THURSDAY, April 9, 2026 (HealthDay News) -- Exposure to untreated or natural water appears to be associated with increased otorrhea episodes in pediatric patients with ear tubes, according to a study published in the February issue of Otolaryngology-Head and Neck Surgery.Alexandria L. Irace, M.D., from the University of Pennsylvania Perelman School of Medicine in Philadelphia, and colleagues investigated the association between specific types of water exposure (treated versus natural water) and the incidence of tympanostomy tube otorrhea (TTO) in pediatric patients who had undergone tympanostomy tube placement at least six months prior. The analysis included survey responses from 137 caregivers of eligible patients.The researchers found that 49.6 percent of respondents reported recurrent TTO. When adjusting for age, smoke exposure, and other potential confounders, patients exposed to dirty water had more than tripled odds of developing recurrent TTO versus patients not exposed to dirty water (odds ratio, 3.18). There was no significant association between clean water exposure and TTO. Findings persisted when comparing patients with zero versus one or more episode of TTO and fewer than two versus two or more episodes of TTO."The role of water precautions in tympanostomy tubes has been extensively debated, yet empirical evidence regarding the impact of water type and otorrhea risk is limited," coauthor Kavita Dedhia, M.D., also from the University of Pennsylvania, said in a statement. "Although this is not a definitive study, it can guide providers to counsel families on when to consider water precautions."Abstract/Full Text.Sign up for our weekly HealthDay newsletter