Cooling It

Hot tubs can be too hot

When a neighbor knocked on the front door of Helen and Wesley LaRoza's house in Simi Valley, Calif., outside Los Angeles, he got no answer. Yet he could clearly hear the burbling sounds of water in the fiber-glass and redwood hot tub that had been installed in their backyard. So he knocked again. Finally, when no one responded, he summoned help. The police found the LaRozas floating in the water--dead. Though detectives first suspected a double suicide, the Ventura County medical examiner, Dr. Donald Kornblum, concluded otherwise: "Quite simply, they died of hyperthermia, or heatstroke. The spa was just too hot."

The death of the California couple underscores a hidden peril in one of America's latest crazes. Some 300,000 Americans have installed hot tubs in their homes and gardens, and another 120,000 are expected to be sold in the U.S. this year. Soothing and relaxing as the warming waters may be, the mini-spas can be killers. Typical of some hot-tub owners, the LaRozas had heated the water to about 114DEG F (46DEG C). Doctors and tub manufacturers recommend only 102DEG to 104DEG F (39DEG to 40DEG C), and even these temperatures should not be endured for more than 20 minutes at a time. As a precaution some tubs are equipped with thermostats that prevent temperatures from exceeding 110DEG F (43DEG C). For good reason: higher temperatures and longer immersions can bring on heatstroke, as the body vainly tries to maintain the normal internal temperature of 98.6DEG F (37DEG C).

To shed heat, the body normally begins to sweat, a process that requires the tiny blood vessels, or capillaries, in the skin to expand. But since the bather is largely submerged in hot water, the sweat cannot evaporate from the skin. Heat builds up in the body, and as the body struggles to get rid of it, more blood is diverted to the capillaries.

The effects can be dramatic. Less blood is available to deliver oxygen to the brain. The heart must pump faster. For anyone with cardiovascular problems, long immersions in hot water can be especially dangerous. If the bather also imbibes--an all too common practice--the alcohol will increase the strain on the heart, and affect the heat-regulating mechanisms in the brain as well. Besides damaging the heart and brain, excessive heat can also cause irreversible harm to the liver and kidneys. Unless bathers get out of the hot tub and replace the lost fluid, they will feel tired. Sometimes they faint. In extreme cases they will lapse into a coma and die.

Something of the sort seems to have happened to the LaRozas. Perhaps lulled by the too warm water and a bit of alcohol, they probably fell asleep minutes after settling into the spa. The sleep turned into coma, the coma to death. Though the deaths are the first to be attributed to hot-tub heatstroke, they are not likely to have been the only ones to occur so far. Says Coroner Kornblum: "God only knows how many cases have gone unreported."

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