Pseudomonas in a Float Tank! – OSP 07

This is a bit of breaking news for the float world. There was a clearly defined case of someone getting sick in a float tank and Graham and Ashkahn are here to tell you what you as a float center owner (or future owner) should know about it and the steps you can take to keep yourself informed on this issue and make sure you don’t repeat any of the same mistakes. 

What is Water Activity? – OSP 03

Float Fund – NSF Magnesium Sulfate Test Results

Float Tank Pseudomonas Case in Vancouver

Listen to Just the Audio

Transcription of this episode… (in case you prefer reading)

Graham: Alrighty. Duty, back again.

Ashkahn: Yeah.

Graham: I’m Graham.

Ashkahn: I’m Ashkahn and this is real. Like this is a real episode. We’re doing a real live … I mean man, like this is going to be new information-

Graham: … live for us, not for you.

Ashkahn: Oh yeah.

Graham: We’ve gone over this a few times-

Ashkahn: I know, I forget. It seems like they’re here. That’s thing-

Graham: It’s true. Like we hold you all so close-

Ashkahn: And we have pictures of you all around this room, so I keep getting that confused, but yeah. Okay.

Graham: Right. But it is life for us. Your excitement here. This is probably the real world and not just some weird simulation. There’s a lot to be stoked on, and we have some information to share too.

Ashkahn: Yeah. So this is an update. What’s going on out there in the world?

Graham: News-

Ashkahn: This news has just broken and this was, we were reporting on it here. Breaking news.

Graham: Yep, fresh off the presses from June 28th.

Ashkahn: Yeah. It took us a little bit to get over here, but we’re here now.

Graham: So, there was a paper that got published up in British Columbia on a case of pseudomonas that was found both in and probably caused by a float tank, which is really interesting.

Ashkahn: Yeah, it does seem like someone out there got sick from a float tank and that’s where we can put that dun dun dun sound effect that we have.

Graham: Hold on, let me just look it up really quick.

Ashkahn: Okay.

Graham: All right. There we go. Yeah. So that’s, yeah, that’s about how you should feel-

Ashkahn: Hopefully, that added some drama to this whole episode here. So yeah, so basically what happened?

Graham: Yeah. When did things go so wrong, is the question.

Ashkahn: Well, maybe some context first. Before we even get into what happened. This is-

Graham: Float tanks are …

Ashkahn: This is, as far as we know, the first actual kind of case of someone getting sick.

Graham: Yeah, first reported case of someone getting sick of any type.

Ashkahn: The first time an actual like health authority-

Graham: Other than throwing up but not actually getting sick with-

Ashkahn: Like infectious disease.

Graham: Yeah, exactly.

Ashkahn: So this is the first time a health authority has actually found a case of someone from a commercial float facility and linked an illness to it. I mean it’s been, for the entire history of the float industry going on, that this has yet to happen. So it is interesting to see that we do actually have a case of that.

Graham: So pseudomonas, we should talk about a little bit before we get too deep into other things. You might recognize it actually, if you’ve been on top of water sanitation research that’s happened. It’s often one of the test bacteria that gets used for different studies. It’s also one of the ones that we used for our NSF study with just pure saltwater to see how that would affect different organisms.

Graham: And it’s also just called hot tub rash, it’s kind of its nickname. Likes warmer water, skin irritant and apparently can also cause some other problems, which we’ll get into a little further down describing this, which I wasn’t even aware of until this study. But normally, it’s a rash that you get from going into a hot tub with other people and it not being the best environment.

Ashkahn: And you see it around them a lot because it really just is one of the most common illnesses that comes from kind of recreational water-

Graham: And it’s everywhere, it’s pretty much everywhere. Pseudomonas just exists in most water sources and supplies and just not inn nearly high enough concentrations to worry about.

Ashkahn: But yeah, it can give you illness and skin infections and other things like that. There are a lot of reported cases of at each year in all sorts of different avenues, and that’s why you see a tested for a lot as well. It’s one of the things that we test for every month when we take water samples into the lab, we’re testing for pseudomonas. It’s in those research papers. The NSF, when they test for the efficacy of disinfection equipment, if they’re testing a UV system or they’re testing an ozone system, it’s one of the things they test for to see if you can properly kill pseudomonas.

Ashkahn: So it is really out there a lot and tested for a lot because it is one of the most ubiquitous, actual contagious diseases people can get out there. And in float tanks it’s particularly interesting because you can get it from it just getting on your skin. When we talk about other ways of getting sick in float tanks, there’s a lot of gastrointestinal illnesses.

Graham: Those are usually the main concerns that a lot of pools have, is like really trying-

Ashkahn: Yeah, cryptosporidium, that one alone is like over 50% of all illnesses each year. E coli, giardia, norovirus, all this sort of stuff are, these are gastrointestinal illnesses, which mean …

Graham: Yeah, one of the things they have in common too, is that they all look terrifying under a microscope if you look at them.

Ashkahn: Yeah. Creepy, creepy little crawlers.

Graham: But another thing they have in common …

Ashkahn: Yeah, basically you to get sick from them, you have to ingest them, right? You have to swallow them and get them into your gastrointestinal track. That’s one of the things where, how float tanks work versus how pools and spas work, can really come into play, right? You just accidentally swallow pool water when you’re swimming and everybody does it. It’s hard to avoid. It goes up your nose, it gets in your mouth, they’ve studied it, all that sort of stuff. You have to swallow enough of this stuff to be able to get sick from it.

Graham: And with float tanks, I mean, you can just kind of visualize in your head how hard it is to imagine getting any amount of the saltwater, that would near the amount in a pool or anything like that, into your nose or mouth much less swallowing it if you did. It’s usually one of those cases where you get a couple of drops on your tongue and then you’re like, plech yech ugh. Yeah.

Ashkahn: So pseudomonas is a skin disease though, right? So we don’t get that same kind of just natural, lower risk from contact that we do from some of these gastrointestinal illnesses. That is one reason that in the float industry we’ve also been curious about looking at it and monitoring it and seeing if it is something that could get somebody sick.

Graham: So what the heck happened? Like where the who, the what, the where, the when, why, why did this pop up?

Ashkahn: Yeah, so it’s a place up in British Columbia, it was a commercial float center. They don’t say in the article exactly which place otherwise, they don’t name the center or anything like that. But they do say it was in Vancouver. Really like the main thing in here that I feel has to be considered for all the rest of this, it does seem like somebody got sick from pseudomonas in a float tank, but what happened here is, according to this article, a customer was taken and put into a float tank-

Graham: This is back in 2017-

Ashkahn: This is in 2017, so this is a case from October of 2017 is when all this stuff actually happened. But the big thing here is that someone put a customer into a float tank that had been non-operational for a couple of weeks. So it sounds like something broke in their filtration system. They couldn’t turn the pump on or filter the float tank. They didn’t use it, it just sat unused and then-

Graham: Not properly being disinfected or anything like that. Like literally just stagnant float tank sitting there, not being cared for.

Ashkahn: British Columbia requires chlorine. They say they didn’t put any chlorine in during that time or anything. And then they put a customer into it, accidentally one would hope-

Graham: After two weeks of not being filtered and just sitting there.

Ashkahn: Yeah. And then that person got a pretty bad case of pseudomonas. Actually had to go to the hospital and it wasn’t just like a light rash or anything like that.

Graham: Yeah, yeah. Like internal pseudomonas with all kinds of complications-

Ashkahn: Pretty serious ear infection, yeah. So that’s what happened, and it does seem like … So they talk a little bit in this article, before we get into some of the other details. I guess one thing that is interesting is how do they know it was actually from the float tank? And they do discuss that. So one thing they did was they asked this person who went to see the doctor and that’s how they linked it back to this float center and everything. If they had done anything else in the 10 days around … There’s a certain window of time that you can actually get pseudomonas before you even see symptoms. So they took that whole kind of window of time and asked them if they were in any other sort of venue that could have gotten them sick, like a pool or hot tub or any other water park, anything like that. And they said that-

Graham: Hotel room bathtub, something like that. And yeah, no, they said no, the float tank was really the only kind of out of the normal thing they’d done that would involve any kind of body contact like that with water that would give them pseudomonas. At least according to them, they’re like this is the only source really that they think is reasonable.

Ashkahn: Other things that make it seem like it probably was this float tank. They did test the float tank and it did have very high levels of pseudomonas in it. Unfortunately, we don’t really know the exact levels. The environmental health office there went in and investigated this after a few days when they realized what was going on. I think they got levels of 200-ish, but it turns out that was also the highest level that they’re test kit went to. So…

Graham: And that’s how it is with everything.

Ashkahn: … like 1.5?

Graham: Yeah, they like maxed out all of the different tests for these and so we don’t really get a good understanding of exactly how bad the situation was in the float tank,

Ashkahn: But we know it was at least 200, so that’s like the one quantifiable thing we know out of here. It could’ve been and likely was much higher than that, but at the very least we do know the float tank had pseudomonas in it and had it at a decent level.

Graham: Yeah. And then in addition, I guess, just closing out also, a way they tried to establish that is … Pseudomonas actually has different isolates. You can imagine it changes and morphs over time as it combines with different hosts and anti-

Ashkahn: Evolution.

Graham: Right? And really quick. Yeah, exactly. Like micro biological evolution, so you can actually get these different identifiable strains, basically. They’re called isolates of pseudomonas. And so they tried to compare the isolates they found from the float tank to the person and that’s where it broke down. They didn’t actually get matching isolates or this would be a … They were similar to each other but didn’t match what was in the float tank is, I believe, what happened.

Graham: Basically what that means is, it would have been a long shot anyway. It’d be really nice if close to the time of infection, or when the person was coming in before they got antibiotics, they could have taken these samples and determined the isolates. But after rounds of antibiotics, after the float tank already had some treatment, it’s unlikely that the pseudomonas is going to be in the same group anyway, was the conclusion. So it means that we can’t definitively say they got pseudomonas from the float tank, but with the other information coming in, I personally think it’s pretty likely.

Ashkahn: Yeah. I mean, so this is really the part where we’re just not microbiologists and can’t really speak authoritatively about isolates and what the heck is going on there. But from the people we talked to who are microbiologists-

Graham: And can speak authoritatively about them.

Ashkahn: … it seemed to be the case. It was like, yeah, it’s not like 100% guarantee sort of thing, but it doesn’t disprove that this came from the float tank because the isolates didn’t match. It does seem like they wished that slightly more controlled research was done in this, like earlier sampling of both the float tank and the person so that there wasn’t a gap of time and antibiotics and testing from the person’s ear, and all sorts of different things that could have led to, even if it was originally from the float tank, still different isolates.

Ashkahn: So, again, as far as we can tell, my impression of it is that, yeah, it does really seem, at least from what we’re reading in this article, that this did come from the float tank.

Graham: And, I mean, other things to note. Like it makes like a float tank that hasn’t been kept up for a couple of weeks and who knows what state it was in before that point, even when the pump was breaking down or maybe some of the equipment was just starting to break and hadn’t totally hit that point where it was totally inoperable. But the thought that there could be a float tank out there that was not actually kept up to standards and was never meant to have a human being thrown in it, could get someone sick is not also the most outlandish thing.

Ashkahn: Yeah, I mean, and it seems like this place, it wasn’t super in communication with the float community at large. So, I wouldn’t be surprised if their general operations weren’t totally up to snuff. They weren’t doing a super great job even before this happened in terms of general cleaning and maintenance.

Graham: And another small thing to note also along that level too, which I don’t know how much weight we should put on this, but the person who actually got sick said that they reported an inability to float freely in the tank, which the author of the article said might be related to low magnesium levels. It also might just be a low water level in general.

Graham: It is kind of interesting, if you’re keeping a tank there and it’s unmaintained, if you’re also cutting off the heat, then it starts to crystallize over time. So it’s very possible that they’d dilute a tank that was kept around for longer. This is all conjecture.

Ashkahn: Speculation.

Graham: Exactly. Or they could’ve just evaporated off enough water, as well, that the water level was lower and so they were touching the bottom and didn’t feel floaty. But there’s at least a chance that their magnesium levels were not as high as they usually are in there.

Ashkahn: So yeah, the weird thing about this is we just did this whole water activity study and found that, at least the results we found, was that the water activity of the float tank was lower than the level that magnesium needs to be able to grow very well-

Graham: And if this sounds like you don’t understand what we’re talking about here, just listen to the last OSP, Occasional Solutions Podcast. Episode.

Ashkahn: Yeah. One of the last few.

Graham: One of the last several. Anyway, we go over-

Ashkahn: We’ll put it in the show notes.

Graham: … where we go over water activity in depth in our new reports. That’s what we’re referencing here. Yeah.

Ashkahn: So yeah, the question is, was this… were they actually at a lower specific gravity that would affect something like, or would make it more likely that pseudomonas could survive? Well … And the other thing is we have this NSF…

Graham: That one too. I was going to say, it’s like a double whammy. Yeah, because the NSF study, which again we’ll link to in the show notes along with a picture of Ashkahn with giant rainbows coming out of his ears.

Ashkahn: Oh, that sounds nice.

Graham: That one was done with just salt water and pseudomonas and another little microbug that we won’t talk about, enterococcus, but it killed off pseudomonas over 24 hours of having no disinfectant and just being shaken occasionally on a table. So like there’s this evidence to show that-

Ashkahn: Occasionally shaken solution.

Graham: That’s good.

Ashkahn: Nice.

Graham: Hold on, pause for laughter. But like I said, we have evidence in two different directions, water activity and just this actual, very formal shaker test study with nothing but saltwater showing that the saltwater at the concentrations that we have, it will kill pseudomonas naturally on its own.

Ashkahn: So yeah, it’s weird. So all of that adds up to a very interesting question as to how a float tank, even left unattended, if it was not diluted or … I don’t know. It’s hard to … I wish there was more information about this, I guess. It’s hard to contact anyone who would necessarily would be able to give a scoop on to what was going on there. Because it also seems like after this was reported, the environmental health offices had not done a huge amount of data collection before that float center started to actually try to get the float tank back up and running.

Graham: They were shut down, by the way. 

Ashkahn: Yeah, they were shut down.

Graham: The operation was shut down-

Ashkahn: And they said they had to fix the float tank and stuff, but there’s no specific gravity measurement during this time. There’s no measurement of any of the stuff that might be useful in decoding what could’ve happened there.

Graham: He didn’t invite us out to be celebrity investigators.

Ashkahn: We have our detective pants. We have our magnifying glasses-

Graham: I don’t know what went wrong here …

Ashkahn: They screwed up, that’s what I’m saying.

Graham: It would’ve been nice to have some extra information.

Ashkahn: So yeah, unfortunately we’re a little sparse on details, but I mean, so …

Graham: Yeah. What are you going to say? Yeah. You go. You go.

Ashkahn: Basically like to me it’s like, it does seem like a case of pseudomonas happened from a float tank, and it does seem like someone actually got sick from a commercial float tank. So that is something that clearly now is within the realm of reality. Right? I mean, that’s the bad news. Someone did get sick and not just like a light sickness, like-

Graham: Seriously sick.

Ashkahn: -Severely ill from it. And the other part of this is just that these were like really extreme circumstances.

Graham: Can you really call it a float tank at that point? It’s more like a water container that doesn’t even have the functioning equipment on the back. Who knows what the specific gravity was.

Ashkahn: Yeah, I mean, it’s a good reminder for all of us out there to realize that we are doing all this stuff for a reason and it is good. But I don’t know. It’s kind of like, it feels like someone, like a restaurant leaving a meal out on the counter for two days …

Graham: Or like two weeks. It’s like your meal has been there for two weeks and someone comes in and eats it.

Ashkahn: And then you’re like, “That person got sick,” and you’re like, “Yeah, like the restaurant was doing a real bad job. So I don’t know. It’s not like the most alarming news to me, I guess. I don’t see this as an indication that there is a widespread problem in the float industry or anything.

Graham: No. And even, this is brought up on, on some calls with different environmental health people, other researchers in microbiology and they pretty much express the same thing. Yeah, obviously this is a float tank that was being not run abysmally. It’s not even like it was a terrible float tank that was open for business. It was just out of commission and absolutely should not have been allowed to float people.

Graham: The world of environmental health is very broad and there are many different jurisdictions and officers out there, but it’s hard to imagine that anyone would really read through this article and come away alarmed about a public health risk that float tanks are posing. And again, our experiences, even with public health officials so far, they’ve had that impression. They’re not like trying to be like, “Oh, you need to straighten up because look, it’s getting people sick now.”.

Ashkahn: I mean the thing is like Vancouver has regulations, there are float tank regulations in British Columbia, and they require chlorine and they’re not the lightest set of rules. They have probably one of the most robust written out set of float tank rules that you have to abide by of pretty much anywhere that I know of. They’re on the short list of places with fully fleshed out float tank regulations.

Graham: For sure. There’s the private one that’s just Graham’s secret code that I keep locked up, other than.

Ashkahn: So you know, this is with health inspectors going out and inspecting and them having to get permitted and that whole process being in place. I don’t know if there’s anything like two huge takeaways to actually take away from this.

Graham: It’s really good to know that it exists.

Ashkahn: Yeah, mostly we just wanted to inform people in case you hear about this and it comes up that here’s the rest of the details. Because if you just hear someone got sick from a float tank, I don’t feel like that really paints the fullest picture.

Graham: Yup. And of course we’ll have the full article in the show notes as well.

Ashkahn: Yeah.

Graham: So …

Ashkahn: Yeah, cool.

Graham: There you have it.

Ashkahn: It’s in.

Graham: Yeah.

Ashkahn: That’s the scoop. We scooped it.

Graham: Yeah. And you know, again, if you have other questions that you’d like to see us answer on here, you know…

Ashkahn: It’s just we’re not really doing that anymore.

Graham: It’s just we need to come to terms with the reality as it exists in the 21st century.

Ashkahn: We just do these when we want to now, occasionally.

Graham: But if you have intro song requests, we will honor that.

Ashkahn: Yeah, definitely that. Please email those in to introsong@floathq.com

Graham: Perfect.

Ashkahn: Cool. See you guys later.

Graham: Me, too. I’ll see you later too.

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