Hot tub, whirlpool, and spa-related injuries in the U.S., 1990-2007.
BACKGROUND
Recreational use of hot tubs, whirlpools, and spas has increased within the past 3 decades. Injuries due to hot tubs, whirlpools, and spas can affect people of all ages and can result in serious disabilities.


OBJECTIVE
This study examines nonfatal hot tub, whirlpool, and spa-related injuries on a national level.


METHODS
The National Electronic Injury Surveillance System database was used to examine cases of nonfatal hot tub, whirlpool, and spa-related injuries treated in U.S. emergency departments from January 1, 1990, through December 31, 2007. Analysis was conducted from November 2008 to March 2009.


RESULTS
An estimated 81,597 patients, aged <1-102 years, were treated in U.S. emergency departments for hot tub, whirlpool, and spa-related injuries, with the number increasing 160% over the 18-year study period (p<0.001). Nearly 73% of injuries occurred in patients aged >or=17 years. Lacerations were the most common diagnosis (27.8%) and accounted for 58% of all head injuries. Slips and falls were the most common mechanism of injury (47.6%); were more likely to result in an injury to the trunk than other body parts (OR=2.49, 95% CI=1.83, 3.39); and were more likely to result in concussions and fractures/dislocations than any other diagnosis (OR=7.813, 95% CI=2.194, 27.823 and OR=3.017, 95% CI=2.057, 4.425, respectively).


CONCLUSIONS
Given the increase in hot tub, whirlpool, and spa ownership and the 160% increase in injuries during the study period, more research is needed to identify the cause of the increase in hot tub, whirlpool, and spa-related injuries and what injury-prevention solutions and policies may be appropriate.
Alhajj
Maya
M
Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio 43205, USA.
Nelson
Nicolas G
NG
McKenzie
Lara B
LB
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006294:Health Resorts; D006760:Hospitalization; D006801:Humans; D006875:Hydrotherapy; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D055815:Young Adult