Risks in use of spas or hot-tubs:
(1) hyperthermia when temperatures are 110°F or higher
(2) drowning
(3) body part entrapment in drain
(4) hair entrapment (shoulder length or longer) in drain
(5) hemorrhage at impact points of high power water jets
(6) cuts on broken glass
(7) fetal injury in pregnant women exposed to high water temperatures
(8) electric shock
Risks for drowning:
(1) unattended, especially small children
(2) concurrent abuse of drugs and/or alcohol
(3) concurrent use of sedatives or medications resulting in drowsiness
(4) concurrent disease (heart disease, seizure disorders, vascular disease, hypertension).
Risks for body part entrapment:
(1) single suction port or drain (occlusion of a single port can result in a very high suction pressure)
(2) failure to provide a cover to the suction/drain port
Precautions:
(1) Prohibit use of alcohol and drugs before or during use.
(2) Never use alone if young, have a concurrent disease, or on a sedating medication.
(3) Use of a secure and tight fitting lid when unattended.
(4) Placing approved covers over suction ports.
(5) Maintain temperature not to exceed 104°F. Lower temperatures are recommended if the session is to last more than 15 minutes. For pregnant or possibly pregnant women the temperature should be no more than 100°F.
(6) The switch to the suction pump should be readily accessible.
(7) Pregnant women and people with pre-existing disease should consult with their physician before use.
(8) Avoid power jets if anticoagulated or if have a significant coagulopathy.
(9) Confine long hair.
(10) Use more than 1 suction/drain port.
(11) Prohibit glass and bottles in region of spa.
(12) Install tub or spa away from metal surfaces and keep electrical appliances away from the water.
