Natural Spa Research Articles

Isotopic evolutionary track of water due to interaction with rocks and its use for tracing water cycle through the lithosphere

Hydrogen and oxygen isotopic compositions of natural spa waters from hot and/or mineral-rich springs (including flowing/pumping wells) potentially provide important clues about water cycle in Earth's interior, because some of the waters are deep-seated and non-meteoric. However, the isotopic compositions of these waters are typically altered by contamination with meteoric water and are thus poorly known. To reconstruct their original (i.e., before these waters mix with meteoric water) isotope compositions, here we develop an isotopic evolution model of the lithosphere-enclosed waters and derive the “ocean-origin lithospheric water curve” (OLWC; δ2H = 60 / (δ18O – 11)) as a typical evolutionary track starting from ocean water. Then we apply them to spa waters from central Japan, a globally unique geotectonic region where double subduction of slabs occurs. The OLWC explains well observed isotope data of subseafloor pore waters, submarine mud volcano pore waters, coastal oil-field brines, and subduction zone volcanic steam. Mixing analysis indicates that lithospheric water accounts for 19–95 % of each spa water we investigated. The nonlinear relationships of the reconstructed water δ18O and Cl or Li concentrations justify our hypothesis that the lithospheric waters are undergoing evolution from ocean water to magmatic water by rock-water isotopic exchange and that they are not simply mixtures of the two. A comparison of the reconstruction results with model predictions under slab subduction settings suggests that most spa waters in the southern to central part of the study region contain progressively evolving lithospheric waters released from the subducting Philippine Sea slab, and that a few at western edge of the region contain waters released from the Pacific slab. The others in the northern and eastern part of the region contain waters at the early-to-mid evolutionary stage, which are discharged from Tertiary marine sedimentary rocks (including tuffs). All these waters were enclosed in the lithosphere for more than 1–5 Ma. Our approach provides useful tools for tracing sources of non-meteoric water and highlights water cycle through lithosphere for more than one million years.

Evaluating Business Performance and Efficiency in the Medical Tourism: A Multi-criteria Approach

Measuring the performance and efficiency of the tourism enterprises is essential regarding the current pandemic situation. In such a context, improving their financial situation and competitive position also depend on the use of innovative multi-criteria evaluation models. The paper's main objective is to propose the newly designed Performance & Efficiency model (P&E model) for Slovak spa enterprises. Its structure consists of three dimensions – P&E_I, P&E_II, P&E_III. The application of Confirmatory Factor Analysis validates 34 key performance ratios reflecting the financial situation of enterprises within the P&E_I. In case of P&E_II, the development of value-added dynamics is measured by using the Economic Value Added Momentum. Using the Data Envelopment Analysis, the level of enterprise efficiency is quantified (P&E_III). The partial results of the dimensions are transformed using min-max normalization to the overall score ranging from 0 to 3. Based on the results, a rating scale of all enterprises is carried out, and both their partial and overall positions are assessed through benchmarking. During the research (2013 – 2018), the best results are achieved for SE03 (Spa Bojnice, Inc.), SE21 (Specialised Spa Institute Marína, s.e.), and SE18 (Spa Horný Smokovec, Ltd.). The worst-rated spa enterprises include SE14 (Natural Iodine Spa Číž, Inc.), SE09 (Spa Sliač, Inc.), and SE19 (Pieniny Resort, Ltd.). The proposed P&E model is easily applicable to other tourism enterprises. The research as carried out enables deepening of knowledge concerning the multi-criteria evaluation and management concepts and helps enterprises overcome current unfavorable situations.

Can Spa Tourism Enhance Water Resources and Turn Them into a National Brand? A Theoretical Review about the Romanian Case

The present article includes descriptive research about how water resources in Romanian medical spas could be better promoted to increase their visibility. Romania is one of the European countries with impressive potential in terms of balneology, having a wide diversity of natural factors that allow treating several medical conditions in the same resort. In addition, one-third of the mineral and thermal water springs in Europe are present on the Romanian territory, making Romania one of the most important European destinations in terms of natural spa resources. The present research aims to illustrate how the Romanian medical spas communicate with tourists about the therapeutic water available in five medical spas: Băile Felix-1 Mai, Techirghiol, Băile Tușnad, Sovata and Covasna, having as its main objective to raise the awareness among the spas representatives regarding the necessity of water management implementation. The research is based on primary data obtained from the official websites of the resorts included in the study and in the published scholarly articles that approached the Romanian medical spas.

Untouchability of natural spa waters: Perspectives for treatments within a personalized water safety plan

Natural SPA waters and their environments were known since ancient times and used for health or recreational purposes in different societies, worldwide. The composition and uses of these spring waters may not allow standard disinfection in pools, representing a challenge for hygiene management. Several safety and quality procedures were proposed, but a systematic approach is still needed. Here, we focus on alternative strategies to provide hints for developing a sustainable Water Safety Plan, based on intrinsic water properties and photocatalytic materials. The antimicrobial activity of four different SPA waters with high mineral content and one drinkable spring water with a low mineral content, was assessed and then tested for the additional bactericidal activity of Titanium Dioxide (TiO2) nanomaterials and/or light exposure at different wavelengths (200–635 nm). A native antibacterial activity was observed in all high mineral content waters, with a CFU reduction of 75–80%. The bactericidal action of TiO2 showed an additional incremental effect, with a reduction of over 99% within 2–5 h. Interestingly, the antibacterial photocatalytic effect was detected also in the visible light range, with a possible pick around 450–455 nm, blue-light. Based on observed results, we propose a model for developing a water safety plan, considering water properties and bather exposure. This candidate approach is personalized on water composition and pool use, trying to avoid chemical disinfectants. Photocatalytic nanotechnologies represent one of the promising alternative treatments and can provide novel perspectives for a sustainable managing of natural SPA water hygiene.

OCCUPATIONAL EXPOSURE ASSESSMENT AT A THERAPEUTIC RADON SPA FACILITY IN HUNGARY.

In order to estimate occupational exposure of workers in a therapeutic radon spa facility, radon concentration in the workplace air was investigated at Markhot Ferenc Hospital, Eger, Hungary. The investigated balneotherapeutic facility and its natural hot spa water are used for treatments and rehabilitations of rheumatic patients. Radon concentration, radon decay products at a bathhouse, treatment rooms and a consultation room were continuously measured in August and September 2018. In the present study, different levels of radon concentration among the observation sites and its clear temporal variations were found, though radon concentrations in the investigated sites were below 300 Bq m-3. Regarding such radon fluctuation and low equilibrium factor level (0.1), the annual effective doses of workers are estimated to be around 0.5 mSv year-1.

The Visit Rate of Bardejov Spa in the Context of its History

Abstract The main objective of this article was to evaluate the impact of historical events on the visit rate of Bardejov Spa in various periods of its development (in the years of 1814–2016). The collection of information on clients’ spa visits, especially the oldest data, was difficult (19th century and 1st and 2nd World War). Much information was available only in the State Archive of the Ministry of the Interior of the Slovak Republic in Hungarian and Latin. Some data for several years were not available at all, and some data were not recorded in writing. The paper summarizes the history of the spa, natural medical sources, spa treatment and indications. At present, the number of guests has an increasing trend, as evidenced by the visit rate for 2016, as well as by current data for 2017. In 2016, Bardejov Spa reached a pick of the visit rate with 25,863 clients. In 2017, there were 27,170 clients. The main clients are the Slovaks, about 90%.

Recreational Use of Spa Thermal Waters: Criticisms and Perspectives for Innovative Treatments.

Natural spa springs are diffused all over the world and their use in pools is known since ancient times. This review underlines the cultural and social spa context focusing on hygiene issues, public health guidelines and emerging concerns regarding water management in wellness or recreational settings. The question of the "untouchability" of therapeutic natural waters and their incompatibility with traditional disinfection processes is addressed considering the demand for effective treatments that would respect the natural properties. Available strategies and innovative treatments are reviewed, highlighting potentials and limits for a sustainable management. Alternative approaches comprise nanotechnologies, photocatalysis systems, advanced filtration. State of the art and promising perspectives are reported considering the chemical-physical component and the biological natural complexity of the spa water microbiota.

Physicochemical characterization of sterilized muds for pharmaceutics/cosmetics applications.

Clays and muds have been used for centuries as cosmetics or pharmaceutical products for various therapies. The suitability of muds and clays for health- and beauty-related applications depends on their physicochemical properties, mineralogical composition, particle characteristics and toxicity. In this work, the physicochemical characterization of 12 mud specimens from different natural spa resorts in Greece and one from Israel (Dead Sea) is presented. All specimens were sterilized at 121°C for 20min, because of their intended use. The Greek mud specimens were collected from various locations in Macedonia, Western Greece and Northeast Aegean. All muds were characterized concerning their mineralogical, chemical components as well as their morphological characteristics using appropriate methods [powder X-ray diffraction (XRD), thermogravimetric analysis (TGA), nitrogen absorption specific surface area measurements (BET), scanning electron microscopy and energy dispersive X-ray spectroscopy]. The concentrations of F-, Cl-, NO3- and SO42- anions at equilibrium with the mud specimens were measured by ion chromatography. Total calcium concentration was measured using atomic absorption spectroscopy, and the concentration of total N, C, H and S in the solids was measured using elemental analysis. Moreover, total phenolic concentration (TPC) in distilled water equilibrated with the mud specimens was measured as an index for their antioxidant properties. Several muds were found to present high TPC. Several of the examined mud specimens were found to have the potential use as pharmaceuticals or cosmetics. Based on the physicochemical characteristics of the mud specimens examined, possible improvement in their use and applicability has been suggested.

The effect of reconstruction works on planktonic bacterial diversity of a unique thermal lake revealed by cultivation, molecular cloning and next generation sequencing.

The aim of this study was to gain detailed information about the diversity of planktonic bacterial communities of a worldwide special peat bedded natural thermal spa lake, and to reveal the effect of a lake wall reconstruction work. To compare the efficiency of different methods used for analyzing bacterial diversity, cultivation, molecular cloning and pyrosequencing were applied simultaneously. Despite the almost unchanged physical-chemical parameters and cell count values of lake water, remarkable differences were observed in the planktonic bacterial community structures during and after the reconstruction by all applied microbiological approaches. Rhodobacter sp. was found to be one of the most abundant community members during the works probably due to the sediment stirring effect of the reconstruction. Following the reconstruction higher diversity was detected than during the works by all approaches. Bacterial strains related to species Chryseobacterium and Exiguobacterium, furthermore sequences related to Arcobacter, Gemmobacter and MWH-UniP1 aquatic group were identified in the highest proportion at that time. Although the differences revealed by cultivation based and independent community structures were significant, only minor disparities were found by molecular cloning and next generation sequencing techniques.

Nature's Hat-trick: Can we use sulfur springs as ecological source for materials with agricultural and medical applications?

Sulfur and its various compounds play a major role in agriculture and medicine. Natural waters rich in hydrogen sulfide may therefore be seen as a sustainable resource for biologically active sulfur species. By sampling such waters from two readily accessible mineral wells in Germany, we are able to show that such waters exhibit interesting nematicidal and antimicrobial activity which may be used in an agricultural context. Whilst applications in the field of agriculture could, in theory, result in an amalgamation of irrigation, soil enrichment and phyto-protection, therapeutic uses are more complex and complicated by the many physiological effects associated with hydrogen sulfide and its oxidized derivatives. The latter may include polysulfides (Sx2-) as well as small sulfur particles. Indeed, we have recently noted significant cytotoxic properties of clean, mechanically produced sulfur nanoparticles against HCT-116 colon cancer cells. Since sulfur-rich natural waters are known to deposit elemental sulfur upon oxidation, they may therefore be used as a natural (re)source of sulfur particles, possibly obtained by direct oxidation on air, mild oxidation with sulfur dioxide or enzymatic oxidation employing Thiobacillus. A similar biotechnological approach involving Staphylococcus carnosus and selenite (SeO32−) produces biologically active selenium nanoparticles of excellent quality and with a pronounced biological activity. Eventually, natural spa waters rich in sulfide seem to open up various interesting opportunities in medicine and eco-friendly agriculture.

Uranium and thorium behavior in groundwater of the natural spa area “Choygan mineral water” (East Tuva)

The natural spa area “Choygan mineral waters”, a unique deposit of natural carbon dioxide mineral waters in Siberia, is located in the Eastern Sayan Mountains. There are 33 spring discharges in this area. Spring waters are mainly of HCO3-Na-Ca type. TDS varies from 300 mg/L to 2600 mg/L, the temperature ranges from 7 °C (in spring 33) to 39 °C (in spring 12), pH varies from 5.9 to 8.3, and the value of the oxidation-reduction potential is from -170 mV to 236 mV. All studied waters were divided into two groups according to their temperature and geochemical conditions: cold fresh water in oxidizing environment and warm slightly brackish water in reducing environment. The uranium concentration varies from 0.7 to 14 μg/l and the thorium concentration varies from 0.001 to 0.33 μg/l in the studied waters. The predominant uranium complexes are (UO2(CO3)3)4-, (UO2(CO3)2)2-, UO2CO3, (UO2(PO4)2)4- in the waters in oxidizing and reducing environments. It was found that acid-alkaline and oxidizing-reducing conditions were the determining factors for uranium behavior and speciation in the studied waters. The pH conditions are determining factors for thorium behavior and speciation in the studied waters. In slightly acidic water the predominant thorium species is negatively charge complex (ThCO3(OH)3)- (more than 95%).

Dissolved gas composition of groundwater in the natural spa complex "Choygan mineral waters" (East Tuva)

The natural spa complex "Choygan mineral waters", a unique deposit of natural carbon dioxide mineral waters in Siberia, is located in the Eastern Sayan Mountains. There are 33 springs discharge in this area. Spring waters are mainly HCO3-Na-Ca type. TDS varies from 300 mg/L to 2600 mg/L and temperature ranges from 7 °C (in spring 33) to 39 °C (in spring 12), pH varies from 5.9 to 8.3, and the value of the oxidation-reduction potential is from – 170 mV to 236 mV. All studied waters were divided into two groups according to their temperature and geochemical conditions: cold fresh water with oxidizing conditions and warm slightly brackish water with reductive conditions. The gas composition of the studied waters is represented by nitrogen (28-75 vol.%), carbon dioxide (6-65 vol.%), oxygen (7-19 vol.%), radon (4-948 Bq/l). The studied gases differ not only by the content but by the different sources.

Disentangling Mechanisms Involved in the Adaptation of Photosynthetic Microorganisms to the Extreme Sulphureous Water from Los Baños de Vilo (S Spain)

Los Baños de Vilo (S Spain) is a natural spa characterized by extreme sulphureous waters; however, populations of chlorophyceans inhabit in the spa. The adaptation mechanisms allowing resistance by photosynthetic microorganisms to the extreme sulphureous waters were studied by using a modified Luria-Delbrück fluctuation analysis. For this purpose, the adaptation of the chlorophycean Dictyosphaerium chlorelloides and the cyanobacterium Microcystis aeruginosa (both isolated from non-sulphureous water) were analysed in order to distinguish between physiological adaptation (acclimation) and genetic adaptation by the selection of rare spontaneous mutations. Acclimation to the extreme water was achieved by D. chlorelloides; however, M. aeruginosa cells proliferated as a consequence of selection of favoured mutants (i.e. genetic adaptation). The resistant cells of M. aeruginosa appeared with a frequency of 7.1 × 10(-7) per cell per generation, and the frequency of the resistant allele, under non-selective conditions, was estimated to be 1.1 × 10(-6) per cells as a consequence of the balance mutation-selection. It could be hypothesized that the populations of eukaryotic algae living in the Los Baños de Vilo could be the descendants of chlorophyceans that arrived fortuitously at the spa in the past. On the other hand, cyanobacteria could quickly adapt by the selection of favoured mutants. The single mutation that allows resistance to sulphureous water from Baños de Vilo in M. aeruginosa represents a phenotypic burden impairing growth rate and photosynthetic performance. The resistant-variant cells of M. aeruginosa showed a lower acclimated growth rate and a decreased maximum quantum yield and photosynthetic efficiency, in comparison to the wild-type cells.

A Romanian Perspective on Training for Wellness

With this study we aim to identify strategies for the diversification, reorganization and modernization of physical therapy and tourism services using Life Long Learning to the level of treatment facilities within health resorts. We tried to assure a complex interdisciplinary and multidisciplinary approach of wellness strategies in the context of promoting quality of life, using natural spa factors for treatment in correlation with the possibilities of specific physical therapeutic interventions to resort profile. Creating a personalized database on certain pathology offers the possibility of following in the dynamics of individual evolution after rehabilitation and spa interventions.

Quantitative Microbial Risk Assessment Model for Legionnaires' Disease: Assessment of Human Exposures for Selected Spa Outbreaks

Evaluation of a quantitative microbial risk assessment (QMRA) model for Legionnaires' disease (LD) required Legionella exposure estimates for several well-documented LD outbreaks. Reports for a whirlpool spa and two natural spring spa outbreaks provided data for the exposure assessment, as well as rates of infection and mortality. Exposure estimates for the whirlpool spa outbreak employed aerosol generation, water composition, exposure duration data, and building ventilation parameters with a two-zone model. Estimates for the natural hot springs outbreaks used bacterial water to air partitioning coefficients and exposure duration information. The air concentration and dose calculations used input parameter distributions with Monte Carlo simulations to estimate exposures as probability distributions. The assessment considered two sets of assumptions about the transfer of Legionella from the water phase to the aerosol emitted from the whirlpool spa. The estimated air concentration near the whirlpool spa was 5 to 18 colony forming units per cubic meter (CFU/m3) and 50 to 180 CFU/m3 for each of the alternate assumptions. The estimated 95th percentile ranges of Legionella dose for workers within 15 m of the whirlpool spa were 0.13–3.4 CFU and 1.3–34.5 CFU, respectively. The modeling for hot springs Spas 1 and 2 resulted in estimated arithmetic mean air concentrations of 360 and 17 CFU/m3, respectively, and 95 percentile ranges for Legionella dose of 28 to 67 CFU and 1.1 to 3.7 CFU, respectively. The Legionella air concentration estimates fall in the range of limited reports on air concentrations of Legionella (0.33 to 190 CFU/m3) near showers, aerated faucets, and baths during filling with Legionella-contaminated water. These measurements may provide some indication that the estimates are of a reasonable magnitude, but they do not clarify the exposure estimates accuracy, since they were not obtained during LD outbreaks. Further research to improve the data used for the Legionella exposure assessment would strengthen the results. Several of the primary additional data needs include improved data for bacterial water to air partitioning coefficients, better accounting of time-activity-distance patterns and exposure potential in outbreak reports, and data for Legionella-containing aerosol viability decay instead of loss of capability for growth in culture.

Halothiobacillus neapolitanus strain OSWA isolated from “The Old Sulphur Well” at Harrogate (Yorkshire, England)

The “Old Sulphur Well” has a subterranean input of water containing 5.5 mM total sulfide, which would be inhibitory to the growth of most bacteria. The obligately chemolithoautotrophic Halothiobacillus neapolitanus is a sulfur bacterium known to tolerate and metabolize high sulfide concentrations, and we report the isolation of H. neapolitanus strain OSWA from this source. Strain OSWA grows well on thiosulfate and tetrathionate as energy sources, and tolerates at least 5 mM sulfide. Its specific growth rates and yields in batch culture were 0.22 h −1 and 5.3 g mol −1 (thiosulfate), and 0.23 h −1 and 9.5 g mol −1 (tetrathionate). Its 16S rRNA gene sequence shows >99% identity to reference sequences of H. neapolitanus, and it shares morphological and physiological characteristics typical of the species. It is one of a very small number of strains of H. neapolitanus described to date, and the first to be isolated from an ancient sulfide-rich natural spa.

Distribution characteristics of natural radionuclides at some spa districts in Japan

In Japan, there are many high-level natural radiation areas such as Masutomi spa (Yamanashi pref.), Misasa spa (Tottori pref.), Ikeda spa (Shimane pref.), and Tamagawa spa (Akita pref.), etc. The Uranium and thorium decay series and K-40 are widely distributed as the sources of terrestrial radiation. Their concentrations are influenced by geological features and are nonuniform. We carried out a study of the behavior and distribution of natural radionuclides in the surrounding soils of high-level natural radiation spa areas by γ-ray energy spectrometry using a Ge(INT) diode detector. It was found that the Pb-212(Th)/Pb-214(U) ratios fluctuated widely in the same areas, of which Tamagawa spa and Masutomi spa were typical.

Surfactant protein A and D differently regulate the immune response to nonmucoid Pseudomonas aeruginosa and its lipopolysaccharide.

We investigated the role of the surfactant proteins (SPs) A and D in the pulmonary immune defense of nonmucoid strains of Pseudomonas aeruginosa, the most etiologic agents of nosocomial Pseudomonas pneumonia. We first examined the interactions of recombinant human SP-D dodecamers and purified natural or recombinant human SP-A with two smooth, and two rough, clinical isolates of nonmucoid P. aeruginosa. SP-D bound to all four isolates, but agglutinated only one rough and one smooth strain. SP-D functioned as an opsonin to enhance the uptake of all four strains by the human monocytic cell line Mono Mac 6 (MM6). SP-D also enhanced tumor necrosis factor-alpha secretion by MM6 cells in response to purified lipopolysaccharide (LPS) isolated from the rough, but not the smooth, strains. Although SP-A bound to all four strains, it did not cause bacterial aggregation or enhance uptake. It showed small but statistically significant inhibitory effects on the cytokine response of MM6 cells to one strain of smooth organisms, but did not significantly alter the response to purified LPS. This study in combination with previously published data strongly suggests that SP-D may play important roles in the local innate pulmonary defense against nonmucoid P. aeruginosa of diverse LPS phenotypes, and preferentially augments the cellular response to rough P. aeruginosa endotoxin.

Scanning electron microscopy and energy dispersive spectrometric microanalysis of crystalline deposits following evaporation of CO3H-, Mg2+ and Ca2+ containing aqueous solutions

This paper is the first application of scanning electron microscopy (SEM) and of energy dispersive selection micro- analysis (EDS) to the study of natural spa waters used as sprays in current dermatological practice; the aim was to relate the mineral composition of the spray to the sensitory perception recorded by the patients. Crystallized deposits were first obtaine d on a collodion film, from two spa waters mainly containing hydrogenocarbonate, calcium and magnesium ions, but differing by their Mg/Ca ratio. In order to understand the types of crystals formed, mineral solutions of simpler composition were prepared and submitted to the same process. Among the crystalline varieties of calcium carbonate, calcite and vaterite were characterized ; aragonite could not be detected in spa waters deposits, despite the presence of magnesium, which favours the crystallization of this orthorhombic form in the artificial solutions.

87Sr/86Sr in Saxon Mineral and Spa Waters

Understanding and preserving the genesis of natural mineral and spa waters is a matter of keen interest. Under a complex analysis programme, 87Sr/86Sr ratios (as well as other isotopes) were measured in such waters at various sites in Saxony, producing values ranging between 0.708 and 0.731. The strontium isotope ratio was found to be closely linked to the flow patterns and variations in the chemical composition of water. The 87Sr/86Sr ratio can thus be used as an indicator to characterize groundwater-rock interaction and hence the variation of flow paths. It is especially useful for differentiating waters in a lithologically heterogeneous aquifer system. However, it has to be applied together with other methods and different samples from the same area should be compared.