Another hot tub hazard. Toxicity secondary to bromine and hydrobromic acid exposure

We describe the clinical course of two patients who developed acute pneumonitis followed by reactive airways dysfunction syndrome after bathing in a hot tub. Additional findings were present and suggested that exposure to a corrosive agent was responsible. Bromine and hydrobromic acid generated from a widely used water disinfectant were implicated as the underlying cause. Physicians should be alert to the possibility that such exposures may initiate or exacerbate inflammatory pulmonary disease.