Recent studies prove the ancient practice of nasal irrigation is effective at fighting the common cold – The Conversation

Report on Nasal Saline Irrigation as a Contributor to Sustainable Development Goals

Introduction: A Low-Cost Intervention for a Global Health Concern

Viral upper respiratory tract infections (URTIs), commonly known as the common cold, represent a significant global health burden, with individuals typically experiencing multiple episodes annually. The widespread and often inappropriate use of antibiotics for these viral conditions contributes to the critical global health threat of antimicrobial resistance (AMR). Nasal saline irrigation, an ancient, evidence-based practice, presents a low-cost, accessible, and effective intervention that aligns with several key targets of the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being).

Alignment with Sustainable Development Goal 3: Good Health and Well-being

Nasal saline irrigation directly supports the achievement of SDG 3 by providing a safe, affordable, and effective health solution that strengthens public health systems and empowers individuals to manage common illnesses responsibly.

Target 3.3: Combating Communicable Diseases

The practice contributes directly to combating the spread of communicable diseases. Research demonstrates that nasal saline irrigation achieves this through several mechanisms:

• Reduced Illness Duration: A 2024 Lancet study of over 11,000 people confirmed that regular irrigation can shorten the duration of symptomatic illness by approximately two days, with other studies suggesting a reduction of up to four days.
• Lowered Viral Transmission: By physically flushing viral particles from the nasal passages, the intervention reduces the viral load. One study on COVID-19 patients showed an 8.9% decrease in viral load over a 16-hour period, thereby limiting the potential for transmission to others.

Target 3.8: Advancing Universal Health Coverage

Nasal saline irrigation exemplifies the principles of universal health coverage by providing an accessible and affordable health service.

• Affordability and Accessibility: The intervention costs very little to implement, requiring only non-iodized salt and sterile water. It does not require a prescription, removing barriers to access for populations worldwide.
• Reduced Medication Dependency: For chronic conditions such as allergic rhinitis, regular use has been shown to enable a 62% reduction in the use of allergy medications, decreasing healthcare costs for individuals and systems.

Target 3.d: Managing Global Health Risks and Antimicrobial Resistance

One of the most significant contributions of this practice to global health is its role in combating antimicrobial resistance (AMR), a major threat identified under SDG 3.

• Reduction of Unnecessary Antibiotics: An estimated 10 million inappropriate antibiotic prescriptions are issued annually for viral respiratory infections in the U.S. alone. Studies show that in over 42% of patient encounters for respiratory infections, antibiotics are prescribed unnecessarily.
• Providing an Effective Alternative: By offering a proven method to reduce symptom severity and duration, nasal saline irrigation serves as a viable alternative to antibiotics for viral infections, directly addressing a primary driver of AMR. This helps preserve the efficacy of antibiotics for necessary bacterial infections.

Mechanism of Action and Efficacy

The therapeutic effects of nasal saline irrigation are based on three primary physiological actions:

1. Mechanical Cleansing: The solution physically flushes mucus, pathogens, allergens, and other debris from the nasal cavity.
2. Antiviral Environment: The saline solution’s slightly acidic pH creates an environment that is inhospitable to viral replication.
3. Restoration of Ciliary Function: The practice supports the natural defense mechanism of the nasal passages by restoring the function of cilia, the microscopic, hair-like structures that propel foreign particles out of the respiratory system.

Procedural Guidelines for Implementation

Effective and safe implementation of nasal saline irrigation can be achieved through the following steps:

1. Prepare the Saline Solution: Mix approximately half a teaspoon of non-iodized salt with one cup (8 ounces) of water. A small amount of baking soda may be added to reduce stinging.
2. Ensure Water Safety: To prevent exposure to harmful microorganisms, it is critical to use only distilled water or tap water that has been boiled for a minimum of five minutes and then cooled to a lukewarm temperature.
3. Administer the Rinse: Using a neti pot, squeeze bottle, or pump-action spray, apply the solution to the nasal passages. The rinse should be performed at the first sign of symptoms and can be repeated multiple times daily, with a minimum of morning and evening applications.
4. Consider Adjunctive Therapies: Gargling with salt water can be used as a complementary therapy. Commercially available seawater solutions containing additional minerals may offer enhanced benefits for some individuals.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being: The entire article is centered on health, specifically addressing the management of a common communicable disease (the common cold), promoting a low-cost and effective treatment (nasal saline irrigation), and tackling the global health threat of antibiotic resistance. It discusses improving health outcomes by reducing illness duration, preventing transmission, and lowering hospitalization risks.

2. What specific targets under those SDGs can be identified based on the article’s content?

• Target 3.3: End epidemics and combat communicable diseases. The article directly addresses this target by focusing on the common cold, a viral upper respiratory tract infection, which is a communicable disease. It highlights how nasal saline irrigation can “decrease the duration of illness” and “reduce viral transmission to other people,” thereby helping to combat the spread of such diseases.
• Target 3.8: Achieve universal health coverage, including access to affordable essential medicines. The article promotes nasal saline irrigation as a treatment that “costs pennies and doesn’t require a prescription.” This aligns with the goal of providing access to safe, effective, and affordable health solutions for all, a key component of universal health coverage.
• Target 3.d: Strengthen the capacity for early warning, risk reduction and management of national and global health risks. The article emphasizes that a major benefit of nasal saline irrigation is its ability to “decrease unnecessary antibiotic prescriptions,” which is a “major contributor to antibiotic resistance.” Antibiotic resistance is a critical global health risk, and promoting alternatives that reduce the misuse of antibiotics directly supports the management of this threat.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Reduction in illness duration: The article provides specific data points that can be used as indicators. It mentions that nasal saline irrigation “reduced the duration of symptomatic illness by approximately two days” and that smaller studies reported a reduction “as high as four days.” This directly measures the effectiveness of combating a communicable disease.
• Reduction in viral load/transmission: An implied indicator is the rate of viral transmission. The article provides a specific metric from a study on COVID-19, where nasal irrigation “decreased COVID-19 viral load by 8.9%,” which serves as a measurable proxy for reduced transmissibility.
• Rate of unnecessary antibiotic prescriptions: The article provides clear indicators of the problem, stating that “10 million inappropriate antibiotic prescriptions are given each year” and that in one study, “antibiotics were unnecessarily prescribed to 42.4% of patients.” A reduction in these figures would indicate progress towards managing the risk of antibiotic resistance.
• Cost and accessibility of treatment: The description of the treatment as costing “pennies” and not requiring a “prescription” serves as a qualitative indicator of its affordability and accessibility, which are key to achieving universal health coverage.
• Reduction in hospitalization risk: The article mentions that the practice could “lower a patient’s risk of hospitalization.” The hospitalization rate for complications from respiratory infections could therefore serve as an indicator of progress.

4. Table of SDGs, Targets, and Indicators

Source: theconversation.com