Radon Spa Research Articles

Radon Solubility and Diffusion in the Skin Surface Layer.

In specific situations such as bathing in a radon spa, where the radon activity concentration in thermal water is far higher than that in air, it has been revealed that radon uptake via skin can occur and should be considered for more precise dose evaluation. The primary aim of the present study was to numerically demonstrate the distribution as well as the degree of diffusion of radon in the skin, with a focus on its surface layer (i.e., stratum corneum). We developed a biokinetic model that included diffusion theory at the stratum corneum, and measured radon solubility in that tissue layer as a crucial parameter. The implementation of the model suggested that the diffusion coefficient in the stratum corneum was as low as general radon-proof sheets. After a 20-min immersion in water, the simulated depth profile of radon in the skin showed that the radon activity concentration at the top surface skin layer was approximately 103 times higher than that at the viable skin layer. The information on the position of radon as a radiation source would contribute to special dose evaluation where specific target cell layers are assumed for the skin.

Chromosome Aberrations in Lymphocytes of Patients Undergoing Radon Spa Therapy: An Explorative mFISH Study.

In the present exploratory study, we aim to elucidate the action of radon in vivo and to assess the possible health risks. Chromosome aberrations were analyzed in lymphocytes of two patients (P1, P2) undergoing radon spa therapy in Bad Steben (Germany). Both patients, suffering from painful chronic degenerative disorders of the spine and joints, received nine baths (1.2 kBq/L at 34 °C) over a 3-week period. Chromosome aberrations were analyzed before and 6, 12 and 30 weeks after the start of therapy using the high-resolution multiplex fluorescence in situ hybridization (mFISH) technique. For comparison, the lymphocytes from two healthy donors (HD1, HD2) were examined. P1 had a higher baseline aberration frequency than P2 and both healthy donors (5.3 ± 1.3 vs. 2.0 ± 0.8, 1.4 ± 0.3 and 1.1 ± 0.1 aberrations/100 analyzed metaphases, respectively). Complex aberrations, biomarkers of densely ionizing radiation, were found in P1, P2 and HD1. Neither the aberration frequency nor the fraction of complex aberrations increased after radon spa treatment, i.e., based on biological dosimetry, no increased health risk was found. It is worth noting that a detailed breakpoint analysis revealed potentially clonal aberrations in both patients. Altogether, our data show pronounced inter-individual differences with respect to the number and types of aberrations, complicating the risk analysis of low doses such as those received during radon therapy.

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.

Impact of radon and combinatory radon/carbon dioxide spa on pain and hypertension: Results from the explorative RAD-ON01 study

Objectives: Therapies with low doses of radon have beneficial effects on patients suffering from chronic painful degenerative and inflammatory diseases. We already showed that this is accompanied by systemic immune modulations. We here focus on pain-reducing effects of very low doses of radon by adding carbon dioxide water and its impact on heart rate variability (HRV), blood pressure and free radicals.Methods: 97 of 103 patients receiving radon spa (1.200 Bq/l at 34 °C or 600 Bq/l, 1 g/l CO2 at 34 °C) were monitored before and at three different time points after therapy. Individual pain perception was analyzed and the capability to process radicals. At each time point, the hypertensive patients (n = 46) were examined over 24 h for blood pressure and HRV.Results: Long-term pain reduction was observed in the majority of patients. A modulation of superoxide dismutase was identified, presumably representing a priming effect for lowering radiation stress. Further, lowering of blood pressure, especially in those patients who additionally received carbon dioxide, was seen. Radon did in particular impact on HRV implying lasting relaxation effects.Conclusion: Radon/carbon dioxide spa efficiently reduces pain. In particular, patients simultaneously suffering from painful and cardiovascular diseases should be treated by combination of radon and CO2.

Immunological aspects of balneology

The skin is the biggest immune organ of the human body. On the one hand the different mineral waters have strong influence on the skin during the head out water immersion, on the other hand they can casue a lot of molecular changes in the human body, by the modulation of the immune system. On the basis of the available evidence among the inorganic elements the sulphur(and its derivatives) has one of the most pronounced effect on the skin and human body. The sulphurous water can inhibit the production of cytokines,especially IL-2 and interferon gamma (IFN-c) Hydrogen sulphide(H2S) decreases IL-1β-induced activation of fibroblast-like synoviocytes at patients suffering from osteoarthritis, which may have a beneficial effect for its treatment. H2S partially antagonizes IL-1β stimulation through selective manipulation of the MAPkinase. Sulphurous thermal water increases the release of the anti-inflammatory cytokine IL-10 and modulates antioxidant enzyme activity. Sulfur bath therapy could reduce the oxidative stress, by alterations of SOD activities. The radon bath can reduce the activation marker of CD69 on T, B, and NK cells. Radon bath has a beneficial effect on clinical parameters in Rheumatoid arthritis. As account of a new study, it showed for the first time a modulation of the peripheral immune cells following standard radon spa therapy. Mud-bath therapy, can decrease the serum adiponectin and resistin levels at patients after mud bath treatment. Balneotherapy caused statistically significant and long lasting decrease in serum levels of C-reactive protein in patients treated with mineral thermal baths. Long-term bathing in CO2-enriched water proved a cellular protein response of epithelial cells in the epidermis. The heatwater has a possible immunomodulatory effect on keratinocytes during the progression of IL-17-mediated inflammatory skin diseases. Skin Microbiome can change in Patients with Psoriasis before and after Balneotherapy. Thermal stress has an immunosuppressive effect. There are growing numbers of studies when the balneotherapy was combined with anti- TNF therapy, and the results demonstrated that the combined therapy gave better results that the biological therapy alone.

Decrease of Markers Related to Bone Erosion in Serum of Patients with Musculoskeletal Disorders after Serial Low-Dose Radon Spa Therapy.

Musculoskeletal disorders (MSDs) are the most frequent cause of disability in Europe. Reduced mobility and quality of life of the patients are often associated with pain due to chronic inflammation. The inflammatory process, accompanied by a destruction of the cartilage and bone tissue, is discussed as a result of (A) the infiltration of immune cells into the joints, (B) an altered homeostasis of the joint cavity (synovium) with a critical role of bone remodeling cells, and (C) release of inflammatory factors including adipokines in the arthritic joint. In addition to the classical medication, low-dose radiation therapy using photons or radon spa treatments has shown to reduce pain and improve the mobility of the patients. However, the cellular and molecular mechanisms of anti-inflammatory effects of radon are yet poorly understood. We analyzed blood and serum samples from 32 patients, suffering from MSDs, who had been treated in the radon spa in Bad Steben (Germany). Before and after therapy, we measured the levels of markers related to bone metabolism (collagen fragments type-1, cartilage oligomeric matrix protein, receptor activator of NFκB ligand, and osteoprotegerin) in the serum of patients. In addition, adipokines related to inflammation (visfatin, leptin, resistin, and adiponectin) were analyzed. Some of these factors are known to correlate with disease activity. Since T cells play an important role in the progression of the disease, we further analyzed in blood samples the frequency of pro- and anti-inflammatory T cell subpopulations (CD4+IL17+ T cells and CD4+FoxP3+ regulatory T cells). Overall, we found a decrease of collagen fragments (CTX-I), indicating decreased bone resorption, presumably by osteoclasts, in the serum of MSD patients. We also observed reduced levels of visfatin and a consistent trend toward an increase of regulatory T cells in the peripheral blood, both indicating attenuation of inflammation. However, key proteins of bone metabolism were unchanged on a systemic level, suggesting that these factors act locally after radon spa therapy of patients with MSDs.

Modulation of the peripheral immune system after low-dose radon spa therapy: Detailed longitudinal immune monitoring of patients within the RAD-ON01 study

The pain-relieving effects of low-dose radon therapies on patients suffering from chronic painful inflammatory diseases have been described for centuries. Even though it has been suggested that low doses of radiation may attenuate chronic inflammation, the underlying mechanisms remain elusive. Thus, the RAD-ON01 study was initiated to examine the effects of radon spa therapy and its low doses of alpha radiation on the human immune system. In addition to an evaluation of pain parameters, blood was drawn from 100 patients suffering from chronic painful degenerative musculoskeletal diseases before as well as 6, 12, 18, and 30 weeks after the start of therapy. We verified significant long-term pain reduction for the majority of patients which was accompanied by modulations of the peripheral immune cells. Detailed immune monitoring was performed using a multicolor flow cytometry-based whole blood assay. After therapy, the major immune cells were only marginally affected. Nevertheless, a small but long-lasting increase in T cells and monocytes was observed. Moreover, neutrophils, eosinophils and, in particular, dendritic cells were temporarily modulated after therapy. Regarding the immune cell subsets, cytotoxic T and NK cells, in particular, were altered. However, the most prominent effects were identified in a strong reduction of the activation marker CD69 on T, B, and NK cells. Simultaneously, the percentage of HLA-DR+ T cells was elevated after therapy. The RAD-ON01 study showed for the first time a modulation of the peripheral immune cells following standard radon spa therapy. These modulations are in line with attenuation of inflammation.

Long-term benefits of radon spa therapy in rheumatic diseases: results of the randomised, multi-centre IMuRa trial

In chronic rheumatic diseases, recent treatment regimens comprise multimodal concepts including pharmacologic, physical/exercise, occupational and psychological therapies. Rehabilitation programmes are used for long-term management of disease. Spa therapy is often integrated in various middle and south European and Asian countries. Here, we investigated radon spa therapy as applied in health resorts compared to a control intervention in rheumatic out-patients. Randomised, blinded trial enroling 681 patients [mean age 58.3 (standard deviation 11.1); female 59.7%] in 7 health resorts in Germany and Austria with chronic back pain (n 1 = 437), osteoarthritis (OA) (n 2 = 230), rheumatoid arthritis (n 3 = 98), and/or ankylosing spondylitis (n 4 = 39); multiple nominations in 146 cases). Outcomes were pain (primary), quality of life, functional capacity, and medication measured before start, after end of treatment, and 3 times thereafter in 3 monthly intervals. Adverse events were documented. To analyse between-group differences, repeated-measures analysis of covariance was performed in metric endpoints and Fisher's exact test in rates. Two-sided significance level of 5% was chosen. Until end of follow-up, superiority of radon therapy was found regarding pain relief (p = 0.032) and analgesic drug consumption (p = 0.007), but not regarding quality of life. Functional capacity was assessed specific to the underlying indication. Significant benefits were found in radon-treated OA patients until 6-month follow-up (p = 0.05), but not until end of study (p = 0.096). Neither the back pain sub-population nor the two smaller patient populations with inflammatory indications benefited significantly in functional capacity. Results suggest beneficial analgesic effects of radon spa therapy in rheumatic diseases until 9 months post-intervention.

AB0154 Radon therapy ameliorates disease progression and prolongs survival in TNF-transgenic mice

BackgroundRadon therapy as alternative therapy for rheumatic diseases in curative tunnels such as the Heilstollen Bad Gastein in Austria has been reported to reduce pain and amount of drug usage...

Micronuclei in lymphocytes from radon spa personnel in the Czech Republic

To assess the radiation exposure of radon spa personnel in Jáchymov, Czech Republic. The frequency of micronucleus-containing cells and the percentage of centromere-free micronuclei (micronuclei containing only acentric fragments) was determined in peripheral blood lymphocytes of 42 individuals working at the Jáchymov spa and 42 control individuals. There was a highly significant increase in the frequency of micronucleus-containing cells as well as the percentage of centromere-free micronuclei in the lymphocytes of spa personnel versus controls. No individual dosimetry data were available. A comparison with results from currently active uranium miners suggests that the individuals examined at the Jáchymov spa had accumulated effective doses in the order of several tens of mSv, very similar to those of the miners. The spa personnel in Jáchymov needs to be monitored on an individual level.

Exposure to radon in the radon spa Niška Banja, Serbia

Abstract There is a well-known radon spa Niska Banja in south-east of Serbia. In Niska Banja spa there is a medical complex and radon is used for therapeutic purposes for many different diseases. This paper presents elevated radon levels in the Niska Banja spa. Indoor radon and radon in water activity concentration measurements in thermal pools and therapy rooms are presented. There are also results from gamma spectrometry measurements of soil, rock and therapy mud. A special attention is paid to the medical staff exposure to radon around thermal pools. The annual effective doses from radon for staff working around the thermal pools in Niska Banja spa are very high comparing to the maximum recommendation level. The maximal radon concentration of (22.90 ± 0.57) kBq m −3 was measured in the basement of the hotel-dispensary “Radon”. This hotel is settled on “bigar” rock – travertine, which has high content of 226 Ra.

Radiological characterization of commercially available “radon spa sources”

Nowadays, artificial “radon spa sources” for home baths are commercially available. Although these sources could give a potential radiation exposure to the users, few studies have been reported on their radiological measurements. In the present study, five types of radon spa sources were collected and their radiological characterization was investigated. The followings were estimated for these samples: (1) radon emanation coefficients (dry and water-saturated conditions), (2) surface γ-ray dose rate, (3) surface count rates for α- and β-rays, (4) activity concentrations of 226Ra, 232Th and 40K, and (5) concentrations of radon and thoron generated from the sources located in an air flow system. The activity concentrations were very high (except for one sample (named “sample B”), although radon emanation coefficient was low compared with soil. This leads to high concentrations of radon/thoron generated from the sample. The maximum surface γ-ray dose rate was observed for sample A (2.7 μGy h−1). If people stay very close to the sample for a long time, the exposure might be significant.

Long-term benefit of radon spa therapy in the rehabilitation of rheumatoid arthritis: a randomised, double-blinded trial

This study investigates the effects of radon (plus CO2) baths on RA in contrast to artificial CO2 baths in RA rehabilitation using a double-blinded trial enrolling 134 randomised patients of an in-patient rehabilitative programme (further 73 consecutive non-randomised patients are not reported here). The outcomes were limitations in occupational context/daily living (main outcome), pain, medication and further quantities. These were measured before the start, after the end of treatment and quarterly in the year thereafter. Repeated-measures analysis of covariance (RM-ANCOVA) of the intent-to-treat population was performed with group main effects (GME) and group x course interactions (G x C) reported. Hierarchically ordered hypotheses ensured the adherence of the nominal significance level. The superiority of the radon treatment was found regarding the main outcome (RM-ANCOVA until 12 months: p(GME) = 0.15, p(G x C) = 0.033). Consumption of steroids (p(GME) = 0.064, p(G x C) = 0.025) and NSAIDs (p(GME) = 0.035, p(G x C) = 0.008) were significantly reduced. The results suggest beneficial long-term effects of radon baths as adjunct to a multimodal rehabilitative treatment of RA.

Radon Treatment Controversy

In spite of long traditions, treatments utilizing radon-rich air or water have not been unequivocally embraced by modern medicine. The objective of this work is to examine factors that contribute to this continuing controversy. While the exact mechanism of radon's effect on human body is not completely understood, recent advances in radiobiology offer new insights into biochemical processes occurring at low-level exposures to ionizing radiation. Medical evidence and patients' testimonials regarding effectiveness of radon spa treatments of various ailments, most notably rheumatoid arthritis are accumulating worldwide. They challenge the premise of the Linear-No-Threshold (LNT) theory that the dose-effect response is the same per unit dose regardless of the total dose. Historically, such inference overshadowed scientific inquiries into the low-dose region and lead to a popular belief that no amount of radiation can be good. Fortunately, the LNT theory, which lacks any scientific basis, did not remain unchallenged. As the reviewed literature suggests, a paradigm shift, reflected in the consideration of hormetic effects at low-doses, is gaining momentum in the scientific community worldwide. The impetus comes from significant evidence of adaptive and stimulatory effects of low-levels of radiation on human immune system.

High natural radiation exposure in radon spa areas: a detailed field investigation in Niška Banja (Balkan region)

The measurement campaigns have been done in the rural community of Niška Banja, a spa town located in southern Serbia, to evaluate population exposure to natural radioactivity. After a screening survey in 200 houses, annual radon and thoron concentrations were measured in 34 houses, and in 2004 a detailed investigation was carried out at six houses with elevated indoor radon concentrations. The paper presents the results of these detailed measurements. The complementary techniques were applied to determine radon and thoron concentrations in indoor air, in soil gas, radon exhalation from soil, soil permeability, and indoor and outdoor gamma doses. Soil and water samples were collected and analysed in the laboratory. Indoor radon and thoron concentrations were found to be more than 1 kBq m −3 and 200 Bq m −3, respectively. Extremely high concentrations of soil-gas radon (>2000 kBq m −3) and radon exhalation rates (1.5 mBq m −2 s −1) were observed. These results will be utilised to set up the methodology for a more systematic investigation.

Häufigkeit der Anwendung konventioneller und unkonventioneller Therapiemassnahmen bei Patienten mit Morbus Bechterew

Objective: A large share of rheumatism patients who are treated by rheumatologists use unconventional therapies additionally. What is the frequency in patients with ankylosing spondylitis who present for treatment at a radon spa? Patients: 75 patients with ankylosing spondylitis presenting for treatment at the Gasteiner Heilstollen Hospital agreed to participate in the study (6 refused). Design: In an open interview a research assistant asked the patients to name all interventions which they have used for the treatment of ankylosing spondylitis. Results: Unconventional therapies (beside treatment at the Gasteiner Heilstollen) were used by 39 patients. Most frequently cited were acupuncture (15×), diet (8×), herbal therapy (7×), and homeopathy (6×). In total 40 different forms of unconventional therapies were mentioned. All patients claimed to have used at least two conventional therapies. Conclusion: Patients presenting for treatment at a radon spa claim to have used conventional therapies more frequently than unconventional forms of treatment.

Cancer mortality in low radon spa area.

Recently lower mortality for cancers of all sites was reported among inhabitants in the Misasa spa area, where there is a high radon background. To clarify the effects of radon exposure on cancer mortality, the effects of a hot spring itself on cancer mortality was investigated in the Beppu spa area, which has only a low radon background, and adjacent control areas. For females, the mortalities for cancers of all sites, liver and lung were higher in Beppu than those for all Japan on the basis of the standardized mortality ratio (SMR), while the SMR for all cancers was lower in adjacent areas. For the male inhabitants in hoth areas the cancer mortalities of all sites were not significantly different from those of all Japan. When we directly compared the most typical spa areas in Beppu and an adjacent control area, a Poisson regression analysis did not show that the relative risk of dying from cancer of all sites was decreased in the spa areas. These results are thus consistent with the view that the lower cancer mortality in the Misasa spa area might be related to exposure to low levels of radon.

Cancer Mortality Survey in a Spa Area (Misasa, Japan) with a High Radon Background

The 1952–88 cancer mortality records for inhabitants of the Misasa spa area, Japan, which has a high radon background, and a neighboring control area without any radon spa were analyzed (average outdoor Rn concentration: 26 mBq‐liter−1 in Misasa vs. 11 mBq‐liter−1 in the control area). Standardized mortality ratios (SMRs) for cancers of all sites were significantly lower among the inhabitants of both Misasa (male 0.538; female 0.463) and the control area (male 0.850; female 0.770), than in the whole Japanese population. Poisson regression analysis showed that the relative risks among the inhabitants of Misasa were significantly lower than in the control area for deaths from cancers of all sites (0.67) and stomach cancer (0.59). The relative risk of lung cancer death was also lower (0.55 times) in Misasa than in the control area, although the difference was not statistically significant. These results suggest that the linear no‐threshold hypothesis for radiation risk may not be valid for exposure to low doses of radon.