[Medical aspects on sauna bathing]. / Bastubad kan vara bra vid ett antal sjukdomar ­ men fler studier krävs - Det vetenskapliga underlaget ännu inte tillräckligt för allmänna rekommendationer.

The literature describing medical aspects on sauna bathing is briefly reviewed. The circulatory effects of heating and subsequent cooling related to sauna bath differ with age, underlying medical condition and use of drugs. The circulatory changes may often be beneficial but can sometimes prove dangerous. More than 2000 sauna bathers were followed for around 20 years in a Finnish population study. The investigators have recently reported health benefits of abundant sauna use for individuals concerning hypertension, ischemic heart disease, dementia and certain pulmonary diseases. Others have recommended the use of sauna for patients with heart failure. Fatal events in sauna are very uncommon and often linked to the use of alcohol, to ischemic heart disease and to bathing alone. Medical conditions in which sauna bathing should be avoided are shortly reviewed. Further studies are urgently needed for illustration of the possible benefit of sauna bath at different medical conditions.

Sauna bathing is associated with reduced cardiovascular mortality and improves risk prediction in men and women: a prospective cohort study.

BACKGROUND: Previous evidence indicates that sauna bathing is related to a reduced risk of fatal cardiovascular disease (CVD) events in men. The aim of this study was to investigate the relationship between sauna habits and CVD mortality in men and women, and whether adding information on sauna habits to conventional cardiovascular risk factors is associated with improvement in prediction of CVD mortality risk. METHODS: Sauna bathing habits were assessed at baseline in a sample of 1688 participants (mean age 63; range 53-74 years), of whom 51.4% were women. Multivariable-adjusted hazard ratios (HRs) were calculated to investigate the relationships of frequency and duration of sauna use with CVD mortality. RESULTS: A total of 181 fatal CVD events occurred during a median follow-up of 15.0 years (interquartile range, 14.1-15.9). The risk of CVD mortality decreased linearly with increasing sauna sessions per week with no threshold effect. In age- and sex-adjusted analysis, compared with participants who had one sauna bathing session per week, HRs (95% CIs) for CVD mortality were 0.71 (0.52 to 0.98) and 0.30 (0.14 to 0.64) for participants with two to three and four to seven sauna sessions per week, respectively. After adjustment for established CVD risk factors, potential confounders including physical activity, socioeconomic status, and incident coronary heart disease, the corresponding HRs (95% CIs) were 0.75 (0.52 to 1.08) and 0.23 (0.08 to 0.65), respectively. The duration of sauna use (minutes per week) was inversely associated with CVD mortality in a continuous manner. Addition of information on sauna bathing frequency to a CVD mortality risk prediction model containing established risk factors was associated with a C-index change (0.0091; P = 0.010), difference in - 2 log likelihood (P = 0.019), and categorical net reclassification improvement (4.14%; P = 0.004). CONCLUSIONS: Higher frequency and duration of sauna bathing are each strongly, inversely, and independently associated with fatal CVD events in middle-aged to elderly males and females. The frequency of sauna bathing improves the prediction of the long-term risk for CVD mortality.

Sudden Death in Sauna Due to Fatal Burns: A Case Report.

Sudden death during or after sauna bathing is a rare event. When occurring accidentally, it is often caused or contributed by consumption of ethanol. To accidentally burn to death because of hot air is highly uncommon without some contributing factor that lowers the person's consciousness. Hot air burns have been reported to develop in 20 to 60 minutes. We present a case of sudden death of a healthy man with rare and extensive hot air burns that developed in less than 10 minutes in the sauna. Ethanol was not a contributing factor. Substantial injuries were found at the autopsy, both external and internal, for instance, small hemorrhages in the stomach mucosa, indicating a heavy antemortem stress reaction. The most probable reason for the extensive scalds was concluded to be, apart from the high temperature, the high degree of relative humidity in the sauna.

[Sauna deaths in Hesse, Germany, between 1994 and 2014]. / Saunatodesfälle in Hessen 1994-2014.

Due to the high ambient temperature, sauna deaths show a few confounding particularities, such as an accelerated onset of the postmortem changes, that can make correct assessment of the manner of death difficult and severely constrain the accuracy of post- mortem interval estimates. This retrospective study, performed at the medicolegal institutes in Hesse, Germany, reviewed all autopsy reports from the years 1994-2014 for sauna-related deaths. 9 relevant cases were found involving one woman and eight men aged between 52 and 80 years (mean and median value: 67 years). Of the individuals who had died of a natural cause, four were found to have had coronary heart disease, which, in the setting of heart hypertrophy and exposure to high temperatures, ultimately led to cardiac failure. In three other cases, a non-natural cause of death had been diagnosed; however, all were attributable to accidents. In two of these, blood alcohol concentrations (BAC) of over two per mil were found. In our opinion, the manner of death should be classified as undetermined in sauna-related fatalities. Such cases require a court-ordered autopsy to reliably identify the actual cause of death.

Deaths in the Turkish hamam (hot bath).

Hamam (Hot Bath) culture is prevalent worldwide. The high temperature and humidity of these places have multiple effects on human health. The aim of this study was to investigate the demographic characteristics, autopsy findings and causes of death of cases who died in hamam and underwent medicolegal autopsies. The study was performed on 15 cases who experienced sudden death or died suspiciously in hamam and autopsied between January 1999 and December 2004. Eleven cases were men and 4 were women. Mean age was 69.5 +/- 3.1 and median age was 74. Eight cases were found dead in a bathtub or pool whereas seven were found out of water. Six of the cases older than 65 died in winter months. The causes of death were recorded as acute cardiac failure in 13 cases, pneumonia and cardiac failure in one, pneumonia and acute pancreatitis in the last case. Elderly patients with cardiac failure and coronary heart disease experience significant health problems in saunas and hamams. They should avoid this tradition unless approved by their physicians (Ref. 35). Full Text (Free, PDF) www.bmj.sk.

[Death on a sauna stove]. / Verbrennung auf dem Saunaofen.

A 67-year-old woman noticed a strange smell from the cellar of her house. When she followed the smell, she found her 64-year-old husband with the face and upper part of his body lying on the stove of the private sauna. He was dead when the emergency doctor arrived. The autopsy revealed upper gastrointestinal bleeding from mucosal lesions in the esophagus with an agonal fall on the sauna stove as the cause of death. In addition, there were signs of chronic alcohol and drug abuse.