Hydrotherapy pools of the future--the avoidance of health problems

The need to minimize the threat of infection to patients and the high incidence of health problems in hydrotherapy pool workers, have led to recommendations especially tailored to the design and operation of the water and air treatment plant of hydrotherapy pools. Hitherto unpublished surveys are detailed which confirm that pathogenic species of Pseudomonas aeruginosa in pools (in which ears may be wetted) cause a high incidence of otitis externa, but rarely cause body rashes (pseudomonas folliculitis) unless there has also been prolonged skin wetting. In brominated pools contact dermatitis is common and can be distinguished clinically from pseudomonas folliculitis by the onset of a pruritic rash less than 12 hours after exposure to the pool and reactivation of the rash on re-exposure to the brominated pool.