CF Parenting IRL: Assessing the risks - Hot tubs, spa pools and the like

Still going with my theme of getting to grips with advice for parents on activities that should be approached with caution when you are the parent of a little person who has CF. I hope these don’t seem negative - after all I plan to be that parent that tells their child they can be whoever they want to be and do whatever they want to. ☺️ Throw themselves in at the deep end - and embrace life! 💕

But I am also that type of person that wants to understand WHY some of these activities are advised against so here’s another post in case it’s of interest to anyone at all - hot tubs and spa pools.

First up is hot tubs and jacuzzis! These stats are pretty minging (and definitely pretty serious for CF families) so here goes … There is strong evidence of the presence of PsA in warm water that is aerosolised and easily inhaled when a person’s head is just above the water when in a hot tub or jacuzzi. In the last few years there have been reported cases of acquired infection of PsA in children and adults with CF - as well as infection in previously healthy adults. PsA has also been isolated from culture plates held 15 cms above the water surface of a hot tub when it was turned on. And PsA has also been found in water samples and swabs from the sides, gutter, drains etc. of hot tubs. Ewwww.

Interestingly there is guidance for spas and people that keep hot tubs that in theory should reduce the survival and growth of PsA in hot tubs and jacuzzis (e.g. levels of free chlorine and bromine, pH of water), but the reality is that given the complex piping systems and the water temperature being perfect for the growth of bacteria, it’s unlikely that these measures would be totally effective.

Spa pools are similarly risky due to the temperature of the water and the fact that they can involve jets of some kind or nutrients in the water that is a breeding ground for many different types of bacteria.

To be honest total avoidance of these is recommended for people with CF. Although I also now feel a little weird about them myself.