For many, taking a hot shower is a refuge, a few moments of relaxation before or at the end of a busy day. But there is growing evidence that daily ritual could be putting you at risk.
"Excuse me. This is one of the things you get," said Mary Lou Area, catching her breath between coughs.
When her symptoms started, Area had been traveling back and forth to California to care for her dying mother. "And the coughing kept getting worse where I would just cough up Kleenexes full of stuff," Area said, sharing her story with our 2NEWS sister station in Denver.
Area was recovering from pneumonia and initially just wrote it off as lingering symptoms. But after weeks of coughing to the point of exhaustion, she went to see a specialist.
"He said, 'You may have this really weird thing,'" said Area.
The weird thing the pulmonologist diagnosed her with was Nontuberculous Mycobacterium Complex or NTM.
"I thought, 'That's ridiculous,'" said Area.
But it is real. NTM often hits women around 50 years old who are slim, Caucasian and otherwise in good health. The other thing they have in common? They take showers.
"For a number of patients, I am absolutely persuaded that showers are the primary means by which they were infected," said Dr. Michael Iseman, professor of medicine at National Jewish Health and the University of Colorado.
Iseman specializes in the treatment of complicated or multi-drug-resistant tuberculosis or disease due to nontuberculous mycobacteria. Iseman told us he and other physicians who specialize in treating rare respiratory infections are seeing a spike in the number of NTM cases.
"We see hundreds if not approaching a thousand patients a year with this condition," Iseman said. And he has also seen evidence showers are to blame. "We've actually surveyed the showers and the water system in these individual's homes and have found, in a modest number of cases, there's an exact fingerprint identity with the organism from the patient's lungs to the organism in the shower head," said Iseman.
We found more evidence linking showers to NTM at the lab of Professor Norman Pace at the University of Colorado at Boulder.
"The stuff you see on this shower head is bacteria," said Pace. "NTM pulmonary disease is heavily under-diagnosed and probably more prevalent in the community than we think."
Pace and his graduate students spearheaded a recent study that found 30 percent of shower heads harbor significant levels of disease-causing bacteria.
"Nasty is the word. I'd throw this one away and get another one," Pace said looking at a sample shower head provided by us.
"These buildups that people usually think of as calcium deposits or soap scum, are really biological," said grad student and researcher Kim Ross.
"In other words, this white stuff is encasing some bacteria that are living in there?" "That's right," Ross said.
Pace said all of us are bathed in bacteria every day, most of it harmless. But in the shower potentially harmful bacteria have a direct route to your respiratory system, he said.
"What that steam-like material is, is microscopic droplets of water and when you inhale those, you are, of course, inhaling whatever is contained in the water," said Pace.
That includes bacteria that is breeding in your household pipes. "I truly believe I got it from a shower head," said Area of her NTM diagnosis. Area said she often stood in a steaming hot shower for 30 minutes at a time before she was diagnosed. Area said she had a portion of her lung removed because of the disease and will be taking multiple antibiotics for years to come to treat the disease.
"It's hard to enjoy your life when you feel not so hot," Area said. She is hoping someone will hear her story, get help and change their routine.
"I am absolutely persuaded that this will be a large public health issue within this decade," Iseman told us.
All the experts we spoke with agree, there is enough preliminary research to suggest further study. The problem is funding. There are efforts under way to get the National Institutes of Health, the Centers for Disease Control and Prevention and the Environmental Protection Agency to participate in more aggressive research and awareness campaigns.
In the meantime, the experts suggest removing and soaking shower heads in bleach or germ-killing cleaning agents as part of a regular cleaning routine. If they do not come clean, Pace said throw them out and replace them, but keep in mind the bacteria will reappear even on a new shower head.
Iseman said increasing the temperature in your water heater to 140 degrees will kill harmful bacteria, but it will also increase the risk of scalding and should be done with extreme caution.
Other advice: remove the shower head completely and use the water straight
from the pipe and avoid steam rooms, hot tubs or any environment where bacteria particles could be inhaled. Additional Information:
- Read more from the Proceedings of the National Academy of Sciences of the United States of America .
- Read about Nontuberculous Mycobacteria