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Help: some chemical causing allergic rash from hot tub


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Folks, I might need some really deep chemistry knowledge from you guys. I got a hot springs salt water spa this year, and used it without issue for 3 months about 4 times a week for 45 minutes at a time. We test our water with the Taylor tester kits and it's damn near perfectly balanced.

Then, out of no where I started getting feverishly itchy rash mostly on my legs and back (usually never where my swimsuit touches), raised and blotchy. I got a skin biopsy, and it came back allergic contact dermititis. Not super helpful. I did patch testing, a few positives came back but nothing relating to what's in my hot tub. I cut out as many possible chemicals in my life (detergent, shampoo, makeup, etc) thinking it was something unrelated that worsens in the tub. I don't believe this is the case.

It's 100% definitive at this point that it occurs within 5-24 hours after I use my spa. I've taken 3-4 weeks off no contact, and tried again. I'm the only one who has used it and has this reaction. We've decontaminated it and drained it out of precaution, but that didn't help. 

I've taken every chemical we use in the spa and figured out the ratio and added it to my bath tub one chemical per bath session to try and figure out which chemical is causing this. At this point, I've tested all of them listed below and not had a reaction. I tried to keep time in the water and temperature roughly the same. I even tried the hot tub with no jets, but still get the problem. 

I'm assuming there's a bunch of chemical reactions that occur in the hot tub that are not happening in my bath tub... Due to combinations etc. Can anyone please help me tease this apart?? I suffer aches and pains from Lyme disease and this tub had helped me so much, and I'm very sad I cannot use it very often now. I will be forever grateful. 

It's a 350 gallon tub, List of items we use:

-Sodium bisulfate at refill as needed

-Sodium carbonate at refill as needed

-Liquid chlorine as needed when salt system is overloaded

-MPS for shock once a week 

-Add CYA at time of fill 

-PH lock (leisure time PH balance) at time of fill

-Metal gone at time of fill

-Pure pool salt for chlorine generator 'Freshwater system'

-We have an ozonator

 

Thank you all so much in advance, 

Cassie

 

 

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this is a good opportunity to "over purge" if you will, to help rule out the factor of biofilms.  one thing we know -- you got better.  So you could still have biofilms in your spa.  all automatic dis

@dlleno true very good point; I was going to ask about leaving the ahhsome in overnight and I think it's a wonderful idea. I hear you on putting the filters in after we think we got most of the gunk;

Oh No....o yuk is horrible and very weak (read my blog i tested this head to head with ahhsome.).   Even the label directions indicate that the company is clueless .  They dont know how biofilms work

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Hi RDspaguy!

We've never dropped under 1ppm of chlorine on this fill (we decontaminated per the directions here at second fill), although on our first one we had some real trouble until we found your forum here and followed all the recommendations. The spa shop really sent us barking up the wrong tree. Now our water is crystal clear!

Presently we have 3ppm chlorine, 0.5ppm CC, CYA @ around 30ppm, TA is 120, calcium hardness about 75, pH 7.4, and temp of the tub is kept 99-100. 

Our water has a very high TA from the tap (250), so it took a LONG time to get it to come down, but finally did, just felt like we had to add a lot of acid and to get it to come down then had to add soda ash to get the PH back up a bit. 

Thank you all so much, I'm truly at a loss here and would appreciate ANY recommendations at all. 

Cassie

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Well....let me just suggest one word: biofilms.  Cant say for sure but Im not convinced this is a chemical problem .  My own hot spring spa was delivered new from the factory contaminated with biofilms.    My story is long but the bottom line is that for me the issue was that water maintenance was horrible.   In your case its possible that you may need to deep clean your new spa because biofilms  are providing safe harbor protection for the actuall  bad guys that are hurting you.

Do you have a medical diagnosis?

Decontamination procedures prescribed by spa stores are generally insufficient because they dont actually kill the bad guys they just attenuate them.   What procedure did u follow?

I suggest a deep clean purge  with a product called 'ahhsome".  For the back story on my experience with biofilms and purging please see my hobby photography blog

 

https://boisediesel.com/blog/2016/7/spa-purge

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Im afraid that even the decon procedures that many use (essentially 100ppm chlorine) are not bad they just dont actually remove biofilms.  In a nutshell its like sending in the marines (high chlorine levels)  too soon.  You need to soften up the battlefield with b52 carpet bombers (ahhsome purge) so that the marines can move in for a complete kill.  The ahhsome label directions show an understanding of this:  basically you dose with ahhsome and chlorine at the same time.  Ahhsome breaks down the outer layers of the biofilm and releases them while chlorine is there for the kill.

Also one thing to note:  biofilms have been shown to survive and even grow in 1-3ppm chlorine 

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Hi Dlleno, I truly appreciate your thoughts and time responding to this!! I'm super desperate. 

The spa place I bought it from suggested I decontaminate by putting in this thing called "oh yuk healthy hot tub cleaner", run the Jets for 30 minutes, leave overnight then super chlorinate and drain. They also suspected biofilm and said this would kick it's butt. A LOT of gunk came out, it appeared to work... 

My diagnosis from my doctors is that I have an allergy to "something" in my hot tub. It's allergic contact dermititis. They really haven't been very helpful though.

My itchiness and rash comes within 5-24 hrs and leaves completely within 72 hours... Steroids help.

Should I try that process again? 

Cassie

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Oh No....o yuk is horrible and very weak (read my blog i tested this head to head with ahhsome.).   Even the label directions indicate that the company is clueless .  They dont know how biofilms work and the spa store probably has a telationship with the distributor .

Ahhsome will wipe the floor compared to o yuk.  Im sorry but o yuk is an over sold under performing product that just doesn't do it.  Here is my test write up:

https://boisediesel.com/blog/2018/10/ohyuk

I highly encourage you to get some ahhsome asap.  Keep us informed here and we will help. Im sorry you are facing this medical problem .  Most retailers are clueless.... they only know what the big labels tell them and train them with.   Many manufacturers are willfully looking the other way.  Watkins is one of them....i know because ive talked to them about this very problem.   They refuse to admit that wet testing at the factory followed by storage and transportation delays is a petri dish for bad guys. 

I would stop using your spa untill you purge with ahhsome.  Dont drain....you will dose with ahhsome first 

 

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33 minutes ago, dlleno said:

 They refuse to admit that wet testing at the factory followed by storage and transportation delays is a petri dish for bad guys.

Been saying that for decades. You would be shocked at what we find when we unpackage a spa after standing it up during delivery. It's so bad, some dealers unwrap at the store before delivery and hose it out so it won't look bad, but it's still in the pipes.

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this is spot on. The reason why , in my opinion of course, you are experiencing this hot tub rash in spite of your careful attention to chemistry is

1.  Bacteria such as this live in the presence of chlorine because they are protected by biofilms shipped with your tub

2.  O yuk did not get the biofilms responsible for protecting the bad guys even though you used chlorine. Run from o yuk!    Use ahhsome.   It is EPA registered for this purpose.

We may or may not be right about the actual bacteria itself.  Presumably a doctor would have known about this possibility.   But whatever the bad guy is i think being conservative is best here and you should  treat as if you actually do have pseudomonas infection in your water, pipes or what have you.  Clearly you don't want this in your lungs (pseudomonas travels via aerosolization) so wear gloves and mask when purging with ahhsome.  

 

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Yes, not saying pseudomonas is the cause of your issue. The list of possibilities is nearly endless, and includes such bacterial all-stars as streptococcus (star of strep throat), e-coli (fecal bacteria and cause of most fresh produce recalls), salmonella (it's not just in raw chicken), shigella (stage name dysentery), legionella (legionnaires disease), and more. 

Plus, there are protozoa such as cryptosporidium (can survive weeks of chlorine exposure and is the most common cause of diarrhea on earth) and giardia (potentially fatal, the main reason for not drinking unpurified water from streams and lakes) and more.

And lets not forget viruses...

Sorry, I get a little carried away sometimes. You don't have to burn your spa. It will be ok. I promise.

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Dlleno and RDspaguy, you guys clearly have so much experience and I really appreciate you going back to basics and re-checking the simplest thing first!

Dlleno I read your report on the Oh Yuk and that definitely convinced me it was a poor choice! I ordered Ahhsome as soon as I read it and it will be here in a week hopefully. Just to confirm from reading, to clean your filters with Ahhsome, you actually put them back into the spa that had ahhsome in it and run the jets? 

Honestly over the years I've had a few health issues where the doctors barked up the wrong tree so I wouldn't put too much stock in them saying it's an allergy... they were aware of "hot tub rash" but didn't seem to think it was that due to how quickly it goes away. I like re-checking our basics it's a good plan still of course. It literally cannot hurt.

This may seem like a stupid question... but I have a few blotches on my body that seem to last for weeks while the others heal, is there anything I should be using on my body to address any sort of bacteria issue on my skin?? I have anti-bacterial soap... LOL definitely not going to jump in the hot tub with ahhsome in it don't worry!

I will follow Dlleno's exact directions for decontamination this time and get back to you all as soon as I possibly can. This hot tub has been a lifelong dream/bucket list item for me so it's literally breaking my heart not being able to use it. I'm sure you guys understand! RDspaguy I will keep the faith here and not make a rash decision (hah get it) and burn the thing down and trust you guys :D CAN'T WAIT to get that ahhsome in the mail.

Hope you're all healthy,

Cassie 

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you're not alone -- others have been in your shoes and its just sad to me that the mfgs have their head in the sand.  There was a situation I think it was last fall where some people in N Carolina actually died from legionaries disease, believed to be caused by display hot tubs from showroom floors.  While I don't know for sure, my guess is that a dealer drained a showroom demo spa and transported it to the fair.  

  1. https://www.legionnairesdiseasenews.com/2020/02/hot-tub-display-state-fair-legionnaires/ 

In any case RD is right -- these things are highly preventable with proper maintenance.  What the industry won't recognize is that these bacteria get trapped inside biofilms and can stay in your tub for, well, until you use the ahh-some procedure to get them.   I say that because at this moment ahh-some is the only EPA registered spa purge product (that I know of) ,which means it has been verified to do what it says:  the label tells the truth and the stuff is safe to use.  My protocol is:

  1. don't let your water 'go to pot' just because you are going to purge.  maintain things carefully as if you were using the tub.  RD -- anything special to do with the salt system here?
  2. dose with ahh-some. follow label directions although I would suggest dosing with ordinary clorox bleach to at least 20ppm.  For you thats approximately 3 cups of liquid grocery store bleach (regular unscented -- stay away from the no splash flavor as well).   sounds like you already have some liquid chlorine so I'm sure you can use that in whatever concentration is appropriate -- you'll have to figure that out but your goal is 20-ish ppm.
  3. Yes -- take your filter(s) out and put them into the  ahh-some dosed vessel, since they are contaminated too.  put them on a length of PVC pipe (see my blog) if they don't behave themselves in there.  most people forget about the filters -- if you look at part 2 of my blog you will see that filter media also harbor biofilms and they need purging too.  Specifically I purged with ahh-some but cleaned my filters in a normal filter cleaning solution  (outside the spa).  then I put them back into the spa and got more material release. that told me that whatever was in the filters didn't get touched by the de-greaser so it wasn't skin oils -- had to be biofim. 
  4. run the jets and drain per label directions.  I would also mix (in a separate bucket) a clean mixture of ahh-some (tough to mix since its a gel, but doable) and a strong concentration of chlorine.   use this to wipe everything down.  make sure to wear gloves and a mask because you are dealing with confirmed pathogens 
  5. in your case I think it would be important to  refill, and purge with ahh-some a second time.  do this  until you get no more release (this takes patience) 
  6. In my experiments I found that ahh-some released a boat load more material after o-yuk has done what it could.  be prepared for more gunk  and be prepared for maybe even more than 2 purges -- you have to decide based on what ahh-some releases.  I have coached others through as many as 15 (yes fifteen) purge cycles 
  7. when you are certain that your ahh-some dosed water is releasing no new material, put your filters back into their normal positions.  then run the jets and wipe up any new material with a microfiber cloth, rinsing in the ahh-some solution you prepared earlier.  
  8. your goal is an ahh-some and chlorine dosed spa, releasing no new material with filters in their normal positions.  that is the cleanest spa known to man.  when you achieve this, then drain, wipe everything down again, and start over with new fill water (note:  its possible, depending on how well you spa drains, that you might have to do a partial 2nd drain).  Note that small amounts of ahh-some are not harmful and actually a good thing.  the reason you don't very much in your water is because of the foam.  

I think in your case I would seek out a dermatologist.  I mean  it sounds to me like the common "hot tub rash" which is often pseudomonas  but no matter what the cause -- the cure for the hot tube is still the same, but a doctor is going to have to address the medical component 🙂

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I saw something similar in 96 or 97. A dealer set up a kiosk in a mall, just a hot tub with no cover, a stand full of brochures, and a part-time salesperson who knew nothing about it. But everyone who walked past would stick their hand in it. Dozens of people wound up in the hospital, they traced it back to the hot tub, and that dealer went out of business. 

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Dlleno,

This whole thing is incredibly eye opening. I wouldn't be shocked dealers are so blind to biofilm- the initial water care instructions given by the dealer were VERY wrong... only once we found this forum did we realize how bad it was. Not even a mention about CYA, yet they had us putting diclor in the tub every week and said we only had to change the water once a year. I can't even imagine how much CYA we had in there, rendering our sanitizer utterly useless. Luckily we understand what to do now, so once this biofilm issue get's resolved hopefully we are good!

Regarding a dermatologist, that's who I've been seeing for the last three months... they did a skin biopsy, allergy patch testing (which had some positives but nothing that relates to the chemicals in the hot tub), the works. They are convinced it's some kind of allergic reaction, but that doesn't change our plan. If the purges don't help, then I'll be back thinking it's allergy....

I am going to follow the instructions you just posted once I get my delivery, and plan for 2 purges- I can't believe some people had to do 15!! Absolutely shocking. 

Cassie 

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Hi folks!! Great news :) my ahhsome came early, so we started this process on Saturday AM! 

First purge was pretty epic- there was a lot of tan gunk then dark gunk that came up for about 20 minutes, I kept wiping it up with a bucket of diluted ahh-some and chlorine like you suggested. During the whole process we had about 25ppm of chlorine. By the end of the 30 minutes, I had wiped up everything from the edges and the water looked very clear and just the normal ahh-some foam. BTW I had rinsed out the filters before the ahh-some purge and put them in the tub section. Once it was drained, there was some scrubbing to do with the ahh-some mixture from the inside of the tub because I could feel a texture on the tub walls. Got that all out, squeeky clean. 

Filled it up, got it to temp, added 25ppm chlorine again then did a second ahh-some purge. There was not much that came up this time if anything at all... there was really nothing to clean up besides some iron oxide from our fresh fill which was normal for us. This made me feel pretty good about not doing a third purge (although if anything came up I would have gladly done it again!). This time once all the water was drained, there was nothing to scrub off or clean up so that's good. 

Now, for our water balancing shenanigans etc... I am having trouble keeping my PH down.

My first step on my new fill was to get 5ppm+ of chlorine in the tub once it got to temp... knowing it takes a few days to get the water balanced right, I'm paranoid now! Our tap water reads with the following: calcium hardness 20ppm, TA 50, PH 8.4. We set our calcium hardness first, to 70ppm ( our salt system manual says to keep it at 50, but we overshot a little). Then we went for the TA, setting it to 150 with baking soda knowing it will come down a bit once our PH comes down. I have my Taylor Test Kit which has the water balance wheel, so to be under 0.5 water balance our TA needs to be roughly 120ish with a CH of 70 and a ph of Ideally 7.5.

We took this slow after the TA got in range; knowing it takes a while to get the PH right. We used the pool calculator site and added 0.5oz dry acid. The next day ~15 hrs ;later we tested the PH and TA again, TA was 80 and PH was 7.8. PH came down as expected, but TA fell much more than I anticipated. We bumped the TA back up to 120 with more baking soda, came back 6 hours later, TA is back up and so is the PH back to 8.4. We felt like we had to overcompensate and bump TA  much higher so it would come down to a reasonable level, so we added baking soda to test 150ppm. 15 hrs later we retested TA 150 and PH 8.4. Using the Taylor test kit we added 1.5 oz dry acid from the acid demand test and then let it sit for 10 hours. PH was perfect at 7.6, TA perfect at 100ppm, CA 70, temp 100 degrees, chlorine still at 5-10ppm.

So at this point we happily added our PH Locker/borates, then I tested immediately after and the PH was right back up to 8.4 and the TA 120.... I didn't add anything besides aerate, which I understand can make the PH go up a litle but we thought it wouldn't after the PH lock and also since the water was balances really well?? This seems to be bouncing right back to 8.4 from nothing.

At this point, we've put the PH lock in there so are we totally screwed? I can't believe how frustrating this has been- last fill somehow we got stuck in the opposite scenario, high TA and low pH.

The things we are following are the taylor test kit #s and directions, and this reference for water care and this pool calc for everything besides acid/base demand which we are getting from the taylor booklet. 

I'm sorry this was so long winded.... 

hot_tub_ahhsome.JPG

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OK @dllenoand @RDspaguy,

Much to my disappointment the PH has remained high this AM. TA is 120, PH is probably closer to 9 (I can't test that high, but considering the amount of acid the demand test wants me to add, it's gotta be high). CH is 70. Water looks amazing for what it's worth. 

I'm sort of at a loss here, I can keep adding acid which seems to change the TA more than anticipated also... so I kind of have to juggle the two? I have been waiting roughly 12-15 hrs between adding things. Nothing seems to change during that time since I've tested throughout it before. 

Thank you all so much once again for your continued support through this whole thing!! 

Cassie 

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Gotta get that ph down. TA and ph are flip sides of the same coin. You can't change one without changing the other. 

If you raise your calcium to 150, your ideal TA is 60-80 at a ph of 7.6-7.8. Maybe try for that.

I am no chemical expert and have never encountered numbers like these. Perhaps @dlleno, @castletonia , @CanadianSpaTech , @Pool Clown can lend us a bit of wisdom.

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I experimented with borates awhile back and learned that they are much like switching from a manual transmission to an auto -- you don't really appreciate the automation until you've perfected the manual approach yourself.    the other thing I learned is that a pH buffer is just that -- a buffer -- which means it won't cut down on the actual amount of acid you will use to keep pH in control over the long haul -- it just smooths out the process.  The other important learning is that using Boric Acid is very different from  using Borax the cleaner found at the grocery store.  I had good success with the Boric Acid, which I purchased from Duda Diesel think it was, but in the end the benefit just wasn't worth the trouble.   btw, using Borax is much trickier because that stuff is net pH positive so you have to start with a relatively low pH.

and to think that Silk Balance but ordinary grocery-store borax into a really expensive container and called it "Clean Start"!  Since I wrote about that a few years ago they have changed the Clean Start formula to a weak "QUAT" which is rather like "O -yuk" -- an inexpensive chemical that does something, but pales in comparison to ahh-some.  

So, what all this means -- you'll have to continue to beat down your pH with dry acid.  perhaps the boric acid helps for the smaller vessel sizes I don't know - my spa is 500 gallons and I have taken to controlling pH without it.  frankly I "switch to bleach"  later than 30ppm because di-chlor is net pH "almost neutral but slightly negative" ,  and I'm using Bromine and Hot Tub Serum which are  both immune to the CYA problem as well.  Bromine is also a benefit, over chlorine, in the task of controlling pH drift.      

by the way ,the Hot Tub Serum is the real deal -- I'm getting fantastic results, great water clarity due to its inherent properties, and my water is six months old.  Seriously, my water has gone to zero sanitizer and the Serum keeps chanting "death to biofilms!"  lol 

I also find that chasing TA is like a dog chasing its tail.  I never target TA and by all means I never raise it -- the impact on pH is just too big, and you end up beating it down  anyway with dry acid.   For an Acrylic Hot tub you can let the saturation index go negative - -yes thats right, negative.  so low CA, and low TA, which is enough to make some heads explode but unless your system manufacturer indicates a warranty issue I wouldn't get wrapped around the axle over a negative SI.  My spa mfg, for example, specifies 50 ppm TA minimum so I do follow that.  

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@dllenoand @RDspaguy, I feel bad about this one; I have no idea what's going on, but it seems my phenol red indicator in my test kit has gone to crap?? It's not expired, but my tap water is also testing 9.0 PH which I know for a fact 2 months ago with this same kit it tested 7.6ish. With my tap water, it goes from purple to yellow and no in between for the acid demand test. That's when I was like OK, there's something wrong here. Unfortunately I had added another 1.5oz of dry acid to the tub before I suspected this..... I pulled out the "inaccurate test strips" and tested the tap water, and that tests like 7.7. The hot tub also tests around 7.8 with my test strips the dealer gave me... so I'm going to say that's probably OK!

I work in engineering and when you start questioning your test equipment that's when you know you're really in the weeds and you start to lose your mind a little... so here we are!  I've ordered a new phenol red indicator and also a new acid demand solution just in case. I also ordered Hot Tub Serum too per your recommendation :)

Cassie 

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  • 2 weeks later...

Hey Cassie....I would really appreciate a follow up on your findings. The pictures of your spa after ahhsome are really eye opening. Really hope you find your solutions. It’s nice to see folks figure out that the Spa dealers know nothing about spas. They would sell a lot more if they just gave good info. Best to you.

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