Vol. 15 •Issue 6 • Page 11
Going Underground to Treat Asthma
Being sent to the salt mines is no longer the punishment it was centuries ago. Today, physicians in Eastern Europe are combining speleotherapy — treatment in caves and salt mines — with medical therapy for respiratory care.
Felix Botchkowski, a Polish health official, first described speleotherapy in 1843. He noted that salt miners rarely suffered from respiratory illnesses. Botchkowski and many of his successors believe that salty, disinfectant air inside salt mines is useful for easing asthma and other lung diseases.
To date, thousands of patients have visited salt mines throughout Eastern European countries such as Poland, Hungary, Armenia, and Ukraine.
Salt mine experience
The Wieliczka Salt Mine Underground Rehabilitation and Treatment Centre, Velicko, Poland, is located 10 kilometers outside of Krakow. The facility offers a 17-day treatment program that consists of 14 six-and-a-half-hour visits to its chambers, located 135 meters underground. (A U.S. football field is approximately 110 meters.)
“The most important factor is a unique climate with very rare bacteriological purity, high relative air humidity, and a large amount of sodium chloride,” said Elzbieta Jucha, assistant director of sales and marketing at the center. “The underground air doesn’t contain dirt typical to the natural environment.”
A stay at the mine is beneficial for people with respiratory problems such as asthma, chronic obstructive pulmonary disease, and sinusitis, as well as allergies, skin diseases, and obesity, according to Wieliczka physicians.
Patients receive three check-ups by doctors (before, during, and after treatment), and two spirometry tests to monitor lung function. Physician-supervised treatments focus on active rehabilitation, or “modern breathing gymnastics,” which aim to help visitors control and improve their respiratory systems.
Visitors may participate in breath control exercises, diaphragmatic breathing, respiratory muscle training, and bronchial tree procedures. These are complemented with music therapy and access to rehab facilities for bicycling, running, and weight lifting.
Additionally, the center prepared a special teen program called “Health Lesson in the Salt Mine.” It combines elements of prevention and health promotion with education and leisure, Jucha said.
So, what’s the cost of spending two weeks in the Wieliczka salt mine? Up to 5,950 PLN, or about $1,940. Insurance may cover the treatment, while accommodations and meals are out-of-pocket expenses for each visitor.
Pros and cons
However, less expensive methods exist for spending time in allergen-free environments, said Paul Enright, MD, research professor of medicine and public health, University of Arizona, Tucson.
“Taking a cruise or going to the beach for a week might have the same effect for people who are going to benefit from speleotherapy,” Dr. Enright said. “The potential benefit of these environments is that they’re probably allergen free, and the air may be moist.”
Moist air and moderate humidity can be good for asthma patients because they promote less airway drying and less bronchospasm.
“But the benefits would only be temporary while patients are down there,” Dr. Enright explained. “If they’re down there for a week, then their airway inflammation might be reduced for that week.”
Apart from the cost and social isolation associated with speleotherapy, it increases the risk of catching a virus from someone else undergoing therapy.
“People with asthma who have upper respiratory viruses can continue to shed viruses for up to two months after they get a cold. In a confined area, their chance of catching a respiratory virus from another person is high,” Dr. Enright said.
Scientific reports also are mixed on the efficacy of speleotherapy. In 1993, a Russian study followed 216 children with bronchial asthma who underwent speleotherapy. The majority of the children showed diminished broncho-obstructive syndrome and improved pulmonary ventilation at the end of treatment. The investigators recommended combining salt therapy with medical treatment of pediatric asthma.1
Other studies, however, indicate there isn’t enough evidence to determine whether speleotherapy is an effective intervention for respiratory problems, and that randomized, controlled trials with long-term follow-up are required.2,3
Dr. Enright’s advice: “If a person is motivated to pay hundreds of dollars on an asthma treatment, it’s probably because they’re in the middle of an exacerbation. Exacerbations, by their nature, are temporary, and by adhering to medical therapy and just letting the passage of time go by, the vast majority of asthma patients will feel better.”
Debra Yemenijian is associate editor of ADVANCE. She can be reached at email@example.com.
For a list of references, please call Debra Yemenijian at (610) 278-1400, ext. 1153, or visit www.advanceweb.com/respmanager.