ISO 21426-2018 PDF

Full title and description

ISO 21426:2018 — Tourism and related services — Medical spas — Service requirements. This International Standard specifies requirements for the provision of quality services at medical spas that use natural healing waters (excluding sea water) and other natural resources, addressing service quality, safety and supporting processes for such establishments.

Abstract

This document sets out service requirements for medical spas (balneotherapy/thermal spa establishments) that rely on natural healing waters and related natural resources. It defines service quality and safety provisions, excludes clinical medical decision-making (i.e., it is not a medical practice guideline), and does not apply to thalassotherapy centres or general wellness spa centres. The standard supports consistent, safe and customer-focused operation of medical spa services.

General information

• Status: Published; confirmed (under ISO five‑year review process).
• Publication date: November 2018 (ISO edition published 2018‑11; national publications commonly dated 16–20 November 2018).
• Publisher: International Organization for Standardization (ISO).
• ICS / categories: 03.080.30 (Services for consumers); 03.200.01 (Leisure and tourism in general).
• Edition / version: Edition 1 (2018).
• Number of pages: 29 pages (official ISO listing; some national reprints/derivative publications show different page counts due to formatting).

Scope

ISO 21426:2018 applies to medical spa operations that use natural healing waters (excluding sea water) and other natural resources to provide therapeutic and remedial services as part of tourism and related services. It establishes service requirements covering organization, facility management, staff competence, hygiene and safety, client information and complaint handling. The standard explicitly excludes clinical medical decision-making and does not apply to thalassotherapy centres or general wellness (non‑medical) spa centres.

Key topics and requirements

• Service quality framework and management of medical spa services.
• Requirements for facilities using natural healing waters (water sourcing, handling and treatment considerations relevant to service safety).
• Staff competence, roles and training for therapists, technical and support personnel.
• Hygiene, infection prevention and safe handling of therapeutic treatments.
• Client information, informed consent for non‑medical services, and limits of spa staff authority (medical decisions excluded).
• Risk management, emergency procedures and incident reporting.
• Accessibility and customer service considerations for tourism clients.
• Documentation, record keeping and complaint handling procedures.

Typical use and users

Operators and managers of medical spas, thermal and balneotherapy centres that use natural healing waters; tourism and public-health authorities setting requirements or evaluating spa services; third‑party auditors and certification bodies; consultants, designers and architects involved in spa facilities; and industry associations preparing guidance or training for spa personnel.

Related standards

Standards and documents commonly referenced alongside ISO 21426:2018 include ISO 7001 (symbols for public information), ISO 17679 / ISO 17680 (related service/health standards where applicable), ISO 13485 (medical device quality management — where devices are used), ISO 10002 (customer satisfaction and complaints handling), and ISO 21542 (accessibility). ISO 21426 was developed under ISO/TC 228 (Tourism and related services) and may cross‑reference other tourism and health service standards.

Keywords

medical spa, balneotherapy, thermal spa, natural healing waters, service requirements, tourism services, safety, hygiene, staff competence, risk management.

FAQ

Q: What is this standard?

A: ISO 21426:2018 is an International Standard specifying service requirements for medical spas that use natural healing waters and related natural resources, aimed at ensuring quality, safety and consistent customer service in such establishments.

Q: What does it cover?

A: It covers organizational and operational service requirements — facility management, staff competence, hygiene and safety, client information, risk and emergency procedures, documentation and complaint handling — but it does not provide clinical medical practice guidance or cover thalassotherapy or general wellness spa centres.

Q: Who typically uses it?

A: Medical spa owners and operators, tourism and health regulators, certifiers/auditors, facility designers, consultants and industry associations involved in spa service delivery and oversight.

Q: Is it current or superseded?

A: The standard was published in November 2018 (Edition 1) and is listed as published/confirmed under ISO’s review cycle; ISO records indicate it was reviewed and confirmed during the five‑year review process (confirmation noted in 2024), so it remains current as of the latest ISO record.

Q: Is it part of a series?

A: ISO 21426:2018 is a standalone International Standard within the ISO/TC 228 portfolio (Tourism and related services) and is often used alongside other tourism, consumer‑service and health‑related ISO standards for comprehensive program development.

Q: What are the key keywords?

A: Medical spa, balneotherapy, thermal spa, natural healing waters, service requirements, tourism services, hygiene, safety, staff competence.