The mechanism of speleotherapy effect and technical information

The illness of the current child’s population is still very high, children are repeatedly ill, especially with diseases of upper and lower respiratory tract. 35% of population suffers with various manifestations of allergic diseases and bronchial asthma. However, this number is getting higher with inhabitants of large cities and industrial areas.

One of the non-invasive treatment method used for such people is speleotherapy, i.e. treatment in caves and artificially made underground premises. The name speleotherapy is not exactly accurate. In our meaning it represents an integrated complex of therapeutic methods, where the own stay is only one part of it, and this can be compared to a stay in a huge natural inhalator. The main emphasis is given to the rehabilitation and sport activities and recondition activities, which are enhanced by both good natural conditions and a direct and positive influence of precisely dosed stay in the underground environment.

This results in a climatic treatment method, which is similar to a classic climatotherapy. However, it is enriched of the underground climate’s direct influence, which has to be understood as a supplement of a year-round complete treatment of these patients.

Near our institution, in the massive of the mountain Příčná, there is a mine pit that was abandoned after the mining activities of Rudné doly Zlaté Hory. We tried to acquire these premises for speleotherapy well before but it was only in 1992 that we were able to proceed with two clinical trials with 40 children. They stayed in two chosen premises for 2 and half hours each day for 21 days. Their stay was combined with some breathing exercises, physical activity and singing. Our attention was focused on monitoring the indicators of humoral activity and on the clinical investigation by the questionnaire method with the interval of 6 and 12 months after the speleo treatment. At the same time we were monitoring the other two controlled sets of 40 children/patients who weren’t attending the speleotherapy.

The examination of humoral immunity before and after the speleotherapy treatment with the children has shown a significant increase of immunoglobulins type IgM, IgA and alfa-1-antitrypsin.

The results of the clinical survey found through the questionnaire method with the parents and the GP’s 6 and 12 months after the speleo treatment have shown a substantial improvement or an improvement of subjective symptoms on average in 80% of the patients (overall health conditions, intensity of coughing, cold) and also a substantial improvement or improvement of objective symptoms on average in 70% of patients (skin eruptions of eczema, shortness of breath, school absence). Last but not least there has been a decrease in total medication intake with 90% of the patients.

The results of the clinical survey of the controlled sets of children who didn’t go through the speleo treatment have shown us the worth of the existence of our institution as part of the comprehensive medical preventive care of repeatedly ill children, and at the same time have shown positive differences in favour of the speleotherapy.

It goes without saying that all the required physical, chemical, and microbiological factors that are necessary for using the underground spaces for speleotherapy comply with standards including radon concentration. All the necessary measurements have been made by the workers of Rudné doly Zlaté Hory, Faculty of Medicine of University Palackého in Olomouc, Military University in Vyškov, University of Chemical Technology in Pardubice, Regional public health authority in Ostrava and District public health authority in Bruntál.

The results of the clinical survey, the development of the immune parameters related to humoral immunity during the treatment of our patients, and the results of physicochemical, microbiological and mycological examinations led us to start the work on the mine reconstruction. In autumn 1993 the work began in cooperation with and under the expert guidance of Rudné doly Jeseník and under the supervision of Báňský úřad (bureau) of Czech Republic. Our speleoterapeutic premisses have started running on 1^st March 1995. From this day on they are being visited daily on average by 90 child patients for the period of 150 minutes. So far we haven’t noticed a single case of an acute shortness of breath or a claustrophobic attack.

The premises for speleotherapy are located 620 m above the sea level and they use 1600 m of underground corridors with a maximum depth of 93m under the surface.

Clinical experiences with the speleotherapy over the last 20 years of running are practically identical with the experiences and results of other centres in Europe. The effect of the treatment last on average 9 months. Therefore, we do recommend to repeat the long-term speleotherapeutic stay 9-12 months after the completion of the treatment at our institution.

The mechanism of action (of effect) is still under investigation, which has shown an important immunostimulatory effect of the exposure of the underground environment’s microclimate on the human organism, and that is both in the area of unspecified immunity and the area of specified immunity (both cellular and antibody).

The microclimate of the underground environment is made up of aerosol, which has got certain qualities. These qualities determine, if the underground environment is suitable or not for the speleotherapy. The essential and necessary condition of these qualities is their stability.

For the speleotherapeutic purposes the required microclimatic ratio of the underground environment should ensure:

Constant temperature, which should not fluctuate during the day nor the calendar year – the average temperature in Zlaté Hory is 7,5 °C.

Constant humidity – it is 97,8% here

Assuring the natural air changing and the insignificant air flow.

The natural depression ventilation system operates on a basis of the temperature differences between the mining environments and the outside. This ensures so-called “self-purifying power” of the underground spaces- in our case they can be used for 20 hours a day.

An environment that is free off microbes, dust parts and allergens

An environment that is free of mycotic particles (fungus, mold)

pH interior of the underground spaces – it should not exceed 5,5 ( up to this value the bactericidal or at least the bacteriostatic function is retained)

High levels of negative ions and a coefficient of unipolarity “P”: (ratio of concentration of the positive and negative ions) it is the key factor to decide if the underground premises are suitable or not for the speleotherapy. If the concentration of any of those ions is sufficiently high and the coefficient “P” is close to 1,0 then the microclimate of the underground is considered to be suitable and effective for the speleotherapy.

The size of the aerosole’s particles 0,2 – 0,5 µ (it enables its penetration into the alveoli)

The absence of ozone

The internal gas concentration (shown in ppm)

Volume and the equivalent volume activity Rn (OAR, EOAR) mostly varies, the radon concentration should be moving up to 1000 Bq/m3. In the underground premises in Zlaté Hory the OAR is maintained around the value of 500Bq/m3 and it is possible to regulate it.