments for hot tub–related injuries, approximately 4800 injuries annually (Figure 1). There was a 160.7% increase in hot tub–related injuries from 2549 in 1990 to 6646 in 2007 (p<0.001). The age range of patients was 1 month to 102 years (mean age=35.9 years; median age=35.0 years). Seventy-three percent of injuries occurred to individuals aged >16 years (Table 1). Men accounted
Discussion
This is the first study to report national estimates, rates, and trends of hot tub–related injuries for all ages treated in U.S. emergency departments. There were more than 81,000 hot tub–related injuries between 1990 and 2007. The prevalence of hot tub–related injuries more than doubled during the 18-year study period. Slips and falls were the most common mechanism of injury, lacerations were the most common diagnosis, and the lower extremities and head were the most common body parts injured.
Conclusion
The prevalence of hot tub–related injuries observed in this study warrants more research to ascertain the reasons for the increasing trend and increased efforts for prevention of these injuries.
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Analysis of invoked slips while wearing flip-flops in wet and dry conditions: Does alternative footwear alter slip kinematics?
2021, Applied ErgonomicsCitation Excerpt :Across Canada, for the most recent reporting year, injuries due to any type of fall account for over one million hospitalizations annually, with a total cost of $8.68 billion (Parachute, 2015). Injuries due to slips are not limited to cuts and contusions, but can result in fracture (Alhajj et al., 2009; Courtney et al., 2002; Sherrington and Menz, 2003), concussion (Alhajj et al., 2009; Hon et al., 2019; Ropper and Gorson, 2007), and even injury to the lumbar spine (Bigos et al., 1986; Manning et al., 1988). Given that footwear is a component of slip risk and the increasing prevalence of minimal, non-conventional footwear being worn in everyday life, greater attention must be given to how alternative footwear such as flip-flops alters slipping kinematics.
Legionnaire's Disease and Influenza
2017, Infectious Disease Clinics of North AmericaCitation Excerpt :Aerosols and droplets are also common in spa pools, mist machines, and humidifiers. They generate water droplets of appropriate diameter (<5 μm) to transport Legionella bacteria deep into the respiratory tract.25 Oropharyngeal colonization with LP is possible, as previously detected in a total of 186 volunteers including 40 hospital patients, who were proved to have a low prevalence of colonization—4.3% subjects were positive by direct fluorescent antibody test.26
Exposure levels to brominated compounds in seawater swimming pools treated with chlorine
2012, Water ResearchCitation Excerpt :In 1998, the fifty French centers of marine cures have welcomed 548,000 “curists” and 528,000 “non-curists” from many different countries (Schwartz, 2005). To prevent outbreak diseases caused by feces-associated microbes, such as viruses and bacteria (Guida et al., 2009; Alhajj et al., 2009), these swimming pools should be disinfected like those supplied with tap water (WHO, 2006). In France, since November 2011, only chlorine-based compounds (such as bleach, sodium hypochlorite, calcium hypochlorite or stabilized chlorine -typically trichloro-S-triazinetrione in stick or tablet-) are authorized in public pools, whatever kind of waters supplying swimming pools (ANSES, 2010).
Bladder Perforation Associated with Hot Tub
2011, Journal of Sexual MedicineBilateral Mastitis as a Complication of Folliculitis Caused by Pseudomonas Aeruginosa Following Hot-Tub Use
2019, Actas Dermo-SifiliograficasFatal Drowning Caused by A Swimming Pool Drainage System
2021, American Journal of Forensic Medicine and Pathology
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