Most spas are surrounded by beautiful natural environments, so these facilities contribute to sustainable economic development and their guests are national and local tourists with a high average stay. This study has the objective of analyzing the factors associated with the level of satisfaction and the profile of spa tourists in Andalusia, southern Spain. The methodology used was a quantitative study based on a stratified cross-sectional survey. Each stratum was a spa, with a population of 53,231 users per year, whose final sample included 725 users. The results found were that the profile of Andalusian spa tourists is predominantly female, over 56 years old, and retired with average incomes below one thousand euros. The level of satisfaction of its users is above the average in the factors of accommodation, restaurants, spa, and public roads and natural environment and most of these clients would recommend it to others [92.4%] and express the intention to return [63.6%] which indicates that Andalusian spas show a very high level of customer loyalty. The study has the limitation of being cross-sectional quantitative research carried out in Andalusia that could be complemented in future research with a qualitative study with experts. The research presents contributions for companies since they could develop strategies to attract users with younger profiles with activities, prices, or spaces that are more appropriate to their needs and seek the conditions to increase the satisfaction of these segments. The study is original since this research is a quantitative study that shows the real profile of the Andalusian spa tourist and their high level of satisfaction with the spa and their loyalty. The surveys were conducted at each spa by a face-to-face researcher with a response rate of 98%.

Water is the common thread and attraction factor of the tourism facilities called “spas”, which are part of health and beauty services. Spa use is currently experiencing a boom that reflects changes in populations, such as an increase in economic wellbeing and a desire to reunite with nature. This research’s objectives were to understand spa tourism’s structural and operational dimensions and to assess this sector’s current situation by using the Delphi method with a panel of 22 experts. The results show that these experts believe that, in Andalusia, spas energize the area as a tourism destination through their natural resources and conservation of key elements. However, spa development policies are scarce, including a lack of autonomous community laws regarding these facilities.

Health tourism is booming all over the world, and thermal spa tourism in Spain is a type of tourism aimed at integrating with nature, achieving sustainable development. In general, its facilities are located in areas specially protected by environmental legislation. This tourism sector attracts an increasingly wide market segment that has become more demanding and better informed and that more frequently uses the Internet to gather information. Tourists’ shopping and consumption habits are increasingly influenced by new information and communication technologies (ICTs), making these a topic of interest among academics and professionals. Website development has been shown to be an area of innovation for spa facilities, but evidence has also been found that this sector has experienced difficulty in adopting ICTs. This research sought to analyse spa websites’ usability by conducting an exploratory investigation of different websites’ contents. The results reveal that the use of new web technologies by spas is underdeveloped, although these facilities have achieved good positions in Internet search engines due to the synergistic effect of the official tourism websites. That is why most of them tell their story, detail their nature and the protection of their spaces. In this way, spas turn their websites into communication channels that convey to tourists their commitment to the environment and sustainable development.

This study sought to obtain conglomerates of spa-goers in Andalusia, Spain, based on a survey of 10 spas’ users. The data from 725 valid survey questionnaires were analysed using a quantitative approach. The results show that 44.6% of users are between 65 and 88 years old and more than 60% are women. Approximately 50% of the respondents are retired, and 60% report a monthly income of less than 1000 euros. Three clusters were identified in the segmentation analysis: users with lower, partial and higher satisfaction. Over half (58%) of the respondents belong to the higher satisfaction segment. Thermal tourism evidently has a strong potential for attracting other tourist segments. Andalusia has thermal springs that attract many tourists, which are located in places of great natural beauty and are part of inland towns’ economic development. The findings confirm the need to improve the existing understanding of spa-user typologies. The benefits derived from health tourism can be analyzed from the concept of value proposition for the company, the user, the community and its environment. To generate income, spa companies must meet the expectations of stakeholders and this begins with an organization that constantly learns and innovates to satisfy users. The managers of the spas lead these projects, introducing important changes in their offer, from traditional medical aspects to facilities and therapies based on relaxation and sustainable natural tourism, promoting their organizations with sustained objectives over time capable of satisfying all stakeholders, creating value capable of attracting and satisfying the different segments of spa tourists, as this study shows.

The authors’ line of research is within the existing methodological debate around the concepts of quality of services, destinations, and quality measurements methods. The authors consider that the most appropriate way to measure quality is to develop instruments according to the destination and context in question, defining the quality of the tourist destination for practical purposes based on the satisfaction experienced by the tourist or the SERVPERF model, weighted and used to measure the quality of sun and beach tourist destinations. The authors of this work propose the knowledge of spa tourism, its quality and its level of satisfaction as a research gap and consider it as a starting point to validate a questionnaire that would allow the measurement and comparison of parameters with other segments already studied and that can also serve as a measuring instrument for tourist segments with similar characteristics, not as well known in the international literature as inland, ecological or nature tourism. Good internal reliability results were obtained in all items and in all dimensions. The factor analysis distributed the weights of the variables in the theoretical model, and construct validity was obtained with an association between the global evaluation by dimension and the general significance. The score of the main questionnaire was statistically significant.

Asbestos in all its forms is a Group 1 material agent with proven carcinogenic effects in the human being since 1977. Exposure to asbestos can be considered unsafe. The use of asbestos in the field of dentistry had a common use in the manufacture of dental prostheses in the 1960s and 1970s. Taking into account the long induction period of this agent and the plausibility for being a risk factor in dentistry, the objective of this study is to propose a plan for the prevention of occupational risks due to asbestos exposure in dentistry by means of the contribution of a panel of experts. An Expert Panel (EP) approach was used in which a group of nine experts identified and documented the use of asbestos in the dental profession. EP was created and followed the protocol in accordance with the EuropeAid Assessment Guidelines. As a result of this study, EP documented the common use and sources of asbestos in dentistry in prosthetic materials, dental dressings, and in the coating of casting cylinders. EP also created a consensus document on the priority measures for the Plan for the Prevention of Risks from Asbestos in Dentistry, based on previous reports from the European Commission Senior Labour Inspectors’ Committee. The document concluded that obtainment of information, receiving specific training on the subject and performing epidemiological studies, and the proper risk assessments were the priority measures to adopt.