Death in Sauna*

Abstract

Bathing in sauna is common in Finland, where there are approximately 2 million saunas among the population of 5.2 million. In this paper, deaths occurring while in a sauna in 1990-2002 in Finland were studied by analyzing police and forensic autopsy reports, death certificates, and toxicological results. The annual rate of death occurring while in a sauna was less than 2 per 100,000 inhabitants. Close to half (51%) of the cases were determined to be natural deaths and exposure to heat was the cause of death in 25%. Overall, 50% of all cases were under the influence of alcohol. The main conclusion is that death in the sauna is a rare event even in Finland where the frequency of sauna bathing is high. The role of alcohol as a risk factor has grown. The prevention of these deaths should focus on less drinking of alcohol and avoid leaving a drunken bather alone in the sauna.

Fatal α-PVP and amphetamine poisoning during a sauna and autoerotic practices

“…In the present case, the sauna was electrical (as is generally the case in saunas located in residence buildings in Finland), and its heating was interrupted by a timer at the end of the final shift. As Finnish saunas are heated to 60-80°C or more [31,32], and the victim's mother was sauna-bathing until 9:30 p.m. when the victim arrived at the sauna, the victim was likely exposed to significant heat prior his death, although the sauna had significantly cooled by the time the police arrived at the scene.…”

“…During a Finnish sauna (temperature 80-100°C, humidity 10-20%) the skin temperature rises within a few minutes to 40°C, and the core temperature rises approximately 1°C in 30 min, while the heart rate increases; heat is lost by increased cutaneous blood flow, vasodilatation, and sweating [32]. In most sauna deaths, a pre-existing cardiac disease or acute alcohol consumption, or both, represent the underlying or contributing cause of death [30,31]. Exposure to sauna heat may also alter drug pharmacokinetics, especially for trans-dermally administered drugs such as nitroglycerine [32] and fentanyl (unpublished case).…”

Cardiovascular and Thermal Response to Dry-Sauna Exposure in Healthy Subjects

“…Sauna constitutes one of the most popular and most extensively studied forms of whole-body thermal treatment. The idea of sauna originated in Scandinavian countries over a century ago and quickly gained popularity and it is now widely used worldwide [1][2][3]. The conditions of a sauna are determined by a combination of efficiency of thermoregulatory response, age, gender, and the cardiorespiratory performance of an individual [4,5], together with the tradition of a given country.…”

“…Overheating of the body takes place in a wooden room with temperatures approaching 70-100 ∘ C and low, 10-20% humidity levels. Usually, sauna duration lasts between 5 and 15 minutes [2,3,7]. Each heating session is followed by cooling down of the body under cold shower or in a pool with cold water.…”

“…Sudden cardiac death constitutes the most serious but very rare adverse effect of sauna bath. This complication has been most often reported in individuals with latent cardiovascular conditions, patients treated with diuretics, and persons who consumed alcohol or used extreme heating/cooling down conditions during sauna bath [2,7].…”