There is little that compares to a hot tub especially, if you live in a cold environment and have one outdoors.

While it's 10 degrees outside, your soul can be warmed with 100 degree waters. Be at peace with yourself, meditate, and contemplate, as it's snowing around you.

But, some precautions are in order. Hot tubs are really swimming pools, with heaters and jets; fancy pools with filters, and chemicals for disinfection.

It's easy to become lax about filter maintenance and chemical use. Users are usually nervous about these things at first, but after a while, if the water looks good, many people don’t give the issue a second thought.

This could be a mistake. The filters must be cleaned in accordance with manufacturer requirements, chemicals must be used in the right amounts to maintain a suitable level of disinfecting chemical and PH.

Failure to do so may allow bacterial to develop. The fact that the water is hot makes this an even more difficult process because, it's harder to maintain appropriate chemical levels in hot water.

Improper chemical or filter maintenance, has been linked with two kinds of illnesses: hot tub lung and hot tub rash. I will generally describe these problems, but if you believe you are sick, you obviously need to see a doctor and read information from an authoritative source.

Hot tub lung is associated with improper disinfection and filter maintenance. A particular bacteria -- mycobacterium avium -- flourishes under these conditions.

When the jets are turned on, the bacteria becomes disseminated through a mist in the air -- which can be inhaled by the hot tub user.

Again, see a doctor. But the reported results are a productive cough and other seemingly flu-like problems. The experts seem to disagree on whether antibiotics work -- or whether steroids will do the trick.

The literature suggests that a lot of doctors are not familiar with this problem, which means a proper diagnosis may be difficult. Apparently, this is somewhat rare, but can be pretty disabling. Based on what I have read, it appears to be curable.

Then there is hot tub rash, which starts with the same problem, sub-standard maintenance. Here, elevated red dots become a rash that seems to occur in areas covered by bathing suits.

It seems that the problem can also produce flu-like symptoms and it self-resolves when you have removed yourself from the tub for about a week.

I love my hot tub, you'll love yours as well. If you have room and can afford one, I hope you get one. But they have issues that most people don’t seem to know much about, best to be safe and follow all directions.

Published: March 17, 2005

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Stuart Lieberman, Esq. writes about environmental issues. He was a New Jersey Deputy Attorney General assigned to the State Department of Environmental Protection from 1986 to 1990. Currently he is a shareholder in the environmental law firm of Lieberman & Blecher, P.C., located in Princeton, New Jersey. Stuart can be reached at slieberman@liebermanblecher.com.