Spa Facilities Research Articles

Incidence and molecular diversity of Acanthamoeba species isolated from public baths in Hungary.

Hungary has a large number of thermal baths and spa facilities which attract hundreds of thousands of tourists annually. Until recently, however, the free-living amoebae were not of public health concern. Genotyping of Acanthamoeba species, potential agents of keratitis and granulomatous encephalitis, was carried out in 20 Hungarian public baths for the first time to assess the incidence and molecular diversity of the genus in the country. Our results show that 6.7% of the samples were positive for Acanthamoeba. Of these positive samples, 6.5 and 7% was from sterilized and unsterilized pools, respectively. The 18S rRNA gene investigation of the nine Acanthamoeba strains found reveals that seven belong to the hazardous T4 genotype. The remaining two samples were of the T15 type. All the strains kept growing at 36 °C. Our results underline the need to develop a control system for free-living amoebae and supervise the disinfection of Hungarian public baths.

An overview of pool and spa regulations in Mediterranean countries with a focus on the tourist industry.

The Mediterranean area is densely populated and a very popular tourist destination. This study aimed at gathering up-to-date information on current national pool and spa regulations. We formulated and duly distributed to 20 Mediterranean countries a questionnaire divided into two sections: for pool and spa facilities, respectively. The questionnaire was formulated in such a way that a positive answer would imply that the specific topic was addressed effectively. While all 20 countries responded to the swimming-pool-related questionnaire, only 11 of these countries reported the existence of spa-related regulations. When combining the response overall of all countries for pool and spa facilities together, of a grand total of 606 answers, 183 (30.2%) were positive. The positive answers in the pool section of the questionnaire were 29% of the total of 420 answers while positive answers in the spa section of the questionnaire were fewer (27.8% of the total of 176 answers). The countries were grouped by geographical area of the Mediterranean basin where they are situated. Also, the questions were grouped into broad thematic categories. The paper presents conclusions drawn on the basis of the data received according to these geographical and thematic groupings.

The Practical Application of Value Added Tax in the Slovak Republic in the Spa Facilities

Among the services exempted from the value added tax without input tax reduction possibility belong the activities for the public good, e.g. health services and social care, education and training, cultural services and others. In the paper we describe the method of determining the tax liability of the value added tax on medical devices (bath, spa), which provides services exempted from VAT, as well as activities which are subject to value added tax. In this paper we solve the practical problems of proportional application, decreasing coefficients, backup and final to the VAT application, which on the basis of our research have the highest impact on the tax deductibility of health facilities in the Slovak Republic.

The relationship between tourism and residents’ quality of life: A case study of Harkány, Hungary

The paper delineates the connections between tourism and the local population’s quality of life in Harkány, a spa-town located in Southwest Hungary. During the spring of 2011, a questionnaire survey of 297 residents was undertaken in the town, in order to investigate their participation in tourism, and associated quality of life issues. In addition, residents’ attitudes related to thermal spa development in the town were analysed, together with the use of spa facilities by locals. The data analysis suggested that whilst the spa has a significant presence in the everyday life of the residents, the development of spa tourism has had very limited effects on their quality of life.

SZACOWANIE DAWEK EFEKTYWNYCH POCHODZĄCYCH OD RADONU W WYBRANYCH PLACÓWKACH GEOTERMALNYCH SPA NA PODSTAWIE INFORMACJI O STĘŻENIACH RADONU

Geothermal waters contain, among other components, soluble radon gas. Alpha radioactive radon is a health hazard to humans, especially when it gets into the respiratory tract. SPA facilities that use geothermal water can be a source of an increased radiation dose to people who stay there. Based on the available literature concerning radon concentrations, we assessed exposure to radon among people - workers and visitors of Spa centers that use geothermal waters. Radon concentrations were analyzed in 17 geothermal centers: in Greece (3 centers), Iran (5), China (4) and India (5). Doses recived by people in the SPA were estimated using the formula that 1 hour exposure to 1 Bq/m3 of radon concentration and equilibrium factor F = 0.4 corresponds to an effective dose of 3.2 nSv. We have found that radon levels in SPAs are from a few to several times higher than those in confined spaces, where geothermal waters are not used (e.g., residential buildings). In 82% of the analyzed SPAs, workers may receive doses above 1 mSv/year. According to the relevant Polish regulations, people receiving doses higher than 1 mSv/year are included in category B of radiation exposure and require regular dosimetric monitoring. Doses received by SPA visitors are much lower because the time of their exposure to radon released from geothermal water is rather short. The analysis of radon concentration in SPA facilities shows that the radiological protection of people working with geothermal waters plays an important role. It seems reasonable to include SPA workers staying close to geotermal waters into a dosimetric monitoring program.

Hot tub lung: an occupational hazard

To the Editor: Hot tub baths have become increasingly common in residences as well as hotels and spa facilities. Recently, such baths have been associated with an emerging disorder known as hot tub lung (HTL). HTL is a diffuse granulomatous lung disease caused by inhalation of water aerosol containing non-tuberculous mycobacteria (NTM), in most cases belonging to the Mycobacterium avium complex [1]. Here, we report a cluster of confirmed, probable and possible HTL with occupational associations. To our knowledge, case 1 is the first confirmed case of occupational HTL in the literature. A 30-yr-old hotel technician (case 1, table 1) developed episodes of cough, dyspnoea, fever and joint pain. His condition progressed with fatigue, weight loss and increasing dyspnoea. He was hospitalised at his third emergency visit. His oxygen tension was moderately reduced (8.9 kPa). His C-reactive protein level was 16 mg·L−1. A chest radiograph was normal but computed tomography showed ground-glass opacities without signs of embolism. He was dismissed after spontaneous remission 3 days later. He continued having some fatigue and dyspnoea on exertion. Fever, accentuated dyspnoea and cough relapsed twice after returning to work. Chest radiography showed diffuse interstitial infiltration and his diffusion capacity was reduced. Lymphocytosis was found in his bronchoalveolar lavage (BAL) fluid, and transbronchial biopsies showed interstitial inflammation and granuloma. HTL was diagnosed when growth of M. avium was found in BAL fluid and it became clear that he had cleaned the hotel’s hot tub facility (facility 1) and its nylon filters with a pressure washer twice weekly. View this table: Table 1. Characterisation of a cluster of confirmed, probable and possible cases of hot tub lung related to maintenance work on hot tubs Two colleagues who had substituted for the first hotel technician at servicing the bath facility during his sick leave also fell ill with similar symptoms (cases 2 and 3, table 1). They were eventually diagnosed with probable HTL but the work-up was insufficient …

C002001 東京渋谷シェスパ爆発事故の概要(【C00200】事故と過失処罰～過失処罰で事故は防げるのか～,法工学専門会議企画:連続講座『法と経済で読み解く技術のリスクと安全』共催,市民フォーラム)

At a city spa in Shibuya, Tokyo, a methane explosion killed three people. Two persons were indicted for negligence causing death. One was the safety manager of the spa, and the other was a designer of the construction company that constructed the spa facilities. Discussion about the accident shows various issues concerning safety and regulatory measures.

Development Strategies on Taking Thailand’s Health Promotion Related Tourism Business into the Global Market

The Royal Thai Government has made it a policy to promote Thailand as the Spa Capital of Asia since 2004. The Ministry of Public Health, in conjunction with the Office of the National Economic and Social Development Board has adopted a five-year plan (2009-2013) to promote the health service business to turn Thailand into a World-Class Spa Destination with the cooperation of both the public and private sectors. The objectives of this study are to analyze the market regarding the promotion of health-related tourism (spas), the potential supply and demand, consumer behavior and visitors’ satisfaction relating to the use of the country’s spa services, strategies for the development and promotion of health-related tourism businesses (spas), the obstacles to achieving this objective, and suggestions with regard to the latter. The population of the study consisted of foreign nationals who used spa services in Prachuabkirikhan, Phuket, Phanga and Krabi provinces, with 100 samples taken from each province. The research methodology used in this study is both qualitative and quantitative in nature, in addition to which a descriptive approach was also adopted. The results demonstrate that, although spas were relatively well known among foreign tourists during 1993-1994, the spa business has enjoyed a boom from 2001 down to the present. The study analyzed both demand and supply of spa business. Most of the foreign nationals interviewed stated that they visited spas during their vacation time and stressed the importance of visiting a spa in planning their travel itinerary. In their opinion, compared with the best spa facilities in Asia, spas in Thailand would prove cheaper. The category of spa that was used the most that was the resort spa. With regard to the atmosphere of the spa itself, the majority favored a natural atmosphere. As for their favorite products, they used proprietary products belonging to the spa service center. Concerning the services the spa offered, they liked body massage the most. As regards their reasons for selecting a particular spa’s services, they did so in accordance with the quality and standard of service. For most of the respondents, their objective in using the services of a spa was to relieve pain in their muscles. It was found that tourists expressed a high degree of satisfaction with regard to their use of the spa’s services and as well as the overall circumstances pertaining to such spas. As far as the strategies for the development of this sector are concerned, these need to focus on management, market planning, competition, marketing and public relations, successful spa factors, and the export market. On the other hand, strategies need to be devised pertaining to the development and supervision of standards, export promotion and spa development. Also included are strategies relating to quality service and customer satisfaction. Clearly, the strengths of this sector would form the foundation of the sales strategies, while efforts should be made to eliminate or improve upon any weaknesses to be found in this business.

Understanding the 3D Structure of a Thermal Water Fissured Granite Aquifer by Use of Geophysical Studies

The thermal hot springs of Caldas de Moncao, located in Northern Portugal, are supplied by a thermal water aquifer that must be preserved from pollution and anthropic effects. Enhancement of knowledge about the aquifer is therefore needed, so sustainable management and water quality preservation can be conducted, namely by replacing the springs by boreholes, which are less vulnerable to pollution. Several investigations have been conducted with this purpose, to review the available geological and hydrogeological information from the area. For this reason, several geophysical surveys were reprocessed and others were acquired and planned, so that a 3D conceptual groundwater flow model of could be drawn. Three seismic reflection profiles were acquired with the objective of locating deep faults capable of transporting groundwater to the surface and to complement information about shallow features available before the seismic survey. This infor- mation included interpretation of a dipole-dipole survey conducted in 2001, that reached an investigation depth of approximately 40 m, and two shallow boreholes drilled, after a deeper geoelec- trical survey performed in the 1980s, to replace the springs. Besides the seismic reflection profiles, seven vertical electrical soundings were also acquired and refraction interpretation of the first reflec- tion data to arrive was also undertaken to complement the information. This paper reports integrated interpretation of the geophysical and geological data to obtain a 3D conceptual model to achieve the above mentioned objectives. After interpretation and lateral correlation of the structures found in the geophysical pro- files, the deep 3D conceptual model integrating the geological, hydrogeological, and geophysical information was constructed. This model was the basis for planning the location of an explora- tory borehole that was drilled afterwards. From two initial locations appearing as the strongest candidates for a successful thermal water production well, one was chosen to drill a third borehole to supply the spa facilities. The third borehole results were very positive— 250 m deep, temperature approximately 50C, and water flow 12.5 l/s. This example shows the utility of using geophysical methods to increase knowledge about groundwater circulation and detect favourable areas for thermal water borehole drilling to replace the hot springs with the objective of protecting the aquifer from pollution.

KARAKTERISTIK DAY SPA DI KECAMATAN KUTA SELATAN, BALI

Spa industry is a fast growing industry in the world as well as in Bali. The annual average growth of numbers of day spas in this area is 40% since 1995. This research was aim at revealing the characteristics of day spa in the Kuta, Bali. Data were collected from 50 day spas. The instrument used is questionnaire fo­cusing on spa business model, spa facilities, spa treatment, spa treatment price and spa human resources. The findings of this research were: spa business model were mostly non-franchise; the annual growth was 40%; average business hours was 13 hours; average area was 1012 m2; average number of treatment room was 8,56 rooms; average number of manicure and pedicure room and other spa facilities were less than one; the most to the least popular massage were Balinese massage, aromatherapy massage, and Shiatsu massage; the cheapest price of treatment per hour was Rp 40.000 and the highest price was Rp 650.000; per­centage of male and female employees were 14% and 86%; employees with com­petencies certificate is 1,2%; educational background of employees were 5% undergraduate, 8% associate degree, 86% senior high school, and 1 % junior high school.

Spatial Planning and Development in Tourist Destinations: A Survey in a Greek spa Town

Thermalism – now known as spa tourism – is an age-old activity in Greece, with a long and rich tradition. Through the millennia, Greece has not only managed to maintain the activity of thermalism intact, but has developed it even further, particularly in more recent times (especially since the beginning of the 19th century). Until the middle of the 20th century, Greece invested in quite a high number of spa facilities at various hot springs located throughout the country. Both domestic and foreign visitors were offered a very satisfactory level of spa services – mainly of a therapeutic nature – for a long period of time in the recent past. However, as perceptions concerning thermalism began to change at the end of the 20th century, new, more ‘modern’ facilities, exclusively dedicated to offering luxury services for health and well-being began to ‘pop up’ in the same areas, next to the ‘classic’ type of therapeutic spa facilities. It is certain that however much contemporary trends may force spa tourism to swing toward providing increasingly less therapeutic services, the relegation or supersession of the ‘classic’ type of facilities and services in the end will not constitute a solution, especially for local communities and the development of those areas. The present article is the result of extensive field research (the completion of questionnaires) conducted by the authors in the spa town of Kamena Vourla (the second-most important spa town in Greece). It is within the framework outlined above that the article attempts to sketch the various characteristics/profiles of visitors to ‘modern’ and ‘classic’ style facilities. The ultimate aim of this research is to suggest that the new type of facilities and their ‘tourists’ do not constitute a one-way street for the local development of hot springs areas; rather, on the contrary, they may indeed pose a trap if not broadened and suitably combined with the ‘classic’ type of therapeutic facilities already in place. Finally, based on the conclusions drawn from the research conducted, the article attempts to determine a suitable form of organization that may prove advantageous to spa tourism destinations. It is hoped that this type of organization might help these areas experience viable economic, social, environmental and other development, as viewed within the context of contemporary perceptions and trends.

The spirit of place of West Estonian resorts

The authors analyse the formation and transformation processes of three Estonian coastal resorts, Haapsalu, Kuressaare and Pärnu. Starting with sea-mud therapies, these towns expanded their health resort activities from the first half of the 19th century and gradually established tourism economies. The preconditions for the birth of a resort and attempt to characterise the spirit of place of a tourism destination are discussed theoretically. The spirit of a place becomes critical during periods of change, when it is necessary to have a clear vision for local policy-making and consolidation of joint activities. It is not enough to have a beach and modern spa or hotel facilities. The resorts need some special attractions, which may be related to historic legacies or careful urban and landscape planning. Coastal tourism has faced major transformations during recent decades and all West Estonian resorts have expanded their capacity for the third time in their history. The method of study is historical and content analysis of written media, archive sources and statistics. The authors find that resorts that have a clearly expressed spirit of place are more successful than those where it is less well experienced.

Website Effectiveness in Wellness Promotion By Portuguese Spas

Until 2004, Portuguese spas were traditionally thought of as establishments in which noninvasive therapies based on naturally occurring sources of mineral water are provided under professional supervision. With the publication of the Decree-Law No. 142/2004, Portuguese legislation regulating spas changed quite dramatically: from that moment on, spa-owners, numbering some 40 establishments countrywide, were allowed to open up what had hitherto been a strictly health-orientated sector. Since then much has changed in the Portuguese mineral springs spa market: one of the main innovations has been the introduction of a large variety of services that may be termed ‘wellness treatments’ — therapies not strictly related to pre-existing health conditions. These are now being offered as a product range in their own right, along with traditional medical treatments, thus diversifying the services provided, with all based on the same highly therapeutic naturally occurring mineral water. Thus spa services are no longer just a health product but have also become a tourist attraction, thereby legally formalising something that, to a limited extent, had always been the case. With the change in the services offered, the typical customer profile has also modified significantly: users of today's spa facilities are younger (between 25 and 45 years of age) than in the past, from the middle- to middle-upper socioeconomic stratum, live in large urban centres, have a reasonably high level of education, and could be either male or female. Such clients often prefer making various short trips over the year to test out different destinations, and choose registered hotels with three or more stars for their stays. The changing client profile has forced firms to adapt the means they employ to establish a growing and loyal client base. Indeed, over the past five years, a large majority of Portuguese spa service providers have significantly upgraded not only their services and infrastructures, but also their use of internet sites. With these changes in mind, the study reported on here aimed to analyse the way such firms currently communicate with prospective clients using the web. The results of this study may offer both Portuguese spas and those in other locations the opportunity to further improve their dialogue with current and potential spa-goers.

Personal Decisions in a Dermatology Spa

The spa business is booming in the United States. More and more spa facilities are opening up, almost on a daily basis. Dermatologists are the owners of some spas, but spas are often being run by other types of physicians or, more alarmingly, by people unfamiliar with treating skin conditions of any kind. This article discusses the importance of the dermatologist-run spa, as well as the author's ideas and experience with opening and running a medical spa or medi-spa.

Antibacterial activities of plant essential oils against Legionella pneumophila

The objective of this study was to determine the antimicrobial activity of essential oils (EOs) extracted from Cinnamomum osmophloeum leaves and different tissues of Cryptomeria japonica against pathogenic Legionella pneumophila at 42 °C. Ten kinds of EOs were extracted by water distillation and their chemical constituents were quantified by gas chromatography–mass spectroscopy (GC–MS). The results showed that cinnamon leaf EO possessed stronger anti- L. pneumophila activity than C. japonica EO. In particular, the highest bactericidal effect was noted in contact with C. osmophloeum leaf EO of cinnamaldehyde type (characterized by its major constituent of cinnamaldehyde accounting for 91.3% of EO), regardless of contacted cell concentration (2 and 4 log CFU ml −1) or exposure time (10 and 60 min). Cinnamaldehyde is responsible for anti- L. pneumophila activity based on the results of antimicrobial testing and statistical analysis. Stepwise regression analyses show that EO concentration is the most significant factor affecting the bioactivity of EO. It is concluded that C. osmophloeum leaf oil of cinnamaldehyde type and its major constituent, cinnamaldehyde, possess strong anti- L. pneumophila activities, and have the great potential to be used as an antibacterial agent to control legionellosis associated with hot tubs and spa facilities widely used in homes and resorts.

循環式入浴施設における本邦最大のレジオネラ症集団感染事例

In July 2002, a large outbreak of legionellosis occurred in a bathhouse with spa facilities in Miyazaki Prefecture. Among the visitors, 295, including suspected cases had pneumonia and/or symptoms of fever, coughing, etc. Of these, 37% were hospitalized and 7 died. Clinical samples from 95 mainly inpatients were collected and microbiologically tested at our laboratory. Legionella pneumophila serogroup (SG) 1 was isolated from 3 of 24 in sputum culture, and none of the 3 had been treated effectively with antibiotics at sputa collection. L. pneumophila antigen in urine was detected by using enzyme immunoassay and/or immunochromatographic kits in 23 of 75 patients. Serum antibodies to L. pneumophila SG1 and Legionella dumoffii were detected in 5 each of 66 patients--9 cases including a case at mixed infection-by microplate agglutination test and/or indirect immunofluorescence assay. At our laboratory, 32 were diagnosed with legionellosis. In this outbreak, 14 were diagnosed at other laboratories, resulting in 46 confirmed cases. Urine antigen was detected more frequently by Binax NOW immunochromatographic assay than by Biotest EIA-31% versus 16% of cases tested. Both assays detected urine antigen only in samples collected within 4 weeks after onset. Antigen concentration in urine enhanced sensitivity-58% and 51%-and extended the period of antigen detection beyond 5 weeks. Both antibody titers to L. pneumophila SG1 and L. dumoffii in more than 90% of sera collected within 3 weeks after onset were < 1:16. The rate of serum antibody titer to > or = 1:128 within 3 weeks was 1.6%, during 4 to 6 weeks less than 10%, and after 7 weeks or more 8 to 25%. After an administrative report was published, L. pneumophila DNA in sputa was detected in 5 of 17 patients by nested PCR, resulting in extra 3 cases. Altogether, urinary antigen detection and PCR were more effective in laboratory diagnostic tests than culture and serology. Culture combined with molecular epidemiology is critical, however, for confirming the source of infection.

循環式入浴施設における本邦最大のレジオネラ症集団感染事例

In July 2002, a large outbreak of legionellosis occurred in a bathhouse with spa facilities in Miyazaki Prefecture. Two hundred-ninety-five patients (including suspected cases) that had pneumonia and/or symptoms of fever, cough and so forth were reported; 37% of them were hospitalized and seven people died. In environmental investigations, Legionella pneumophila serogroups (SGs) land 8, L. dumoffii, L. londiniensis, some other Legionella species and many kinds of amoeba were isolated from 55 samples of bathtub water, tank water, filters and so forth in the spa facilities. The dominant isolates from the bathtab waters belonged to L. londiniensis, L. dumoffii and L. pneumophila SG1, and their maximum concentrations were 1.5 x 10(6), 5.2 x 10(5) and 1.6 x 10(5) cfu/100 mL, respectively. L. pneumophila SG1 strains isolated from bathtub water, tank water, filters and sputa of patients showed a indistinguishable DNA fingerprint pattern by pulsed-field gel electrophoresis (PFGE), confirming that the source of infection was the spa water. Our study indicate that spas may be a significant health hazard if hygienic management fails.

The thermal-mineral water of Backa and the possibilities of its exploitation

Bačka is a region of Vojvodina which spreads between the Hungarian border on north, The Tisa river on east and the Danube river on west and south. This is a relatively small area, 8,671 square km, but it contains significant amount of thermal and mineral water. Only certain number of collectors, with general mineralization up to 4 g/l and temperature around 75°C, are exploited. For the time being, the thermal water of Bačka are used merely for heating spa and sport facilities. Regarding its quality and amount, this water could be used in many different ways beside this one, for example, in agriculture, industry, tourism, etc.

Patent Searching — What, Why, When, Where?

H2S and CO2 are two well-known emissions with cumbersome management and not yet established bulk utilization plans. The invention converts H2S and CO2 in syngas and, as the only by-products, elemental sulphur and water by means of a dedicated (i) Regenerative Thermal Reactor (RTR) and (ii) Acid Gas to syngas (AG2S) process layout thanks to the overall reaction: 2 H2S + CO2 = H2 + CO + S2 + H2O. The reaction is globally endothermic, but it can energetically supplied in situ thanks to a minor injection of oxygen/air. The oxygen injection generates the exothermic reaction S + O2 = SO2 in an appropriate amount so as to achieve and preserve the optimal conversion temperature. The SO2 generated for energy sustainability is therefore converted within the process layout. The once-through conversion is 75%v for the H2S and 50%v for the CO2. The unreacted reactants are split from the syngas and by-products and recycled upstream for complete conversion. The invention is the first process utilizing no sources, neither bio nor fossil, but only emissions to generate syngas and, hence, hydrogen. Two moles of syngas are obtained every three moles of emissions, also achieving the total neutralization of H2S and a relevant cut of CO2. Technology development has reached out the industrialization level. The laboratory testing has been developed in Politecnico di Milano, at the facilities of the Center for Sustainable Process Engineering Research (SuPER); the bench-scale tests have been exerted at the Sotacarbo Sustainable Energy Center SpA facilities and the industrial application is just started at Itelyum Regeneration srl, an ecorefinery for exhausted oil recovery.

Health status of spa visitors

German compulsory health insurance grants outpatient and inpatient prevention and rehabilitation treatments at spa facilities to avoid early retirement and long term care. A survey including participants between the age of 55 and 75 (n = 721) was conducted to determine the extent to which the current granting of spa treatment complies with regulations ("Begutachtungsanleitung Kuren"). The analysis was based on the data provided in the treatment application form by the general practitioners and on the answers of participants to a questionnaire on health-related quality of life (IRES). It compared a) cases granted outpatient/inpatient treatment at spa facilities, b) cases granted prevention/rehabilitation treatments at spa facilities and c) participants in spa treatments and controls from the IRES standard sample. For musculoskeletal diseases and diseases of the connective tissue, outpatient treatment was more often granted than inpatient treatment. There were no differences in the diagnoses of participants in prevention and rehabilitation treatments. Patients complaining about severe impairments/disabilities were granted inpatient rather than outpatient treatment. There were only minor differences between cases granted prevention and rehabilitation treatments respectively. The participants in spa treatment felt more impaired/disabled than controls of the standard sample. Overall, the selection of participants in spa treatment and the referal to outpatient and inpatient and inpatient treatments for the most part follows a needs-based pattern; however, improved differentiation is required between outpatient and inpatient prevention and rehabilitation treatments.