Heat therapy, including saunas, jacuzzi, and hot tub bathing, has gained global popularity. However, the escalating incidents of injuries and fatalities associated with hot tub activities are a significant public health concern. This study aims to comprehensively review and analyze the pathophysiological factors contributing to hot tub-related deaths, addressing the need for awareness and mitigation strategies. A comprehensive search of electronic databases, PubMed and Science Direct, was conducted to identify articles relevant to bath-related deaths. Eligible studies were exported to the Rayyan (Qatar Computing Research Institute, Qatar) software for data analysis. The data extracted from the 18 studies were compiled to elucidate the mechanisms underlying hot tub bath-related deaths and to advocate for the adoption of potential mitigation strategies and future directions to prevent such incidents in the future. The review revealed insights into the current trend of fatalities linked to hot tub bathing. A detailed analysis of pathophysiological aspects, encompassing hemodynamics, electrolyte disturbances, serum glucagon alterations, and the impact of alcohol and substance abuse during hot tub use, was conducted. Furthermore, we explored the effects of temperature and conducted a thorough discussion of postmortem evidence analysis concerning deaths related to bathtub usage. Finally, the paper discusses mitigation strategies to prevent fatalities attributed to hot tub bathing. In conclusion, our review highlights growing public health concerns surrounding injuries and fatalities related to hot tub activities. Through an examination of the incidence rates, pathophysiological factors, and proposed mitigation strategies, we provide crucial insights for enhancing safety and addressing the escalating risks associated with hot tub bathing.
Keywords: drowning; hot tub drowning; hot water bath; mitigation strategies; tragic deaths.
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