For doctors

Subterraneotherapy

Subterraneotherapy is based on subjecting patients to the synergistic action of a set of physical, chemical and biological stimuli in underground spaces.

Microclimate affects the human body systemically (as a stimulus) and locally (in the airways) by the isolation from allergens and other irritating and harmful factors. The high concentration of NaCl in the aerosol in underground spaces stimulates the motor and secretory activity of the respiratory epithelium. It also has an impact on its cleansing and moisturising.

     


Microclimate

Stable climatic conditions (temperature 12.9-14.5°C and humidity 60-75%) prevent the bronchi from contracting and the respiratory mucous membranes from drying; such conditions also stimulate adaptation mechanisms of the body.

Air purity insulating from irritants (smog/impurities) and allergens present in the air on the ground.

The concentrations of Particulate Matter that were recorded during the measurements carried out in the “Wieliczka” Salt Mine Health Resort chambers, amounted to an average of 20 μg/m3, while the concentrations on the ground often exceed the alarm level of 300 μg/m3[3]. Extremely low concentrations of respirable dust (PM2,5), were recorded at an average level of 7 μg/m3. Such concentrations should be considered extremely low. The European standard for PM2,5 is 25 μg/m3. This type of dust is of the greatest importance to our health because, due to the small particle size (2,5 μm in a diameter) it reaches our lungs. Not only the quantity, but also the quality of the dust present in the air is of great importance. While 80% of the underground aerosol is sodium chloride, on the ground we encounter mainly heavy metals, benzo(a)pyrene, other polycyclic aromatic hydrocarbons and volatile organic compounds. Underground microclimate, which is characterised by a low degree of pollution, has a positive effect on the respiratory system and our well-being; it also enhances the effects of underground pulmonary rehabilitation.


Graph 1. Mean daily PM2,5 concentration in the “Wieliczka” Salt Mine and in Krakow.

Aerosol rich in minerals (3,0 - 8,0 mg/m3), especially sodium, potassium, calcium and chloride ions - has anti-inflammatory properties and helps in clearing the airways.

Graph 2. The content of water-soluble ions in the tested air samples from the Boczkowski chamber.

Graph 3. The percentage of determined ions in air samples from the Boczkowski chamber.

Exceptional microbiological purity favours the restoration of bacteriological equilibrium (or: normal bacterial flora)

Graph 4. The comparison of the concentrations of fungal spores of the Cladosporium genus in the “Wieliczka” Salt Mine and in Krakow.

Ionisation (concentration of 1200 – 4700 air ions/cm3 several times exceeds the values found on the ground) has a positive effect on the respiratory system, nervous system and hormonal balance.

Isolation from external stimuli provides full mental rest and reduces stress.

Atmospheric pressure in underground chambers is higher than on the ground; this increase is proportional to the depth. The increase in pressure is a positive climatic stimulus for the human body, because when the air saturation with oxygen is normal (as on the ground) the gas partial pressure in the blood increases and oxygen supply of tissues is better.

Air movement in underground excavations is forced by their ventilation system. It has an influence on the formation of brine mist and is an important factor promoting the rapid regeneration of air in the chambers, after the stay of larger groups of patients.

 

Pulmonary rehabilitation

Because of the high effectiveness in reducing the symptoms of respiratory diseases pulmonary rehabilitation has become a part of the standards of treatment. A comprehensive respiratory rehabilitation program was developed by a team of specialists of the Health Resort based on the recommendations of the Polish Society of Lung Diseases and the guidelines of the European Respiratory Society and the American Thoracic Society. The aim of the personalised therapy of chronic respiratory diseases is to:

  • improve the quality of life of patients with chronic respiratory diseases,
  • reduce the severity of symptoms,
  • improve treatment control,
  • increase the awareness and involve the patient in the process of treatment,
  • improve exercise tolerance and physical efficiency.

The treatment program is based on four important elements:

  • the use of natural resources,
  • rehabilitation focused on the optimal use of the respiratory system,
  • optimisation of pharmacological management,
  • health education.

During the treatment, in-depth specialist diagnostics of the respiratory system is applied and the progress of rehabilitation is monitored. The training plan includes the assessment of exercise tolerance and setting individual rehabilitation goals.

The aim of the personalised therapy of chronic respiratory diseases is to:

  • improve the quality of life of patients with chronic respiratory diseases,
  • reduce the severity of symptoms,
  • improve the treatment control,
  • increase the patient’s awareness and involvement in the process of treatment,
  • improve exercise tolerance and physical efficiency.

Because of the high effectiveness in reducing the symptoms of respiratory diseases pulmonary rehabilitation has become a part of the standards of treatment. A comprehensive respiratory rehabilitation program was developed by a team of specialists of the Health Resort based on the recommendations of the Polish Society of Lung Diseases and the guidelines of the European Respiratory Society and the American Thoracic Society.

 

Indications

  • chronic obstructive pulmonary disease (COPD),
  • recurrent diseases of the nose, sinuses, pharynx and larynx,
  • chronic bronchitis and pneumonia,
  • allergic disorders,
  • asthma.
 

Contraindications

  • cancer at present or in the past (a five-year grace period is not over),
  • immunosuppressive treatment: cytostatics, cyclosporine, radiotherapy, high doses of steroids regardless of the cause of application,
  • serious damage to the motor system preventing independent movement,
  • severe respiratory and circulatory failure limiting the patient’s activity to a sedentary lifestyle,
  • clinically active infectious diseases, acute or chronic (carriage is not a contraindication),
  • acute infectious diseases with fever.

The services will not be provided to persons suffering from:

  • rheumatic and degenerative diseases of the osteoarticular system,
  • ischemic heart disease in the course of unstable angina or arrhythmia threatened with the loss of consciousness,
  • uncontrolled hypertension,
  • unstable diabetes,
  • mental illness, especially depression and claustrophobia syndromes,
  • pregnant women.
 

Research and development

The aim of research and scientific activity of the “Wieliczka” Salt Mine Health Resort is to optimise the treatment process, supervise therapeutic factors and provide objective, scientifically confirmed information on the applied treatment method.

The scientific and research activity of the “Wieliczka” Salt Mine Health Resort in the field of allergic diseases and respiratory system diseases is under the patronage of the Jagiellonian University Medical College, while the field of tourism and physiotherapy is supervised by the University of Physical Education in Krakow.

The “Wieliczka” Salt Mine Health Resort constantly monitors physicochemical and biological parameters, as well as controls climatic factors important in the process of treatment. A number of medical projects are also being conducted here, focusing mainly on the chief diseases treated in the “Wieliczka” Salt Mine Health Resort.

Detailed information on research cooperation and scientific articles on subterraneotherapy can be obtained by completing the form below (badanianaukowe@kopalnia.pl)

 

Expert opinions

„Pulmonary rehabilitation is indicated in every patient who, despite the optimal medical treatment, has symptoms, limited exercise tolerance, the impaired ability to perform daily activities or reduced quality of life.”

Prof. Lucyna Mastalerz, MD, PhD – Regional Consultant in the field of Lung Diseases

„Climatic therapy supports the treatment of chronic inflammatory diseases of the airways, both allergic (allergic rhinitis, asthma) and non-allergic. Because subterraneotherapy additionally isolates the patient from exposure to natural allergens and harmful chemicals it has the advantage over other methods of climatic treatment.”

Ewa Czarnobilska, Professor of the Jagiellonian University – Regional Consultant in the field of Allergology – Chairwoman of the Małopolska Division of the Polish Society of Lung Diseases, Head of the Centre of Clinical and Environmental Allergology, Jagiellonian University Medical College

„Subterraneotherapy is a valuable treatment method for chronic upper airways infections. Brine mist has a beneficial effect on the condition of the mucous membranes of the nose, throat and larynx, which significantly reduces the complaints of laryngological patients. The research carried out at the “Wieliczka” Health Resort confirms the therapeutic effect of brine mist on the mucous membranes of the nose and paranasal sinuses.”

Prof. Jacek Składzień, MD, PhD– Regional Consultant in the field of Otolaryngology

 

References

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Błażejczyk K, Wiszniewski A. Operat uzdrowiskowy dla sanatorium uzdrowiskowego w urządzonych podziemnych wyrobiskach górniczych Kopalni Soli w Wieliczce. IGiPZ PAN, Wieliczka 2011. Archiwum Kopalni Soli „Wieliczka” Trasa Turystyczna (dane niepublikowane)

Bromboszcz J, Włoch T, Rehabilitacja pulmonologiczna. Wytyczne AACVPR do programów rehabilitacji pulmonologicznej. Wyd. Elipsa-Jaim. Kraków 2012

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Gębarowska E, Pusz W, Kucińska J, Kita W. Comparative analysis of airborne bacteria and fungi in two salt mines in Poland. Aerobiology 2017; doi.org/10.1007/s10453-017-9502-6

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