Hot Stone Massage Disinfection Protocols

Are you an RMT who wants to ensure your hot stone cleaning and disinfection protocols meet BC standards? Or a patient who’s curious about how the stones are sanitized? Here’s what I learned from the CCHPBC (our regulatory College) and Vancouver Coastal Health, and the standards that we follow at Intent Health.

College & Health Authority Expectations

The College directs RMTs to follow the directives of BC’s Ministry of Health and the applicable local Health Authorities.” In BC, local Health Authorities such as Vancouver Coastal Health follow the “Ministry of Health's Guidelines for Personal Service Establishments”. (See Table 13 on page 28 for “low-level disinfection”.)

Step-by-Step Disinfection

  • Bleach dilution for roasters: Use 4.77 ml (≈ 1 tsp) bleach per 2.5 L water. Adjust proportionally for different water volumes.

  • Regardless of the heating method (roaster or heating pad with disinfectable cover) you need to scrub with soap, disinfect and dry after every appointment.

  • Soap scrub: After each appointment, scrub stones with soap and water.

  • Disinfectant spray: After scrubbing with soap, rinse the stones, then spray to saturation with a disinfectant. Let sit for the manufacturer’s recommended contact time (e.g., 2 min for ½ tsp/L bleach; 3 min for Pre-empt). Wipe or air-dry, then return stones to the roaster or heating pad.

  • Daily roaster care: At day’s end, empty and dry the roaster.

  • Cleaning and disinfecting the stones can take around 15 minutes, which is why some RMTs charge more for this type of massage.

Quick-Reference

  • ✅ Correct bleach ratio for roaster (1 tsp / 2.5 L water)

  • ✅ Soap-scrub & disinfect after every use

  • ✅ Follow your local health authority’s protocols

  • ✅ Replace daily bleach solution; mix fresh every 24 hrs

  • ✅ Use unexpired bleach (discard 6 months after opening)

Additional Tips

  • Bleach breaks down faster in hot water - don’t over-dilute or leave solution too long.

  • Excess bleach can off-gas - avoid respiratory irritation.

  • For stones sourced outdoors, perform an initial high-level disinfection: scrub with soap, then soak in 1:9 bleach:water (100 ml bleach / 900 ml water).

College Quote (April 24, 2025, personal communications):
“It is the responsibility of each Registered Massage Therapist (RMT) to comply with the Practice Environment Standard of Practice and to exercise professional judgment in applying these standards to the specific circumstances they encounter in their practice. RMTs are also required to follow the current recommendations and directives issued by public health authorities, infection prevention and control agencies — specifically, the Ministry of Health and the applicable local Health Authorities.”

If you receive differing guidance from your local BC health authority, please send us the name and contact info of the person you spoke with - we’ll follow up to clarify any discrepancies.