SPECIFICITY, LEGISLATION AND CONTROL OF NATURAL MINERAL WATERS USED IN THERMALISM (FRENCH MEDICAL HYDROTHERAPY CENTERS)

Waters used for hydrotherapy in French medical hydrotherapy centers are legally called Natural Mineral Waters (NMW). Sometimes they are called Thermal Waters but this denomination is little confusing with hot (drinking) waters. There is no legal specific definition of NMW used in spas ; the only definition is the European definition for bottled NMW (directive EC 2009/54) witch fully applies to spa centers. Natural mineral waters have their own specificity that differentiates them from any ordinary water. A NMW must have properties favourable to health; other requirements are the stability of chemical composition, a groundwater origin and have a great original purity. This is not the chemical composition of the water that determines whether or not it will be classified as mineral water, but the evidence of the therapeutic effectiveness of water according to guideline of Academy of Medicine. First, water should be characterized and a thorough study of its components done. Such waters are very complex, the various dissolved species remaining in equilibrium each other. It is also clear that some mineral waters, as sulphide waters, chloride waters and sulphate waters, because their components predispose for use in thermal treatment of respiratory or metabolic disorders internal. But it appears only as a presumption of efficiency. The regulation of mineral waters requires high level of microbiological purity every where in spa centers : the water must be free to all points of use of pathogens (including Pseudomonas aeruginosa and Legionella pneumophila ) and the parasites. In case of contamination of any part of the treatment room, local Health Authorities will immediately close it. Official recognition by local Health Authorities and Academy of Medicine are the guarantee of the therapeutic efficacy of these waters ; a strict control of water and sanitation facilities and sooner the certification process of spa therapy centers provide a high level of safety.