Trial reportJournal of physiological anthropology2017
Does waterfall aerosol influence mucosal immunity and chronic stress? A randomized controlled clinical trial.
Trial report in Journal of physiological anthropology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- The effectiveness of nature-based interventions on mental health: A systematic review.Applied psychology. Health and well-being · 2026Pooled it
- Nature Exposure and Its Effects on Immune System Functioning: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Green exercise and mg-ca-SOBMC musculoskeletal disorders · 2019Trial
- From urban to alpine: environmental microbial transfer in urban adults - the ALM Study.Frontiers in public health · 2025Article
- Interactions with Nature, Good for the Mind and Body: A Narrative Review.International journal of environmental research and public health · 2024Review
- Greenspaces and Health: Scoping Review of studies in Europe.Public health reviews · 2024Article
- Effects of short-term waterfall forest aerosol air exposure on rat lung proteomics.Annals of translational medicine · 2022Article
- Waterfall Forest Environment Regulates Chronic Stress via the NOX4/ROS/NF-κB Signaling Pathway.Frontiers in neurology · 2021Article
- The effects of negative air ions on cognitive function: an event-related potential (ERP) study.International journal of biometeorology · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe specific microclimate of alpine waterfalls with high levels of ionized water aerosols has been suggested to trigger beneficial immunological and psychological effects. In the present three-armed randomized controlled clinical study, we focused on effects on (i) immunological reagibility, on (ii) physiological stress responses, and on (iii) stress-related psychological parameters.
methodsPeople with moderate to high stress levels (n = 65) spent an active sojourn with daily hiking tours in the National Park Hohe Tauern (Großkirchheim, Austria). Half of the group was exposed to water aerosol of an alpine waterfall for 1 h/day (first arm, n = 33), whereas the other half spent the same time at a distant site (second arm, n = 32). A third arm (control, n = 26) had no intervention (except vaccination) and stayed at home, maintaining their usual lifestyle. The effect of the interventions on the immune system was tested by oral vaccination with an approved cholera vaccine and measuring specific salivary IgA antibody titers. Lung function was determined by peak expiratory flow measurement. Electric skin conductance, heart rate, and adaption of respiration rate were assessed as physiological stress parameters. Psychological stress-related parameters were analyzed by questionnaires and scales.
resultsCompared to the control group, both intervention groups showed improvement of the lung function and of most physiological stress test parameters. Analysis of the mucosal immune response revealed a waterfall-specific beneficial effect with elevated IgA titers in the waterfall group. In line with these results, exposure to waterfall revealed an additional benefit concerning psychological parameters such as subjective stress perception (measured via visual analog scale), the Global Severity Index (GSI), and the Positive Symptom Total (PST).
conclusionsOur study provides new data, which strongly support an "added value" of exposure to waterfall microclimate when combined with a therapeutic sojourn at high altitude including regular physical activity.
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