Nasal irrigation – is it safe?

Nasal irrigation (nasal rinsing) is the passing of water or saline solution through the nasal passages.

This can be done by using a range of rinsing devices such as:

• a bulb syringe
• squeeze bottle
• battery-operated pulsed water device
• neti pot.

Nasal irrigation has occurred for many years as it can form part of a religious or traditional cleansing practice.

It may also be used to provide relief for colds, congested sinuses, and allergies.

Nasal irrigation is generally safe but it is essential to:

• keep the rinsing device clean
• use a safe, treated source of water.

When does nasal irrigation become unsafe?

Harmful microorganisms may be found in any water, including drinking water that has not been correctly:

• filtered
• treated
• disinfected.

These microorganisms may include certain amoebae which may be quite safe to drink, but when they are forced into the nasal passage they can live, grow and spread up into the brain.

Once in the brain they can cause amoebic meningitis.

What is amoebic meningitis?

Amoebic meningitis (primary amoebic meningoencephalitis) is a disease that causes inflammation and eventual destruction of the brain and its lining. It is rare but usually fatal.

It is caused by a single-celled amoeba Naegleria fowleri that occurs naturally in fresh water and damp soil.

Naegleria fowleri can thrive in water temperatures between 28 °C and 40 °C.

The following symptoms usually occur within 5 days (between 1 to 7 days) of infection:

• severe and persistent headache
• sore throat
• nausea
• vomiting
• high fever
• sleepiness
• death.

How do I know if someone has amoebic meningitis?

Diagnosis must be made by a medical professional. See a doctor or attend a hospital emergency room urgently if you suspect anyone has contracted amoebic meningitis.

Is tap water safe to use for nasal irrigation?

Tap water (scheme drinking water) that is chlorinated before being piped to your tap is safe for all ordinary domestic purposes such as:

• drinking
• food preparation
• showering
• bathing.

However, there are a few specialised purposes for which tap water is not suitable such as:

• cleaning or storing contact lenses
• nasal irrigation.

What type of water is safe to use for nasal irrigation?

The types of water safe for nasal irrigation include:

• distilled or sterile water
• boiled and cooled tap water
• tap water passed through a filter with an absolute pore size of 1 micron or smaller.

Boiling and cooling water

To boil water using a kettle, boil the water until the automatic switch turns off. If using a stove top for this, let the water boil until a continuous and rapid stream of air bubbles rise from the bottom of the pot or kettle.

Cool the water until lukewarm.

How do I use and care for my nasal irrigation device?

There are many different ways of rinsing the nasal passages ranging from:

• using cupped hands
• devices that include:
  • neti pots
  • bulb syringes
  • nasal sprays
  • nasal irrigation machines.

It is important to avoid contaminating the treated water that is to enter the nasal passages.

• Hands should be washed, cleaned with soap, and dried before holding any correctly treated water.
• Any nasal irrigation device should be clean and dry before treated water is added to it.
• Use only correctly treated water to prepare any nasal solutions.
• Follow the nasal irrigation device manufacturer’s directions for use.
• After use, wash and rinse any nasal irrigation device following the manufacturer’s directions. Make sure you dry the interior with a paper towel or leave open to air dry between uses.

Translated information about nasal irrigation

Some information is also available in other languages.

Arabic – Nasal irrigation – is it safe? (PDF 205KB)

Chinese Traditional – Nasal irrigation – is it safe? (PDF 132KB)

Indonesian – Nasal irrigation – is it safe? (PDF 74KB)

Farsi – Nasal irrigation – is it safe? (PDF 376KB)

More information

Contact Environmental Health Services at your local government (external site).

---

---

This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.