Report on a Pilot Study into The Effects of Saline Nasal Irrigation (SNI) Upon Nasal Symptoms in Woodworkers

By Swami B. Saraswati and Dr Steve Rabone.

ABSTRACT

Aims
1) To determine if SNI decreases prevalence and/or severity of nasal and general symptoms amongst woodworkers
2) To determine woodworkers' acceptability of SNI.
3) To determine the effects of SNI upon: snoring, predisposition to and recovery from colds, sense of smell, nasal airflow patterns, mouth breathing.
4) To discover: the participants' reasons for trialing SNI and attainment of these reasons; any unexpected benefits or side effects; personal experiences of the technique; problems in learning and performing the technique; usage patterns; usual location and times of nasal cleansing; time taken to perform; lifestyle impositions caused by the method; likelihood of longer term usage.

Methods
A group of 46 volunteer woodworkers were randomly divided into 2 groups. One group used the intervention technique twice daily for 8 weeks whilst the other group was the control. Groups were crossed-over after the 8 weeks. At 16 weeks all participants were free to choose to cease or continue usage of the technique for a further 12 months follow-up period. Self reporting questionnaires were filled in by all participants at the beginning, cross-over, and at the end of the follow-up periods of the trial.

Results
1) The procedure of SNI was shown to be significantly (p=0.0001) associated with a perception of decreased nasal problems during both the cross-over period and the one year follow up period. Beneficial changes in other aspects of health and well being appeared to associated with the procedure but inconsistently.
2) Acceptability of the procedure indicates that 21 of the 46 subjects were still using the procedure regularly after 1 year. Additionally, perceived usefulness of SNI showed a favourable response with 34 subjects saying they found the procedure quite useful or very useful.
3) Data was weak and inconclusive on the effects of SNI upon snoring and its effects upon catching and recovering from colds. There was strong evidence for improvements in the sense of smell, gross nasal airflow, nasal airflow imbalances and reduction in mouth breathing.
4) Most participants attained their intentions for entering the study group. There was a high number (124) of unexpected benefits. Side effects were shown to be minimal and overcome by time and experience with the procedure. Nearly all subjects had favourable impressions prior to and after first learning the technique with some apprehension and difficulties showing up whilst first learning SNI. Overall satisfaction after 16 months was 90%. Difficulties with the technique at some stage were reported by between 30 and 54% of users. Average usage of the practice varied from a high frequency of 10.8 times weekly at the beginning to a low of 2.8 times weekly by the end of the trial. When optional, 57% of the subjects adopted regular use, 28% as needed and 15% not at all. Usual location of nasal cleansing was at home for 95% of users. The average time taken to perform SNI was 4.3 minutes. 87 - 97% of users found the technique to be of no inconvenience to their usual lifestyle. Intention of usage beyond the 16 month study period was 41% on a regular basis, 30% on a need to basis, 29% not at all.

Summary & Conclusions
(Rabone) The study provides reasonable evidence that SNI significantly improves nasal symptoms in volunteer woodworkers. It shows that most woodworkers who wish to try the procedure will regard it is a useful aid and will adopt the technique with varying usage according to their own needs.
(Saraswati) The study also gives indications of SNI's potential usefulness in other areas of health and well being. The effects of SNI upon wood dust in woodworkers should be the starting point from which to explore the wider ramifications of a clean and well functioning nasal system.