There is nothing quite as relaxing as having a hot bath especially on a cold winter’s day. However, bathing with very hot water has a host of dangers and this is not just for babies and the elderly. Every year emergency rooms see scores of injuries caused by bathing in very hot water and this practice can also complicate other illnesses.
How hot should bath water be?
It is therefore important to be aware of the risks associated hot baths. It is equally important to define what hot water means. Individual tolerance means some people can withstand and may even prefer higher temperatures than others. While there is no specific upper limit, it is accepted that bath water temperature should not exceed 110F (43C).
Lower temperatures apply for babies where it should not exceed 98.6F (37C). However, it may be preferable to not approach this upper limit with baby’s bath water. Try to ensure that baby’s bath water is lukewarm rather than hot. Water around 28C (82.4F) to 30C (86F) may be preferable as it is not dangerous yet still comfortable for baby.
Always measure the temperature of bath water with an appropriate thermometer if there is any reason to suspect impaired judgement when it comes to detecting temperatures. This is particularly important when it comes to the bath water of babies as the tolerance levels between a baby and adult may differ significantly.
Dangers of Hot Baths
The following dangers of hot baths may apply whether a person showers or soaks in a tub filled with water. While both can be equally dangerous, the latter may be more so at times. Soaking in a tub means that most of the body is immersed in the water without any air between. In a shower there is a stream of water within air able to move between the tiny jets of water.
Furthermore since most people are standing in a shower, they are able to move out of it more quickly and therefore minimize exposure time to the hot water. Nevertheless a hot shower can also be dangerous especially when it comes to changes in heart functioning as a result of the heat exposure. Standing strains the heart to a greater degree than lying down.
Falling in the bathroom can lead to serious and sometimes even deadly outcomes. Most of the time this is not dependent on the temperature of the bath water. However, trying to rapidly exit out of a very hot bath or shower can increase the likelihood of a fall. In some people there is a greater risk of falls due to dizziness, poor balance and changes in blood pressure.
Another contributing factor of hot water with falling in the bathroom is related to steam. As the steam makes contact with the walls and floor it condenses into tiny droplets of water. This can make these surfaces slippery which increases the chance of falling. It is more likely to be a problem for the elderly who have poor balance and impaired mobility.
This is probably the most common type of hot water injury a person can sustain. The skin’s ability to withstand the hot water has an upper limit. Once this limit is reached the skin will become damaged. There are different degrees of burns depending on the temperature of water and duration of exposure.
Scalds and burns can be severe particularly in people who cannot detect the heat of the water. This may be seen in diabetic neuropathy where the nerves are damaged due to long standing diabetes. As a result the exposure to water may be much longer. Similarly a person who has problems with mobility may not be able to exit the hot water fast enough. Both these problems are more likely to affect the elderly.
Alterations in Body Temperature
A hot bath can cause overheating especially if the bath is very long and more so if the environment is hot, like during a heat wave. However, most people will feel uncomfortable and either reduce the bath water temperature or step out of the bath. If the temperature regulating centers in the brain are impaired as occurs with certain diseases and medication, then a person may not make these changes. As a result the body temperature rises. This can increase the possibility of a heat stroke during hot weather.
Having a hot bath especially in cold weather also has another danger. The superficial blood vessels of the skin dilates (widens) when exposed to heat. This allows for the body’s inner temperature to be dissipated into the environment and prevent overheating. However, after stepping out of a hot bath the blood vessels may remain dilated for a long time and the body continues to lose heat. Depending on other factors the body temperature can drop too low (hypothermia).
Read more on heat stroke.
Low Blood Pressure
Widening of the superficial blood vessels on the skin also leads to a change in blood pressure. This fluctuation is usually not significant most of the time but for people with heart and blood pressure disorders it can be a major change. As a result the blood pressure drops with a hot bath similar to changes that can occur in hot weather.
A person may also experience dizziness and poor balance due to this drop in blood pressure (hypotension). This has an added danger in terms of falling within the bathroom. Head injuries in these cases may be complicated by the already low blood pressure and can lead to serious complications, or even death if the heart fails while trying to accommodate.
Read more on hypotension.
Intoxication impairs a person’s ability to detect temperatures and also their sense of judgement. It can also causes alterations in blood pressure and heart activity. This applies to alcohol, strong prescription medication and even illicit substances. Based on the possible scenarios mentioned above, intoxication can lead to hot water injuries.
This is more likely to occur with severe intoxication. Accidental drowning is also a possibility. While this can occur in water of any temperature, being immersed in very hot water while intoxicated may lead to dizziness and even loss of consciousness with the low blood pressure. Therefore drowning is more likely to occur in these instances.