Hot tub, whirlpool and spa-related injuries in the United States: 1990-2007

Background: Recreational use of hot tubs, whirlpools and spas has increased within the past three decades. Injuries due to hot tubs, whirlpools and spas can affect people of all ages and can result in serious disabilities. This study examines non-fatal hot tub, whirlpool and spa-related injuries on a national level.

Methods: The National Electronic Injury Surveillance System database was used to examine cases of nonfatal hot tub, whirlpool, and spa-related injuries treated in US emergency departments from January 1, 1990 through December 31, 2007.

Results: An estimated 81,597 patients, aged <1 to 102 years, were treated in US emergency departments for hot tub, whirlpool and spa-related injuries, with the number increasing 160% over the 18-year study period (p<.001). Nearly 73% of injuries occurred in patients aged 17 years and older. Lacerations were the most common diagnosis(27.8%) and accounted for 58% of all head injuries. Slips and falls were the most common mechanism of injury (47.6%), and were more likely to result in an injury to the trunk than other body parts (OR=2.49; 95% CI:1.83-3.39), and were

more likely to result in concussions and fracture/dislocations than any other diagnosis (OR=7.813; 95% CI: 2.194-27.823 and OR=3.017; 95% CI: 2.057-4.425, respectively).

Conclusions: Given the increase in hot tub, whirlpool and spa ownership and the 160% increase in injuries over the study period, more research is needed to identify the cause of the increase in hot tub, whirlpool and spa-related injuries and what injury prevention solutions and policies may be appropriate.