This study examines the possible dermal absorption of lithium ion into the blood serum of spa/hot tub bathers. Fifty-three participants (28 males and 25 females) spent 20 minutes per day, 4 days per week for 2 consecutive weeks in one of two assigned spas. The participants were randomly assigned to one of the two spas after matching based on sex, age, and use of oral contraceptives. The test spa contained 40 +/- 5 ppm lithium ion, while the control spa contained no additional lithium ion above the background levels of approximately 0.02 ppm. The exposure in the spa treated with lithium ion (from lithium chloride) simulated the maximum exposure that would be expected in a spa sanitized with lithium hypochlorite. The two spas were maintained at 101 +/- 2 degrees F. Serum lithium ion levels before and after spa use were determined using graphite-furnace atomic absorption spectroscopy with a minimum detectable level of lithium ion in serum of 2 micrograms l-1 (ppb). There was no statistically significant difference in serum lithium levels between the control and treatment group at any stage. We conclude that dermal exposure to lithium ion (as would be present after treatment of a spa with lithium hypochlorite) did not result in a detectable increase in the serum lithium ion level.