Hot Lung Tub Cleaning

[clarencehe]

I believe I developed "hot tub lung" and have MAC colonization of my hot tub due to improper maintenance. My symptoms have resolved since discontinuing use, and most medical website recommend discontinuation of tub use as treatment. However, I still have the tub and enjoying using it after exercise and to help with my low back pain. I was wondering if I thoroughly cleaned the tub and started a proper maintenance plan if I could continue using it. Any suggestions for tub cleaning? Also, any recommendations of a good treatment schedule (cost less important than ease)? My understanding is than Mycobacterium species can be relatively CL resistant. Thanks for any assistance

[chem geek]

I believe I developed "hot tub lung" and have MAC colonization of my hot tub due to improper maintenance. My symptoms have resolved since discontinuing use, and most medical website recommend discontinuation of tub use as treatment. However, I still have the tub and enjoying using it after exercise and to help with my low back pain. I was wondering if I thoroughly cleaned the tub and started a proper maintenance plan if I could continue using it. Any suggestions for tub cleaning? Also, any recommendations of a good treatment schedule (cost less important than ease)? My understanding is than Mycobacterium species can be relatively CL resistant. Thanks for any assistance

Hillbilly Hot Tub has a good cleaning procedure that I can't seem to find right now. So stay tuned on that (it involves super-chlorinating your tub).

Can you give some specifies on your disinfection routine before you developed "hot tub lung"? Where you using chlorine or bromine or biguanide/Baqua (it sounds from your post that you may have been using chlorine)? Did you have any alternative system such as metal ions with Nature2 or enzymes or an ozonator? If using chlorine, what kind of chlorine were you using (e.g. Dichlor)? What was the dose of sanitizer that you used and how often and when relative to your soak time (i.e. before or after soaking)? What is the size of your tub in gallons? How often did you soak (times per day or days per week and hours per soak)? How many people soaked in the tub? How many weeks or months was it since the last water replacement when you developed "hot tub lung"?

The bacteria don't actually develop a resistance to chlorine. Chlorine is a broad-spectrum and rather destructive chemical -- it doesn't act like an anti-biotic that only attacks a single chemical pathway or mechanism so single or a small number of mutations don't confer resistance. Instead, some bacteria form biofilms on surfaces if not killed right away and biofilms are (and always have been long before chlorine was every used) resistant to chlorine. Also, continued use of Dichlor can make the chlorine less effective and that can allow the bacteria to grow. Also, many people don't use enough sanitizer so the bacteria are given enough time with no sanitizer to take hold.

The reason for my many questions is that I'm keeping track of hot tub lung/rash/itch incidents and trying to determine patterns.

Richard

[clarencehe]

I believe I developed "hot tub lung" and have MAC colonization of my hot tub due to improper maintenance. My symptoms have resolved since discontinuing use, and most medical website recommend discontinuation of tub use as treatment. However, I still have the tub and enjoying using it after exercise and to help with my low back pain. I was wondering if I thoroughly cleaned the tub and started a proper maintenance plan if I could continue using it. Any suggestions for tub cleaning? Also, any recommendations of a good treatment schedule (cost less important than ease)? My understanding is than Mycobacterium species can be relatively CL resistant. Thanks for any assistance

Hillbilly Hot Tub has a good cleaning procedure that I can't seem to find right now. So stay tuned on that (it involves super-chlorinating your tub).

Can you give some specifies on your disinfection routine before you developed "hot tub lung"? Where you using chlorine or bromine or biguanide/Baqua (it sounds from your post that you may have been using chlorine)? Did you have any alternative system such as metal ions with Nature2 or enzymes or an ozonator? If using chlorine, what kind of chlorine were you using (e.g. Dichlor)? What was the dose of sanitizer that you used and how often and when relative to your soak time (i.e. before or after soaking)? What is the size of your tub in gallons? How often did you soak (times per day or days per week and hours per soak)? How many people soaked in the tub? How many weeks or months was it since the last water replacement when you developed "hot tub lung"?

The bacteria don't actually develop a resistance to chlorine. Chlorine is a broad-spectrum and rather destructive chemical -- it doesn't act like an anti-biotic that only attacks a single chemical pathway or mechanism so single or a small number of mutations don't confer resistance. Instead, some bacteria form biofilms on surfaces if not killed right away and biofilms are (and always have been long before chlorine was every used) resistant to chlorine. Also, continued use of Dichlor can make the chlorine less effective and that can allow the bacteria to grow. Also, many people don't use enough sanitizer so the bacteria are given enough time with no sanitizer to take hold.

The reason for my many questions is that I'm keeping track of hot tub lung/rash/itch incidents and trying to determine patterns.

Richard

Thank you for your response. I have an approximate 8 year old small two person tub with an ozanator. I changed the water approximately every 2 to 3 months depending on usage, but it could have been longer between the most recent water change. The tub is outside and nonenclosed. Disinfection routine was relatively lax. I would check the levels with chem strips (I think it only measures total CL levels), and if low add some diclor. Never checked CYN level or knew about them until I read about them on this site recently. I am really the only tub user. Occasionally my wife would use it, but rarely. Soak time approximately 15-30 minutes 2 to 3 time per week.

I read one article in "applied and environment microbiology" (article for August 2004) that suggested that MAC CL resistance could vary but I may have misunderstood about that.

Anyway, Do you think it would be possible super chlorinated the tub and still be able to use it. Or should I get rid of it? Get a new one?

Thanks again for your help.

[chem geek]

Thanks for the info. Did the hot tub lung develop soon after a fresh refill or more toward the middle or the end of your 2-3 month water change?

I think that superchlorinating will work, but again I hope that Hillbilly Hot Tub chimes in since I can't find the great procedure that was posted for that (I forget the FC level that was used and for how long, etc.).

[Accent]

I was never diagnosed with hot tub lung, but I've had some problems with coughing while using the tub which I've attributed to lapses in hot tub maintenance. I've had the cough go away after super-chlorinating the water to something over 10 ppm (sorry, just test strips) and leaving it in overnight, draining, and refilling. Just super-chlorinating without refilling did not make the cough go away. This last time I got the cough, after I superchlorinated but before I drained and refilled, I used a product called "spa flush," which claims to remove biofilms from the pipes. I don't know if it made the difference or not, but the new water seemed extra clean and sparkly when I refilled after having used spa flush. I've also noticed that it's easier than before to keep my free chlorine levels up, so maybe spa flush removed some bad gunk that was hiding in the pipes and causing trouble before.

I had read Hillbilly's instructions and somewhat modeled my first clean and refill after them, but to be honest, they seemed more involved than I was willing to try and I think mine did the trick - at least for a couple months before I started coughing again.

[WaterBeast]

I can't find them either, but I did write my own procedure that I think was inspired by an earlier post from Hillbilly Hot Tub.

Post with basic decontamination process

In this case I would make sure that the cleaning of the spa cover, spa edges above the waterline, etc. went further and was followed with a real disinfectant/sanitizer, not just a cleaner.

Good luck with it.

[Hillbilly Hot Tub]

Sorry, zoo around here plus it is our busy time of year.

Decontamination steps.

1. Filters: Remove the filter(s) and either clean or replace it. To clean the filter first use a filter cleaner per label directions. After rinsing the cartridge, completely submerge it in a 1/10 dilution of liquid bleach from 1-4 hours. Inspect and clean the filter housing interior. Install the filters after spa decontamination is complete.

2. Raise the water level in the spa to 1/2 inch above the high water mark.

3. Add at least 100 ppm chlorine to the spa.

4. cover the spa.

5 circulate the water at the maximum rate for at least 30-45 minutes. Make sure all jets aor open and on high.

6. While the water is circulating, turn the blower , if equiped, on and off every 5 minutes. If you have air to the jets turn the air adjustments off and on every 5 minutes.

7. Stop the circulation by turning jets off.

8. While spa is draining rinse the sides several times.

9. Clean the spa with a surface cleaner and rinse off to remove the cleaner.

10. Drain spa to remove any excess water and cleaner

I would add to this that the pillows,cover, under the edges of the control knobs shouls also be wiped with bleach water. I would through the pillows right into the tub while it is decontaminating.

11. Refill spa with water, replace the filter with a new or cleaned filter.

12. Balance the water.

13. To verify decontamination, shock treat the spa with 10 ppm of chlorine. Allow the spa to circulate for 8-12 hours and check sanitizer level in the spa. If there is no free chlorine, excessive demand still exsists, repeat the decontamination procedure.

14. If free chlorine still exsists proceed with routine maintenance of the spa.

15. If after 2 successive attempts to decontaminate the spa, evidence of contamination persists, a serious problem may exist. Do not resume spa use, contact a professional to resolve.

Excuse any typing errors, I am trying to multi task today!

[clarencehe]

Sorry, zoo around here plus it is our busy time of year.

Decontamination steps.

1. Filters: Remove the filter(s) and either clean or replace it. To clean the filter first use a filter cleaner per label directions. After rinsing the cartridge, completely submerge it in a 1/10 dilution of liquid bleach from 1-4 hours. Inspect and clean the filter housing interior. Install the filters after spa decontamination is complete.

2. Raise the water level in the spa to 1/2 inch above the high water mark.

3. Add at least 100 ppm chlorine to the spa.

4. cover the spa.

5 circulate the water at the maximum rate for at least 30-45 minutes. Make sure all jets aor open and on high.

6. While the water is circulating, turn the blower , if equiped, on and off every 5 minutes. If you have air to the jets turn the air adjustments off and on every 5 minutes.

7. Stop the circulation by turning jets off.

8. While spa is draining rinse the sides several times.

9. Clean the spa with a surface cleaner and rinse off to remove the cleaner.

10. Drain spa to remove any excess water and cleaner

I would add to this that the pillows,cover, under the edges of the control knobs shouls also be wiped with bleach water. I would through the pillows right into the tub while it is decontaminating.

11. Refill spa with water, replace the filter with a new or cleaned filter.

12. Balance the water.

13. To verify decontamination, shock treat the spa with 10 ppm of chlorine. Allow the spa to circulate for 8-12 hours and check sanitizer level in the spa. If there is no free chlorine, excessive demand still exsists, repeat the decontamination procedure.

14. If free chlorine still exsists proceed with routine maintenance of the spa.

15. If after 2 successive attempts to decontaminate the spa, evidence of contamination persists, a serious problem may exist. Do not resume spa use, contact a professional to resolve.

Excuse any typing errors, I am trying to multi task today!

[clarencehe]

Sorry, zoo around here plus it is our busy time of year.

Decontamination steps.

1. Filters: Remove the filter(s) and either clean or replace it. To clean the filter first use a filter cleaner per label directions. After rinsing the cartridge, completely submerge it in a 1/10 dilution of liquid bleach from 1-4 hours. Inspect and clean the filter housing interior. Install the filters after spa decontamination is complete.

2. Raise the water level in the spa to 1/2 inch above the high water mark.

3. Add at least 100 ppm chlorine to the spa.

4. cover the spa.

5 circulate the water at the maximum rate for at least 30-45 minutes. Make sure all jets aor open and on high.

6. While the water is circulating, turn the blower , if equiped, on and off every 5 minutes. If you have air to the jets turn the air adjustments off and on every 5 minutes.

7. Stop the circulation by turning jets off.

8. While spa is draining rinse the sides several times.

9. Clean the spa with a surface cleaner and rinse off to remove the cleaner.

10. Drain spa to remove any excess water and cleaner

I would add to this that the pillows,cover, under the edges of the control knobs shouls also be wiped with bleach water. I would through the pillows right into the tub while it is decontaminating.

11. Refill spa with water, replace the filter with a new or cleaned filter.

12. Balance the water.

13. To verify decontamination, shock treat the spa with 10 ppm of chlorine. Allow the spa to circulate for 8-12 hours and check sanitizer level in the spa. If there is no free chlorine, excessive demand still exsists, repeat the decontamination procedure.

14. If free chlorine still exsists proceed with routine maintenance of the spa.

15. If after 2 successive attempts to decontaminate the spa, evidence of contamination persists, a serious problem may exist. Do not resume spa use, contact a professional to resolve.

Excuse any typing errors, I am trying to multi task today!

[clarencehe]

Thank you everyone for the information. I am going to use the procedure and will post if it works. Also, the symptoms developed towards the end of the water change period. Thanks again for all of your help.

[chem geek]

FYI. The spa decontamination procedure is in this PDF file.

[Nitro]

The last thing the decontamination process says is:

"If after 2 successive attempts to decontaminate the spa, evidence of contamination persists, a serious problem may exist. Do not resume spa use, contact a professional to resolve."

What will a professional do to reslove what two decon's couldn't, sell you another tub?

Kidding aside, I am curious to know what can be done other than more decon's. Any ideas?

[cashews]

The last thing the decontamination process says is:

"If after 2 successive attempts to decontaminate the spa, evidence of contamination persists, a serious problem may exist. Do not resume spa use, contact a professional to resolve."

What will a professional do to reslove what two decon's couldn't, sell you another tub?

Kidding aside, I am curious to know what can be done other than more decon's. Any ideas?

how about filling the entire tub with bleach? heh heh....and a pipe snake to scour out the plumbing....

I wonder.