Swimmer’s ear costs millions in healthcare each year: CDC report

By Dr. Ananya Mandal, MDMay 22 2011

Swimmer’s ear (otitis externa) is a common infection that accounts for almost $500 million in U.S. health-care costs each year, according to a new government report. The report from the U.S. Centers for Disease Control and Prevention, published in the agency's May 20 Morbidity and Mortality Weekly Report, says this condition results in 2.4 million doctor visits annually in the United States, each visit costing an average of $200.

Michael Beach, the CDC's associate director for healthy water, said in a CDC news release, “Most people think of swimmer's ear as a mild condition that quickly goes away, but this common infection is responsible for millions of illnesses and substantial medical costs each year.” Many of these cases are preventable, he added.

Swimmer’s ear is a painful condition and is caused by water from swimming, bathing or other wet activities sitting too long in the ear canal, allowing germs to multiply. Warm temperatures and humidity increase the risk of developing swimmer's ear, which is commonly caused by germs found in pools, lakes and other recreational swimming spots, the CDC authors explained. The infection usually clears up with a regimen of prescription antimicrobial ear drops.

According to the report, it is the first to look at the costs associated with swimmer's ear. It said that one out of 123 Americans sought medical treatment for swimmer's ear in 2007. Children between 5 and 14 years old had the highest rates of doctor's visits between 2003 and 2007, the researchers found, but adults 21 and older accounted for more than half of the visits. Forty-four percent of reported cases occurred in June, July or August, and the South was the region with the highest rates.

For the study the team used data from two national databases to determine the number of outpatient visits for swimmer's ear between 2003 and 2007. To estimate the costs of those visits, they looked at an insurance database for millions of people who have employer-provided health insurance. The cost estimate included what the insurers paid, the patients' out-of-pocket costs, and the price of prescription treatments.

After determining that the average per-patient cost was $200, researchers multiplied that amount by the 2.4 million cases to arrive at the total health cost estimate for swimmer's ear.

Regionally, swimmer's ear was most prevalent in the South, which accounted for 45 percent of the nation's outpatient visits and 42 percent of emergency-room visits between 2003 and 2007. Next was the Midwest, which accounted for 21 percent of all outpatient visits for swimmer's ear and 22 percent of emergency-room visits. The Northeast accounted for 20 percent of outpatient visits and 18 percent of emergency-room visits, while the West accounted for 14 percent of outpatient visits and 18 percent of emergency room visits.

“By taking simple steps before and after swimming or coming in contact with water, people can greatly reduce their risk of this painful infection,” Beach said. These include drying ones ears after swimming or showering. To attempt to keep ears dry within water. One should not put foreign objects in the ear canal or remove ear wax yourself because these can irritate skin inside the ear, possibly leading to an infection he said. He also said one should ask the doctor if they can use alcohol-based ear drops after swimming. Itchy, flaky, swollen or painful ears could indicate you have swimmer's ear. If you notice these symptoms, or have fluid draining from your ears, you should consult your doctor, experts advice he said.

In an editorial accompanying the report, CDC staffers said that prevention of swimmer's ear could yield considerable savings. They suggested that doctors teach patients how to avoid swimmer's ear, and that they stress this information during summer visits.