Swimmer's Ear Responsible for Nearly a Half Billion in Health Care Costs

Germs found in pools and at other recreational water venues are one of the most common causes of swimmer's ear.

Swimmer's ear leads to about 2.4 million doctor visits each year and is responsible for nearly $500 million dollars in annual health care costs, according to estimates released by CDC. The report, published in CDC's MMWR, is the first national study to estimate health care costs associated with this common ailment. Swimmer's ear can develop when water stays in the ear canal for a long time, allowing germs to grow and infect the skin. Exposure to water—through swimming, bathing, and other activities—and living in warm and humid climates increase the risk of developing swimmer's ear. Germs found in pools and at other recreational water venues are one of the most common causes of swimmer's ear. Most cases of swimmer's ear can be easily treated with prescription antimicrobial ear drops.

In 2007, 1 in 123 Americans went to the doctor for swimmer's ear. Between 2003 and 2007, rates of doctor's visits for swimmer's ear were highest in children between the ages of 5 and 14 years. However, more than half of the reported infections occurred in adults over age 20. People living in the South had the highest regional rate of swimmer's ear. Cases peaked during the summer swimming season, with 44 percent of cases occurring in June, July, or August.

The overall estimates for the number of cases were calculated using CDC's 2003-2007 National Ambulatory Medical Care Survey and the 2007 Nationwide Emergency Department Sample, a project of the Agency for Healthcare Research and Quality. To estimate the costs associated with swimmer's ear, CDC scientists used a large proprietary database that contains health care claims for millions of people who have employer-provided health insurance, the Marketscan commercial claims database. They identified outpatient cases of swimmer's ear and analyzed the total cost for each visit. The costs included the amount paid by the insurer and the person's out of pocket costs, and included the cost of prescriptions for treatment.

By analyzing the database, CDC determined an average cost per case of $200 for patients who didn't need hospitalization. That average cost was multiplied by the 2.4 million cases to determine the overall cost estimate for swimmer's ear cases.

"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," said Michael Beach, Ph.D., CDC's associate director for healthy water. "By taking simple steps before and after swimming or coming in contact with water, people can greatly reduce their risk of this painful infection."

In observance of Recreational Water Illness and Injury Prevention Week, beginning Monday, CDC is providing the public with updated recommendations for preventing swimmer's ear:

  • When around water, keep your ears as dry as possible
  • Dry ears after swimming or showering
  • Refrain from putting objects in the ear canal or removing ear wax yourself because both can damage the skin in the ear, potentially increasing the risk of infection
  • Talk to your doctor about whether you should use alcohol-based ear drops after swimming

People should consult with their health care provider if their ears are itchy, flaky, swollen or painful or have fluid draining from them, CDC noted.

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