Spa could have direct effects for physical and mental health but also non-daily pleasure with a visit to spa itself and surroundings. Therefore, the visit should be strongly related with quality of life (QOL) as well as general health status. First of all, this study was conducted to clarify these relationships. Secondly, the QOL was investigated as a confounding factor to health effects of spa. Subjects of this study are about all 6, 000 citizens older than 40 years of age living in Japanese J-town. Self-administrated questionnaires were distributed to the subjects at once and collected for the analysis (Response rate; 94.5%). With regard to the spa visit, (1) no visit at all recently in two or three years, (2) once a year, (3) twice or three times a year and (4) once a month, (5) twice or three times a month were classified.
With regard to QOL (Quality of Life), a questionnaire of WHO-QOL was used. The present study demonstrated the visitors to spa have significantly higher WHO-QOL for each subcategory; physical health, psychological status, social relationship, and environment status compared with non-visitors. Therefore, the visitors have had higher total scores of WHO-QOL compared with non-visters. With regard to past history of fracture, the visitors have had significantly lower it's prevalence compared with non-visitors. However, the significance of prevalence was cancelled in adjusting the WHO-QOL. WHO-QOL relating to the frequency of spa visit as well as the prevalence of fracture was identified as a confounding factor to health effects of spa.